I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: Medicare/Insurance => Topic started by: Meinuk on November 11, 2010, 12:15:30 PM
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http://www.medicare.gov/medigap/default.asp (http://www.medicare.gov/medigap/default.asp)
From the CMS Website:
A Medigap policy is health insurance sold by private insurance companies to fill the “gaps” in Original Medicare Plan coverage. Medigap policies help pay some of the health care costs that the Original Medicare Plan doesn’t cover. If you are in the Original Medicare Plan and have a Medigap policy, then Medicare and your Medigap policy will pay both their shares of covered health care costs.
Insurance companies can only sell you a “standardized” Medigap policy. These Medigap policies must all have specific benefits so you can compare them easily.
You may be able to choose up to 12 different standardized Medigap policies (Medigap Plans A through L). Medigap policies must follow Federal and State laws. These laws protect you. A Medigap policy must be clearly identified on the cover as “Medicare Supplement Insurance.” Each plan, A through L, has a different set of basic and extra benefits.
It’s important to compare Medigap policies because costs can vary. The benefits in any Medigap Plan A through L are the same for any insurance company. Each insurance company decides which Medigap policies it wants to sell.
Generally, when you buy a Medigap policy you must have Medicare Part A and Part B. You will have to pay the monthly Medicare Part B premium. In addition, you will have to pay a premium to the Medigap insurance company.
You and your spouse must each buy separate Medigap policies. Your Medigap policy won’t cover any health care costs for your spouse.
For additional information on Medigap policies, including why you would want to buy a Medigap policy and information about what Medigap policies cover, please read our publication, Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare.
CORRECTION: It is only offered in a few states: Several states require Medigap insurance companies to offer a limited Medigap open enrollment period for people with Medicare Part B who are under age 65. The following states require insurance companies to offer at least one kind of Medigap policy during a special open enrollment period to people with Medicare under age 65:
California; Connecticut; Kansas; Louisiana; Maine; Maryland; Massachusetts; Michigan; Minnesota; Missouri; Mississippi; New Hampshire; New Jersey; New York; North Carolina; Oklahoma; Oregon; Pennsylvania; South Dakota; Texas; Washington; Wisconsin
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I didn't answer the poll because Jenna has Medicare and PPO insurance.
If I am not mistaken, the Medigap option is no longer offered with the Obamacare bill.
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In Arizona, insurance companies are not required to sell Medigap policies to Medicare beneficiaries under age 65, and they don't.
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here is the CMS tool for searching medigap policies: http://www.medicare.gov/find-a-plan/questions/medigap-home.aspx (http://www.medicare.gov/find-a-plan/questions/medigap-home.aspx)
Karol, that is news to me about Obama Care. I know that medigap is in place for 2011.
I am totally sheltered here in NY, I didn't realize that few states offer it. Here is the under 65 link: http://www.medicare.gov/medigap/under65.asp (http://www.medicare.gov/medigap/under65.asp)
Several states require Medigap insurance companies to offer a limited Medigap open enrollment period for people with Medicare Part B who are under age 65. The following states require insurance companies to offer at least one kind of Medigap policy during a special open enrollment period to people with Medicare under age 65:
California; Connecticut; Kansas; Louisiana; Maine; Maryland; Massachusetts; Michigan; Minnesota; Missouri; Mississippi; New Hampshire; New Jersey; New York; North Carolina; Oklahoma; Oregon; Pennsylvania;
South Dakota; Texas; Washington; Wisconsin
Also, some insurance companies will sell Medigap policies to people with Medicare under age 65. However, these policies may cost you more. Remember, if you live in a state that has a Medigap open enrollment period for people under age 65, you will still get another Medigap open enrollment period when you turn age 65.
Also, if you join a Medicare Advantage Plan (formerly Medicare + Choice) and your coverage ends, you may have the right to buy a Medigap policy. If you have questions, you should call your State Health Insurance Assistance Program.
Right to suspend a Medigap policy for disabled people with Medicare
If you are under 65, have Medicare, and have a Medigap policy, you have a right to suspend your Medigap policy. You can suspend your Medigap policy benefits and premiums, without penalty, while you are enrolled in your or your spouse's employer group health plan.
If, for any reason, you lose your employer group health plan coverage, you can get your Medigap policy back. You must notify your Medigap insurance company that you want your Medigap policy back within 90 days of losing your employer group health plan coverage.
Your Medigap benefits and premiums will start again on the day your employer group health plan coverage stops. The Medigap policy must have the same benefits and premiums it would have had if you had never suspended your coverage. Your Medigap insurance company can't refuse to cover care for any pre-existing conditions you have. So, if you are disabled and working, you can enjoy the benefits of your employer's insurance without giving up your Medigap policy