Term: Medigap


Description:

What Is It:

Medigap is a policy that is sold by private insurance companies to fill in the "holes" or "gaps" in the original medicare plan coverage. Medigap came into existence through the passage of the Medicare Modernization act of 2003. This act created 12 standard Medigap plans labeled A through K, with plan A covering the basic benefits and plans B through K covering additional benefits. It help's cover Medicare costs such as deductibles, coinsurance and co-payments. Some of the more comprehensive plans can cover things such as prescription drugs, routine eye exams and dental care. These 11 plans can be chosen depending on how much extra coverage you need.

Who Qualifies:

Only people who are covered by Medicare A or Medicare B are allowed to purchase the Medigap plan. This is mainly used by seniors or those that have increased health issues that their Medicare plan does not cover.

The Cost:

This varies depending on the amount of benefits you want. The more benefits your plan has the greater the cost for the Medigap plan. It also depend on what region of the country you are in.


Applications:

Surveys that have been completed shows an overwhelming satisfaction rate. The study is from 2005 and shows a 90% of the Medigap customers are satisfied with their coverage. A total of 84% of those interviewed would also recommend their coverage to a friend.
Below is a link for a PowerPoint Presentation of the complete report.



Web Resources:

http://www.medigapchoice.com/site/page/what_is_medigap
http://www.medicare.gov/medigap/Default.asp
http://www.aging-parents-and-elder-care.com/Pages/Medicare.html

Related Terminology:

Medicare- Medicare is the federal health insurance program that covers most people age 65 and older. Some younger people who are disabled or who have End-Stage Renal Disease (permanent kidney failure) are also eligible for coverage.

Citations/References:

http://www.medigapchoice.com/site/page/what_is_medigap

Graphics:

Coverage
A
B
C
D
E
F
G
H
I
J
Core Benefits
X

X
X
X
X
X
X
X
X
X
Part A deductible

X
X
X
X
X
X
X
X
X


Part B deductible


X


X



X
Skilled nursing care co-payment


X
X
X
X
X
X
X
X
Foreign travel emergency care


X
X
X
X
X
X
X
X
Part B excess charges (100%)





X


X
X
Part B excess charges (80%)






X



At-home recovery



X


X


X
X
Preventive services




X




X
Prescription drugs (up to $1,250)*







X
X

Prescription drugs (up to $3,000)*









X
*Starting in January 2006, you will not be able to purchase a new Medigap policy with prescription drug coverage.



Chart1.png
Medigap Approval Rating Based on a 2005 Study