Medigap insurance, otherwise known as supplemental insurance, is a protective health care insurance intended to cover the “gaps” that Medicare Plans A and B do not pay for.
Think of a Medigap plan as an iceberg: Medicare works as basic health insurance to cover 80 percent of medical costs (the bottom portion of the iceberg). The supplemental insurance covers the remaining 20 percent (the tip). Essentially, it provides beneficiaries with insurance that picks up the out-of-pocket costs left after their initial coverage.
Plans in Massachusetts are valid throughout the United States and overseas at any medical facility that accepts Medicare.
The vast majority of states offer ten standard Medigap options. In Massachusetts, only two Medigap plans exist. These include the Core Plan and the Supplement 1 Plan. Most insurance companies use these two names when discussing plan options to keep communication clear and concise. Regence Blue Shield and Blue Cross, however, calls its Core plan “Medex Core” and the Supplement 1 plan is referred to as “Medex Bronze.”
According to a recent study released by the Kaiser Family Foundation, Medigap policies have often been a source of supplemental insurance for beneficiaries who do not qualify for Medicaid, who do not want to re-enroll in a managed care plan, or who already have supplemental insurance through their workplace. Approximately 90 percent of beneficiaries have supplemental coverage of some kind. Only one in five beneficiaries relies on Medigap to supplement Original Medicare coverage.
Medicare is provided through the federal Centers for Medicare and Medicaid Services, but supplemental insurance is administered through private insurance companies. Some of these companies offer bonuses and partnerships with external organizations to provide even more benefits to consumers. In Massachusetts, for example, Humana Insurance Company works with Reader’s Digest to provide additional benefits. Those who enroll receive bulletins about health management, heart health, nutrition and other health issues, as well puzzles and games to exercise the mind.
In Massachusetts, the Open Enrollment period allows for flexible plan choices. For example, someone who needs knee surgery can enroll into a Medicare plan before his or her operation and once he or she has recovered from surgery can decide to un-enroll or enroll in a different company’s plan.
In Massachusetts, no one can be denied enrollment into Medigap regardless of past or current health situations. All seniors must pay the same fee for the same insurance regardless of health or age and there are no caps on any healthcare insurance products in Massachusetts.
Fill out the zip code form to compare plans and prices on Medigap policies offered in Massachusetts.
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