### Navigating Medicare Choices: Simplifying Your Health Insurance Decisions
Choosing the right Medicare plan can feel overwhelming for the 65 million beneficiaries sorting through options each year.
For about 34 million people enrolled in original Medicare, an additional decision is whether to add a Medicare supplement plan, known as Medigap.
If the complexity of these choices feels daunting, don’t worry, says Ari Parker, co-founder and head Medicare advisor at Chapter, a service that helps people nationwide shop for Medicare plans.
“Figuring out supplemental insurance for Medicare – and if so, what kind – can be complicated for first-timers,” says Parker, author of "It’s Not That Complicated: The Three Medicare Decisions to Protect Your Health and Money." “Once consumers identify their priorities, the choices become more manageable.”
#### Key Takeaways:
- **Medigap Policies**: Help cover costs not included in original Medicare, such as co-insurance, copays, and deductibles.
- **Eligibility**: Only for those with original Medicare (Parts A and B), not Medicare Advantage plans.
- **Best Time to Buy**: Within the first six months of having Medicare Part B at age 65, when coverage cannot be denied due to preexisting conditions.
#### What Is Medigap?
Medigap plans are supplemental insurance plans sold by private insurers for those with original Medicare. They cover many costs that original Medicare doesn’t, like co-insurance, copays for doctor visits, and sometimes deductibles.
There are 10 standardized Medigap plans available in most states, named by letters (A, B, C, D, F, G, K, L, M, N). Plans with the same letter offer the same benefits, regardless of location or insurance company, with the only difference being the price.
If you have original Medicare, a Medigap plan can be highly beneficial since original Medicare covers only 80% of medical costs after the deductible. A Medigap plan can help cover the remaining costs.
“There is no out-of-pocket cap with original Medicare,” says Susan Stewart, a licensed insurance broker in Muskegon, Michigan. “Most people can’t afford the 20% cost for outpatient surgery, emergency room visits, or expensive tests like CT scans and MRIs. If a beneficiary chooses original Medicare, a Medigap plan is wise to limit and clearly define out-of-pocket expenses.”
#### What Medigap Does Not Cover:
- Dental care
- Hearing aids
- Long-term care
- Prescription drugs
- Private duty nursing
- Vision services
“If choosing your healthcare provider is a top priority, a Medigap plan might be right for you,” says Parker. “Suppose you're being treated for cancer and want to see a doctor at the University of Texas MD Anderson Cancer Center. With a Medigap plan, you’d be covered without worrying about network limitations or geographical restrictions.”
Before diving deeper into Medigap, it’s a good idea to review original Medicare and Medicare Advantage.
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