Medigap Health Insurance - Eligibility and Considerations

Today’s senior citizens have many different health care options under the Medicare system. It is often overwhelming for those who are just beginning to prepare for enrollment.

If you are at least 65 years of age, you will most likely be automatically enrolled in Medicare Part A. If you also decide to participate in Medicare Part B, you are eligible for Medigap health insurance. If you are under the age of 65, you may be able to qualify for Medicare and the supplemental plans if you meet certain requirements set by the program and your state.

Medigap health insurance, also known as Medicare supplemental plans, was created to help senior citizens pay for health care related expenses not addressed by the original Medicare program. If you join one of the Medicare Advantage plans, which work like an HMO or PPO, a supplemental plan may no longer be necessary.

Although you do not need to give up the plan, it cannot be used to pay for the co-payments and deductibles of the Advantage plan. To cancel the Medigap policy, you must contact the insurance provider, not Medicare. It is illegal for anyone to sell you a supplemental policy if you already have an Advantage plan.

The only exception is if you are switching back to the original Medicare program. Medicare health plan is a term that applies to many different policies. It is purchased through a private insurance company and provides Medicare Part A and B benefits.

Depending on the context, it could refer to one of the Medicare Advantage Plans, Medicare Cost Plans, Programs of All-Inclusive Care for the Elderly (PACE) or any of the Demonstration/Pilot Programs. If you have joined one of these plans and are not satisfied with the benefits or guidelines, you may be able to purchase Medigap health insurance if you are returning to the original program within 12 months.

If this is the situation, you may be able to get the same Medigap health insurance plan you had before the change. If your plan included coverage for your medications, you will be able to join Medicare Part D. However the original plan will no longer include drug coverage.

The health care needs of senior citizens have changed significantly since the Medicare program was first instituted. The original program, which included Parts A and B, has been modified to include Parts C and D. Supplemental insurance plans provide additional coverage and benefits not addressed by the original program.