Is Medigap Coverage Worth It? Assessing its Value

Is Medigap Coverage Worth It

Medigap coverage, also known as supplemental insurance, has become an important healthcare plan for many because the Original Medicare Plans (A and B) only cover about 80% of healthcare costs. The remaining 20% of out-of-pocket costs can sometimes be very expensive to afford, thus necessitating a financially smart decision.

Although not many people with the Medicare Plan have Medigap coverage, there’s an increasing debate about whether it is a smart financial choice. MedigapCoverage assesses these points and helps you understand whether getting private Medigap coverage is worth it.

Is Medigap Coverage Worth It?

Many Medicare beneficiaries admit that Medigap insurance is worth it. As opposed to being considered a waste of money, most people consider the decision a financially smart option, especially because medical care services can be expensive.

Although Medigap premiums vary in price, depending on several factors, beneficiaries can often shop around to find the perfect coverage option for them based on their most important preferences.

With such preferences catered to, insurance policyholders can effectively mitigate the out-of-pocket costs, deductibles, and copayments associated with their existing Medicare plans. In fact, they can also enjoy extended coverage, which protects their pockets from prescription medication costs.

Do I Need Medigap Coverage?

The question of needing Medigap coverage is a case-sensitive one. However, all qualifying persons who wish to save some money should get Medigap coverage to reduce their out-of-pocket costs and improve their finances.

While getting Medigap coverage is recommended for many reasons, it is important to note that the plan comes at an extra cost which can be negotiated based on the provider and coverage option. It is also important to research eligibility for such coverage plans, especially the presence of an existing Original Medicare Plan.

So, if you’re wondering whether to get Medigap coverage, consider the following;

– Do you travel often or stay outside the country for extended periods? If yes, then getting Medigap coverage is recommended. Ensure that your Medigap coverage offers international or out-of-country protection for instances where you may fall sick or experience a health crisis outside of the United States

– Is the Medigap Coverage approved by Medicare? Medigap insurance is highly regulated by the Federal government. It is important to shop for plans that have been approved to work in conjunction with your existing Medicare plan. While the coverage options and benefits may differ from one provider to another, the basics of the program often remain the same.

What Benefits Does Medigap Coverage Offer?

One of the best ways to understand the true benefits of Medigap coverage is to take a careful look at health insurance costs with Medicare.

Many people pay a premium-free amount for their Medicare Part A (due to the years of work and tax deductions), while Medicare Part B often costs around $164.90 monthly. Most people pay their Medicare Part B costs directly or out of their Social Security Benefits.

Despite these payments, including the Income Related Monthly Adjustment Amount (IRMAA) paid by high-income earners, there are additional out-of-pocket costs to be shouldered by the patient when they access medical services.

The out-of-pocket costs include the following;

  • Medicare Part A Deductible of about $1,600
  • Medicare Part A Coinsurance of about $400 per day after the 61st day of inpatient treatment and $800 per day after the 91st day of inpatient treatment
  • Medicare Part A Hospice Care, often mostly covered by Medicare
  • Medicare Part A Blood, where patients are responsible for the first 3 pints of blood transfused
  • Medicare Part A Skilled Nursing Facility Coinsurance, costs $200 per day from the 21st day
  • Medicare Part B Deductible, costs $226 annually
  • Medicare Part B Coinsurance, where you pay 20% of the annual deductible
  • Medicare Part B Excess Charges, where you pay up to 15% excess charges on Medicare-approved amounts for healthcare services    

The above out-of-pocket costs are often overwhelming for seniors and Medicare beneficiaries to carry. This often necessitates Medigap insurance plans that offer higher protection while improving financial planning and predictability. With Medigap insurance coverage, seniors and Medicare Plan beneficiaries can bundle their payments in one (the Medigap insurance premium) while significantly lowering their monthly costs on healthcare services.

In addition to saving costs, Medigap coverage also provides improved flexibility for policyholders to access the best healthcare services needed without worrying about costs, appointments, or distance. In fact, those who love traveling can leverage the protection offered in their policy to secure medical access at lower or no costs outside the United States.

The health and financial benefits of getting Medigap coverage cannot be overstated. Seniors and Medicare beneficiaries considering the option should start shopping for the best coverage, policies, rates, and premiums.

Kishan Rana

I'm Kishan Rana, an IT engineer and avid technology enthusiast. Blogging is my passion and I love to write about technological wonders. Being an SEO professional with around 8 years of experience with good leads I provide SEO services to top-level companies around the globe.

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