Medicare is good, but as recipients know, it does not cover everything, by far. That’s why so many seniors on Medicare rely on private medigap insurance to close the gaps in Medicare. Note: Medigap is a type of insurance policy that is NOT related to Medicare coverage, a Medicare Advantage or private health plan, or any other government program.

Is this something you should consider? Perhaps. If you:

• Have a chronic illness.
• Anticipate needing surgery.
• Have reason to expect that you’ll have long or frequent hospital stays.
• Plan to travel outside the country.
• Are healthy but are not a risk taker and just want added peace of mind.

All of these are reasons to purchase medigap insurance. Without this additional coverage, the coinsurance, copays and deductibles you may have to pay can quickly become overwhelming. Medigap insurance can help narrow those out-of-pocket costs.

When Should You Buy a Medigap Policy?

Ideally the best time to buy medigap is within your six-month medigap open enrollment, which starts the month you turn 65 and have enrolled in Medicare Part B medical insurance. During that time, it doesn’t matter that you have health problems. You can still buy a policy at the same price healthier people will pay. Unfortunately if you missed that open enrollment period for medigap, you may not be able to get it at all, and if you do, it could cost more. That’s because after open enrollment, insurance companies can decide not to accept your application at all. And if they do, they can use medical underwriting to decide how much to charge you.

What Is Covered?

Medigap plans, lettered from A to N, offer a uniform set of benefits. Each letter represents a specific set of benefits, so check carefully before you buy. Not every state offers every plan.

The most basic coverage is Plan A. The most comprehensive is Plan F and, according to information provided by the U.S. News & World Report, it covers coinsurance, blood, deductibles, skilled nursing in facility care, foreign travel, and Part B excess charges. The other plans have various combinations of covered benefits. All of the plans, except for Plan K and Plan L have no out-of-pocket limits.

Travel Outside the United States

Medicare covers care within the U.S., but it probably will not cover you if you travel elsewhere. Medigap insurance, on the other hand, will provide emergency care for medical expenses in foreign countries.

Here are a few specifics:

Medigap Plans C, D, F, G, M and N provide foreign travel emergency health care coverage when you are traveling outside the United States.

Plans E, H, I and J will also provide emergency health care coverage during foreign travel. However, these plans are no longer sold. If you have a policy that was issued before June 2010 it should still be good.

All of the plans listed above pay 80% of the charges for care that is medically necessary, while you are outside the country, after you meet the $250 deductible. Also, the emergency care must begin within the first 60 days of your trip if Medicare doesn’t cover the cost.

Getting Help

Selecting the right plan for you is easier with the help of a broker. By the way, there is no charge for using a broker, so take advantage of this resource. A good broker or agent should ask a lot of questions and offer a lot of options in the process of finding your ideal plan. Companies offering medigap plans cannot solicit business, so if you are interested in finding a policy, you’ll need to initiate contact yourself, so ask around to find someone you can trust.

Happy hunting!

Teresa Ambord is a former accountant and Enrolled Agent with the IRS. Now she writes full time from her home, mostly for business, and about family when the inspiration strikes.

Meet Teresa