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Summarizing the Medigap Plan

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Summarizing the Medigap Program

Medicare Part A and Part B do not always cover all of medical services and/or treatments that the beneficiary may need. Because of the “gaps” that these plans do not cover, many individuals often purchase additional insurance such as Medigap insurance or insurance a previous employer provides. Medigap is private insurance that may cover unpaid amounts within the annual deductible, any coinsurance, and payment for non-covered services. Private insurers offer these Medigap plans but the federal and state law regulates coverage and standards. Policyholders must pay monthly premiums and may choose 1 of 10 plans. The monthly premiums and plans vary depending on the insurance company selected but a set core of benefits is common among all Medigap plans. Medigap coverage also eliminates the need for the practice to file separate claims because the carrier automatically forwards the claim to the payer and the provider is paid directly. (Valerius, Bayes, Newby, & Seggern, 2008)
Based on the information in this week’s readings and looking over the suggested websites, I feel that the different plan offered through Medigap at the prices offered is fairly reasonable. Because of the many different plans offered, the policyholder can choose a plan that fits them both medically and financially. Depending on the monthly premium the insured pays, Medigap covering certain expenses such as a long hospital stay, could save an individual a lot of money. The fact that standardized Medigap plans are guaranteed renewable as long as the premium is paid on time regardless of health conditions is beneficial as well. ("Web Md”)
One implication of having a private company company associated with a government insurance program is that coered services may be substitutable for uncovered services which could potentially change which services are covered. A second implication is possessing private insurance could possibly reduce the poverty level reducing the demand for government funded programs. (Cutler, 2003)

Reference:
Cutler, D. M. (2003). Supplementing Public Insurance Coverage with Private
Valerius, J., Bayes, N., Newby, C., & Seggern, J. (2008). Medical insurance: An integrated claims process approach (3rd ed.). Boston, MA: McGraw-Hill
Web MD. Retrieved from http://www.webmd.com/Medicare/medigap…...

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