Medicare supplement insurance fills the gaps between Medicare benefits and what you must pay out of pocket for deductibles, coinsurance, and copayments. It is often called Medigap insurance.
Medigap policies are sold by private insurance companies. Medigap policies only pay for services that Medicare thinks are medically necessary, and payments are generally based on the Medicare approved charge.
There are special rules regulating Medigap. Insurance companies must try to protect buyers by ensuring that buyers carry only one policy. You can buy Medigap if you have Medicare Parts A or B.
If you have Medicare and a Medigap policy, you should not need any other medical insurance policies. The Illinois Department of Insurance can give you a list of companies that sell Medigap plans in Illinois.
Medigap policies can not include drug coverage for people enrolled in Medicare Part D.
How to pick a health insurance plan
It is often difficult to compare insurance policies because each company uses its own special words, and you often end up comparing apples and oranges.
To help you compare plans, there are currently 10 standardized Medigap plans. Those plans are labeled A through N. Some plans are no longer sold but if you currently have them you can keep them. It is illegal for an insurance company to sell anything other than those 10 Medigap plans.
The Medicare website has an interactive tool designed to help you compare Medigap policies. This tool helps you compare your needs with the coverage provided by these standardized Medigap plans.
Medicare also publishes a comprehensive booklet that explains Medicare, Medigap and other insurance issues.
Study your policies paragraph by paragraph. Make sure they provide the coverage you want. The plans are standardized to offer the same benefits regardless of what company offers them. The only difference between companies is cost.
The best way to make sure that you have the best coverage at the least cost is to shop around before you buy insurance.
When presented with an insurance policy offered by one salesperson, have another salesperson look it over and tell you whether he or she has one that is better at a lower cost. Always ask for an explanation of the terms and coverages you do not understand.
Getting counseling about Medigap
The Senior Health Insurance Program (SHIP) is a free counseling service that helps senior citizens who have problems or questions about their health insurance. SHIP counselors can answer questions about Medicare, Medicare Supplement Insurance, Medicare Advantage Plans, Prescription Drug Coverage through Medicare and Long-Term Care Insurance. Their contact information is below:
Senior Health Insurance Program
Illinois Department on Aging
One Natural Resources Way
Springfield, IL 62702-1271
Phone: 1-800-252-8966; 888-206-1327(TDD)
Here are some organizations that can give you more information on health insurance for senior citizens.
Illinois Division of Insurance (DOI)
For more information about Medigap or long-term care insurance, visit the Illinois Division of Insurance website.
Also, here is a fact sheet from DOI on Medigap policies, and one on Long Term Care Insurance Companies.
Office of Consumer Health Insurance
If you have complaints or questions regarding your insurance policy, you can file a complaint with:
The Office of Consumer Health Insurance (OCHI)
Illinois Department of Insurance
320 West Washington Street Springfield, Illinois 62767-0001
Medicare Interactive helps you learn about things you should consider before purchasing a long-term care insurance policy.