Who Is Eligible for Medicare?

Medicare is designed to provide health insurance for those who are 65 and older. There are, however, exceptions to this age minimum for people who qualify for disability with certain medical conditions. This includes those with amyotrophic lateral sclerosis and end-stage renal disease.

Eligibility Requirements Medicare Supplement Plan G

Only those people who have Medicare Part A and Part B can buy a Medigap policy. Those who have a Medicare Part C Advantage Plan cannot purchase this type of insurance.

Once you turn 65 and have Medicare Part B, you enter the Medigap open enrollment period, which lasts 6 months. During this time, the insurance company can’t use medical underwriting to determine whether or not it will offer you a policy. This means it can’t do any of the following things as a result of your health issues:

• decline to sell you a Medigap policy
• insist that you wait for some time before coverage begins (except in certain cases)
• charge you more based on your health

After the open enrollment period ends, the insurance company can refuse to sell you a policy based on your health or charge you more, unless you have a guaranteed right to buy a Medigap policy. (This usually happens in cases where you lose your existing policy through no fault of your own.)

Call a Licensed Agent: 817-952-3153

Can the Insurance Company Make You Wait for Coverage?

In most cases, an insurance company can’t make you wait for your Medigap coverage to begin. However, if you have a pre-existing condition, you might have to wait for coverage for up to six months. This is called the “pre-existing condition waiting period.” After six months expires, the Medigap policy covers the costs associated with your pre-existing condition. (Your condition will still be covered during the pre-existing condition waiting period by Medicare, but the Medigap policy won’t cover the out-of-pocket costs.)

What Is Medicare Supplement Plan G? 

Medigap Plan G is one of 10 Medicare Supplement Insurance plans. Medigap assists with fees such as coinsurance, copayments, and deductibles that aren’t covered under Medicare Part A and Part B, also known as Original Medicare.

How Medicare Supplement Plan G Works

After Medicare pays its approved portion of medical costs, Medigap Plan G helps supplement remaining out-of-pocket expenses. You must pay a separate monthly premium for Medigap coverage, which is privately insured but standardized across all states except Massachusetts, Minnesota, and Wisconsin.

Since Plan F is no longer available to new applicants, Medigap Plan G is one of the more comprehensive Medicare Supplement plans on the market. According to Medicare.gov, here is what Medigap Plan G covers and doesn’t cover.

Medigap Plan G covers:

• Part A deductible.
• Part A coinsurance and hospital cost up to 365 days after Medicare benefits are exhausted.
• Part A hospice care coinsurance or copayment.
• Part B coinsurance or copayment.
• Skilled nursing facility care coinsurance.
• Blood transfusion (first three pints).
• Emergency health care service for the first 60 days when traveling outside the U.S.

Medigap Plan G doesn’t cover:

• Part B deductible.
• Long-term care.
• Private-duty nursing.
• Dental care.
• Vision care.
• Prescription drugs (available only on plans purchased before Jan. 1, 2006. You can receive prescription coverage through a Medicare Part D plan).

Cost of Medigap Plan G

Since Medigap Plan G coverage is privatized and regulated by the state, the price varies by age, location, and such factors as tobacco use.

The best time to buy your Medigap Plan G policy is during the six-month Medigap Open Enrollment Period, which starts the first month you have Medicare Part B and once you’re 65 years of age or older. Medigap policies can cover only one person, regardless of marital status.

To find out the cost of Medigap Plan G in your area, call Ashford Insurance at 817-952-3153.

There are plenty of options and types of coverage when it comes to Medicare benefits. Out of the 64 million people in the United States who receive traditional Medicare benefits, 81% use some sort of Medicare supplement insurance, according to Medicare.gov, a nongovernment resource for health care information.

If you have questions about Medicare call 817-952-3153.