What is Medigap Insurance and Do You Need It?

 

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About the Author: rr1455

19 Comments

  1. thanks soo much for taking the time in explaining what medigap is…!
    I’m taking a course in medical insurance and use YouTube for more clearer explanations and understanding!
    you did a perfect Job!
    you deserve an A+

    1. Thanks for reaching out with your question about TRICARE and Medicare. In most cases, TRICARE for LIfe is TRICARE”s version of Medigap insurance, so you wouldn’t need additional coverage. If your medical services are covered by TRICARE and Medicare, then Medicare will pay the authorized amount and TRICARE will pay the remaining amount. With that said, it’s always a great idea to contact your Benefits Administrator to make sure your TRICARE for Life plan works as a supplement to Medicare…and, to make sure it will cover the full 20% co-insurance. I hope that helps.

  2. Thank you to a viewer for asking me to clarify the Medigap Open Enrollment Period. In my example, I begin with a Part B effective date of February 1. You have an opportunity to purchase a Medigap plan with no health questions asked up until the six month Medigap Open Enrollment period ends…which, in this example, is July 31.

  3. I am finding your videos very helpful and informative, thank you!
    My question is -lets say I just turned 65 and am not enrolled in medigap yet but am still within the open enrollment period of the 6 months and get diagnosed with cancer, will I be able to enroll?

    1. Hi Sophie…I appreciate your kind words and am so glad my videos are proving to be helpful. To answer your question about the Medigap Open Enrollment Period — the insurance carriers are NOT allowed to ask you any health questions during your 6 month Medigap Open Enrollment period. So, if you’re diagnosed with cancer, you can still enroll in a plan up until the final day of your 6 month window.

  4. Scare stories about “20% adding up quickly”aren’t helpful – they are playing on emotion, not reason. Drop the other shoe – that $180/month Medigap costs add up even more quickly! The Please DETAIL how much the woman with cancer actually had to pay out of pocket vs the cost of years of Medigap payments.

    The woman with cancer can get on an Advantage plan for very little (some cost $0), that caps per PartB for say $3400/yr, and then her part A&B deductibles add up to $1399. Most ppl can afford to shell out up to $4800/yr for a worst-case year or two when they have cancer or some major problem, vs paying $2k/yr every year insurance whether you are healthy or not.

    Here’s a better idea. Get an inexpensive Advantage plan that covers your doctors (you can change Advantage plans every year in the open enrollment period) and a reasonable partB cap, then set aside ~$20k as a medical emergency fund to cover your partA&B expenses just in case things go extremely badly for you.

    1. I appreciate your opinion about Medicare Advantage plans. But, I have to (respectively) disagree with your blanket statement about Medicare Advantage plans being a “better idea”. There are many people who don’t have good Medicare Advantage options where they live. And, many more people who would like to have the freedom to choose their own provider. As you probably know, Medicare Advantage plans force you to use their network of doctors. Whereas, someone who has Medicare and Medigap can use their coverage anywhere in the United States. As for the cancer patient, I don’t know what her out of pocket costs were…didn’t ask. But, I do know that the bills were more than she could handle — and, she was still in treatment. Keep in mind, a Medicare Advantage plan isn’t an option until the Annual Election Period (Oct 15-Dec 7) with the plan starting January 1. So, this wouldn’t be an immediate answer to solving her coverage issue. This IS a scary situation. Many people go on Medicare and find out, like this lady, the hard way about the 20% coinsurance. My goal is to to help people make informed decisions. If it gets a little emotional along the way, so be it.

  5. i am a 62 year mold male, non smoker, i bought a medigap plan with united health care/aarp 3 years ago, my disability was a fall that i broke my ankle in 2010, after therapy and no more visits to the ortho dr. i filed and got ssid in 2012, and medicare in 2014, bought medigap at 190 dollars a month, it is now 334 dollars a month,i have no major health issues, but because im not 65 , is why they say my premiums are so high , in short ,they say im high risk simply because i cant climb telephone poles after doing it for 36 years, i have plan N,, my mother in law is 89 and has TB, and alzhimers, has fell twice, broke arm once and hip once, yet she has plan N at 191 dollars a month, so the insurance companies claim they go by cost and that im more likely to have higher cost than her,,,don’t tell me about discrimination, this is it as much as possible,, and the real kicker here is united health care says in 2 year and 4 months that my cost will go down because i will be removed as disabled and 65 and my premiums at todays rate will be 165 dollars for plan N,,talk about price gouging and one of the biggest dumbass things i have ever ran in on about health care, this is like the movie groundhog day, i can’t grasp or comprehend how they get by doing this. By the way i enjoyed your video and every time i talk to an agent, i pack my bags,they play the guilt trip thing to the max,,,thanks for time and place to rant

    1. Hi James…sadly, your story is all too familiar. I talk to people weekly in similar situations. Some states are better than others. But, overall, it’s frustrating for so many. Wishing you all the best!

    1. Hi Mikey…As I commented before, I’m always trying to make improvements. Some microphones work better than others. But, I believe I’ve found the best option moving forward.

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