Medigap insurance, or Medicare Supplement, pays for health care costs not covered by Original Medicare (Parts B and A). Copayments and deductibles are included. Medicare Supplement plans, which are sold privately by insurers, are regulated under state and federal laws. Medicare Supplemental Insurance Plans policies may help cover some medical expenses out of pocket, but they do not qualify as Medicare Supplement plans.
The basic benefits of all Medicare Supplement policies are the same, but premiums differ by insurer. A Medicare Supplement plan offering more comprehensive coverage is likely to have higher monthly costs. The Department of Financial Services (DFS) regulates Medicare Supplement insurers and the plan rates they charge.
DFS is Indiana’s agency for licensing, registration, examination, and regulation of a wide range of financial institutions. Among these are banks, credit unions and insurance companies. DFS supervises Medicare Advantage Plans. Medicare Advantage Plans are private health plans that have been approved by the Centers for Medicare Medicaid Services. Medicare Advantage Plans follow Medicare regulations and offer Medicare-like benefits. Prescription drug coverage is usually included. The DFS website provides a list of approved Medicare Advantage plans by county and state.
DFS also lists premiums per region and by county. The premiums are determined by the type of plan, your age and if you smoke. The premiums are paid in addition to your monthly Medicare Part B premium.
Most supplemental health plans require that you use doctors, hospitals and other healthcare providers who are part the Medicare network. Some supplemental insurance plans have an annual deductible, coinsurance or both.
Medicare Part B covers preventive care at no charge, except for an initial wellness exam and certain preventive treatments that are subject to a yearly fee. These services include a welcome-to-Medicare physical, bone mass measurements, and an annual wellness exam, as well as diabetes, blood pressure, and cholesterol screenings, mammograms, pap tests, and prostate cancer screenings.
Plan F is one of the most popular supplemental plans. Plan F pays all Medicare deductibles and costs, but not Part A. Plan G, which is available nationwide, pays the Part B deductible but has higher coinsurance than Plan F. Plan N has lower coinsurance but has a $20 office visit copayment and a $50 hospital out-of-pocket copayment.
Some Medicare Supplement plans are not valid when you travel out of the service area. Check with your Medicare supplement insurer about traveling abroad to ensure you’ll have the coverage you need. If you need a cancellation of your Medicare supplement policy and return to the United States, be sure to get back any premiums you haven’t earned.
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