Merritt Personal Lines Manual: Medigap Policies in a Nutshell
The following chart summarizes the coverages offered (or not offered) by the 10 standard Medicare Supplement policies.
MEDICARE SUPPLEMENT (MEDIGAP) POLICIES
| Plan A | B | C | D | E | F | G | H | I | J | ||
| Basic | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Benefits |
| Medicare Part A Deductible | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | ||
| Medicare Part B | Yes | No | No | Yes | No | No | No | Yes | |||
| Skilled Nursing Care | Yes | No | No | Yes | No | No | No | Yes | |||
| Foreigh Travel Emergency | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | |||
| At-Home Recovery | Yes | No | No | Yes | No | Yes | Yes | ||||
| Preventive Care | Yes | No | No | No | No | Yes | |||||
| Excess Charges, Medicare Part B | 100% | Yes 80% |
Yes | No 100% |
Yes 100% |
Yes | |||||
| Prescription | Yes | Yes | Yes |
The key is to shop carefully if you're in the market for Medigap coverage. While the benefits will be the same, no matter what company you purchase your policy through, the prices will vary from state to state and company to company. That's because not all states have the same medical costs and, insurance companies have different claims experience. And, prices are increasing, which has forced many people and companies alike, to opt for a managed care approach to covering seniors' health care issues.
Since Plan C is Plan C, no matter which company is offering it, when you shop around for coverage, you'll be looking at price, service and reliability. It's also vital to find an insurance company you feel comfortable with - and one that is reputable and in good shape financially. Your state insurance department can alert you to any problem companies.
Also, preexisting conditions can be a major issue for Medigap coverage. Many older people are being treated for some medical problems. These conditions may be significant (high blood pressure, heart conditions, etc.) or minor (allergies or mild hearing loss).
As with any health insurance policy, you should investigate the coverage limitations for preexisting conditions. First, read through the policy and ask your agent for an explanation. Most Medicare supplement contracts define a preexisting condition as any condition for which the policyholder sought treatment or advice in the six months prior to the effective date of the policy.
Most Medicare supplements have a six month waiting period for coverage of preexisting conditions. Some companies have no preexisting condition exclusion, some impose a 90-day or three month exclusion, but none can be greater than six months.
