Medigap and the upcoming changes in the standardized plans
- Author William Richards
- Published March 2, 2010
- Word count 506
Medigap Health Insurance Plans the supplementary health insurance plans for Original Medicare does a great help to the beneficiaries by bridging the gap between the actual medical bill payable and the Original Medicare policy coverage. These plans were standardized in 1992 and since then there had been 12 standard Medigap Health Insurance Plans under the letter cover A through L. These plans as they are supplementary insurance plans to the Original Medicare therefore these plans cannot be used with any other plans like the Medicare Advantage plans. Moreover, the fact is that you cannot purchase these plans if you are in any other plan other than the Original Medicare and even if you are already a beneficiary of these plans and you switch over to any other plan like the Medicare Advantage plan then also you can no more use the benefits of these plans unless you switch back to the Original Medicare.
Besides that these Medigap Insurance Plans are sold and administered by the private insurance companies only. But till date there are only 12 standard Medigap Insurance Plans to be sold by the insurance companies only. And also there is another limitation to the insurance companies as well. The fact is that though the Medigap Insurance Plans are sold and administered by the private health insurance companies only but still not any single company can change the policy benefits of the insurance plans by it own. Therefore, this gives the guarantee to the beneficiaries that they would get the same benefits of the insurance plans purchased by them irrespective of the company they purchase the policy from. Therefore, if you purchase a Medicare Supplement Insurance Plan from a particular company, say Plan C then you can be certain that you shall get all the benefits of Plan C as mentioned in the offer document irrespective of the company you are purchasing the policy from.
There is a different fact to be mentioned in this context. Though there had been no changes in the standard Medigap Insurance Plans after 1992 but by June 1, 2010, these twelve standard Medigap plans would undergo several major changes. With the effect of these changes four of the existing plans would be dropped and instead of that two new plans would be introduced. These changes had been made due to the federal legislation passed in 2005 in which there would be few additional consumer protections for California beneficiaries.
Moreover, the primary criterion to get enrolled for the Medigap Health Insurance Plans is that a person must be a beneficiary of the Original Medicare Part A and B. These two plans are considered by the most basic plans. However, during the open enrollment period which begins within 6 months of turning 65 a person may get enrolled to the Medigap Insurance Plans on a guaranteed issue basis, which means that the person may not need to go through medical screening. But other than the open enrollment period the insurance company may as for medical screening and may obtain an attending physician’s statement if the company thinks it necessary.
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