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Summarizing the Medigap Program

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Submitted By krissa77
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Summarizing the Medigap Program Medicare Parts A and B do not cover everything for patients who have it. Medigap fills in these “gaps” in coverage. Some people would certainly benefit by purchasing a Medigap policy. A Medigap policy can help its holders pay for their deductibles and co-pays for Medicare Parts and B. Some other services, like medications and emergency care while traveling in foreign countries, may be covered by Medigap policies. Based on my understanding of the Medigap program, I believe it meets consumers’ needs quite well. For people who are unable to meet the additional costs of co-pays, deductibles, and medications, this program can help. After reading the material from the American Diabetes Association (n.d.), the plans’ costs seems to be fair, taking into consideration the limits and benefits each plan offers. For example, if a person paid a co- pay for a hospital stay and did not have a Medigap policy, that person’s expense would be higher than themonthly premium for Medigap. If an individual does not need to visit the doctor frequently, has fairly good health and anticipates remaining healthy, choosing to pay an occasional co- pay may wind up being a better financial decision than paying a monthly premium. One implication from having a government insurance program and a private insurance company in association with each other is the services that are not and are covered by each. People who have private insurance as well as government insurance will generally have a greater number of covered services available, while having just the government insurance will limit patients to services that are strictly medically necessary unless they receive authorization for others. American Diabetes Association. (n.d.). Medigap. Retrieved August 28, 2009, fromhttp://www.diabetes.org/advocacy-and-legalresources/healthcare/medicare/medigap.jsp

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Summarizing the Medigap Plan

...Summarizing the Medigap Program Medicare Part A and Part B do not always cover all of medical services and/or treatments that the beneficiary may need. Because of the “gaps” that these plans do not cover, many individuals often purchase additional insurance such as Medigap insurance or insurance a previous employer provides. Medigap is private insurance that may cover unpaid amounts within the annual deductible, any coinsurance, and payment for non-covered services. Private insurers offer these Medigap plans but the federal and state law regulates coverage and standards. Policyholders must pay monthly premiums and may choose 1 of 10 plans. The monthly premiums and plans vary depending on the insurance company selected but a set core of benefits is common among all Medigap plans. Medigap coverage also eliminates the need for the practice to file separate claims because the carrier automatically forwards the claim to the payer and the provider is paid directly. (Valerius, Bayes, Newby, & Seggern, 2008) Based on the information in this week’s readings and looking over the suggested websites, I feel that the different plan offered through Medigap at the prices offered is fairly reasonable. Because of the many different plans offered, the policyholder can choose a plan that fits them both medically and financially. Depending on the monthly premium the insured pays, Medigap covering certain expenses such as a long hospital stay, could save an individual a lot of money. The...

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