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Medigap Plans, Yes Or No? What You Need To Know Before You Invest In Insurance

Do you need a Medicare supplement? If you're not sure whether to explore Medigap plans, stop at original Medicare, or try another option, take a look at the questions to ask right now.

Will You Need Help to Pay for Uncovered Expenses?

Even though Medicare Parts A and B may pay for a significant portion of your medical expenses, this federal insurance program for people 65 and over and some younger adults with disabilities won't cover 100 percent of your costs. Whether you have an existing condition or you have concerns about your ability to pay for coinsurance, copays, or deductibles in the future, a medical supplement can help.

Do You Have a Medicare Advantage Plan?

While you must have original Medicare (Parts A and B) to buy a Medicare supplement, you can't use both Medigap and an Advantage plan together. Medicare Advantage plans, like Medigap, require the enrollee to have original Medicare. You must also purchase Advantage plans from private insurers.

Unlike Medigap, an Advantage plan takes the place of Parts A and B—and doesn't cover out-of-pocket costs. Advantage plans often cover more services and have additional benefits (such as prescriptions, vision, or dental costs) than original Medicare. But you may still have to pay for deductibles, copays, or coinsurance.

Medicare supplements won't pay for these added expenses in the same way they would if you only had original Medicare. If you have an Advantage plan and feel it makes more sense financially or coverage-wise to have a supplement that pays for expenses not covered by your medical insurance, you'll need to drop your Advantage plan, if it's allowed.

Can You Drop Your Advantage Plan and Get Medigap?

It's not always possible to drop enrollment in an Advantage plan and re-enroll in Medigap. Some Medicare supplement policies come with guaranteed issue rights or Medigap protections known as a trial right. The trial right allows you to try a Medicare Advantage plan and later go back to original Medicare and a supplement.

Before you make any changes to your Medicare or Advantage plans, talk to a qualified insurance agent or provider. The agent can help you to determine whether you can drop your Advantage plan and purchase Medigap.

Can You Pay Extra for Insurance?

Medigap does cover deductibles, copays, and some other medical expenses. But it typically isn't free. Private insurance companies provide supplement plans. The insurer will explain the premium you'll pay monthly. If the cost of the insurance is less than what you'd pay in out-of-pocket expenses, it makes sense to choose a Medigap option.

For more information about Medigap plans, contact a local insurance agent.