It’s the painful truth: Medicare doesn’t cover all of your health costs. If you want more coverage, you’ll have to buy more insurance.
Enter Medigap plans.
Also known as Medicare Supplement Insurance, Medigap covers some of the expenses that Original Medicare doesn’t cover, such as copayments, coinsurance and deductibles.
You’ve seen the commercials. Medicare only pays 80% of your approved charges for Part B services like visits to the doctor.
If you want coverage of that extra 20%, you’ll need a Medigap plan.
“The goal is to fill the gaps in Original Medicare,” said Tricia Blazier, product manager for Allsup Medicare Advisor, a Medicare plan selection service.
You might be thinking about buying a Medigap plan now if you have decided to drop your Medicare Advantage plan during Open Enrollment and enroll in Original Medicare.
Keep in mind, Medigap plans generally don’t cover your drugs or other things like long-term care or dental and vision care.
Premiums for Medigap plans vary depending upon the type of plan you choose and the insurance carrier.
For instance, the monthly premiums for Medigap Plan F — one of the most popular types of Medigap policies — for someone living on the Upper East Side of Manhattan would range in price from $ 261 to $ 469.
Consider yourself lucky if you live in New York State.
Elsewhere in the country, you’re only guaranteed coverage if you purchase a Medigap plan during a six-month period that begins on the first day of the month when you turn 65.
“But in New York, no one can turn you down at any time or charge you more,” because of your health status, Blazier said.
Regardless of where you live, all Medigap policies are “guaranteed renewable,” meaning your insurance company can’t drop you, so long as you pay your premiums.
But if you have a preexisting condition, you might have to wait up to six months until coverage kicks in.
Under New York State law, insurance companies must shorten the waiting period by the number of days that you were covered by some form of “creditable” coverage, so long as the coverage was continuous for more than 63 calendar days.
So how do you go about choosing a Medigap plan?
First understand that they come in ten flavors each labeled by a letter: A B C D F G K L M and N. (There is also a high deductible Plan F, with a deductible of $ 2,140).
Each lettered plan offers different levels of benefits. F and C are the most robust and are often the most expensive.
Each letter plan offers the same standard benefits regardless of the insurance carrier — and regardless of the cost.
“I advise people to go with the best deal,” said Fred Riccardi, client services director at Medicare Rights Center.
To see a list of all the Medigap policies available in New York State, go to dfs.ny.gov/consumer/caremain.htm#medgap.
Plug in your zip code and look for a list of carriers and their rates.
Take a close look at each lettered plan to understand their cost and their coverage.
If you need help choosing a plan, reach out to HIICAP, New York State’s Health Insurance Information, Counseling and Assistance Program.
Dial 311 or 212-341-3978.
“First think about the benefits you want, and then look at the cost,” Riccardi said.