A Quick Look at California Medigap

One of the first things people ask us when shopping for California Medigap plans is what\’s the different between Medicare supplemental plans and Medigap Luckily, that\’s the easiest question to answer when first becoming familiar with all the various terms and jargon that swirl around California medigap. They are, put simply, one in the same. It\’s just two different ways to state the type of insurance. Medigap is especially well suited as a name since the role it plays is right there in the name and so accurately describes why California medigap coverage is important. Let\’s dig a little deeper and see how a the name puts us on the right course to understand Medicare and it\’s \”gaps\”.

Medicare has gone through changes over the years (decades really) but the core of Traditional is Medicare is pretty much the same. Yes, we have added Part D for medication and other various changes over the years but the bulk of the plan is relatively untouched as it applies to what we generally think of as medical care…services delivered by hospitals and doctors. Medicare was designed to cover the bulk of health care costs…not everything in an attempt to keep the cost of the program down. In doing this, there are certain \”gaps\” in coverage…some are not terribly big while others can be financially ruinous. It\’s these gaps that led to the name Medigap in Medigap insurance. Essentially, it\’s coverage to fill in the gaps of Medicare, and to this effect, it\’s very successful. So what\’s the deal with Medigap plans? How are the different?

Good question and really it\’s the first one to ask (and answer). The easiest approach is to understand where the \”gaps\” in Medicare are since they fall into a few (less than 10) main categories. Let\’s break them out for California Medicare. The first gaps deal with core benefits in Part A and Part B. Part A is for hospital or facility based coverage and it\’s generally the part of Medicare you have been paying into all your life (or your spouse\’s life). Part B is for physician provided care and generally covers labs, x-rays, and other services not under Part A. There are two gaps (as in Medigaps) associated with these benefits. The first gap is a deductible required for each part per calendar year. The second gap deals with co-insurance required after the deductible is met. This gap in Medicare means that you will pay 20% of the charges once the deductible is met and this 20% can continue indefinitely. The various California Medigap plans will cover these deductibles and co-insurance costs differently depending on which plan you choose. Some will cover all 4 gaps (such as the F plan) while others might only cover the Part A deductible (and not B). All the California medigap plans cover the 20% coinsurance for Part A which is important since this is the biggest gap in traditional Medicare with the most potential risk to the subscriber.

The other gaps are less critical but still important to consider. They are Hospice care, Skilled Nursing, Preventative, first 3 pints of blood, and Emergency Foreign Travel insurance. When considering the cost difference between the various California Medigap plans, it\’s hard to justify the any savings against excluding one or any these gaps. There isn\’t enough cost savings on the premium to go down the scale in coverage. This leads us to the F California Medigap plan as not only a prudent value proposition but also, the most popular of the Medigap plans available in California

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