A nurse explaining insurance to a senior.

Everything You Need to Know About Medigap Insurance

0 Comment Category: Assisted Living

Seniors should be well aware of their financial options when choosing an assisted living home so that they can have a relaxed and comfortable stay. However, not many older adults know that Medicare does not provide cover for all kinds of medical expenses, and assisted living costs fall in that category. This is where having supplemental insurance, known as Medigap insurance, can come in handy.

Medigap insurance is offered by private insurance companies to pay for the healthcare costs that are not covered by Medicare. However, you need to have a clear understanding of what is included in Medicare before choosing a supplemental Medigap insurance plan. For instance, if you have both Medicare Part A and Part B coverage, then getting a Medigap policy will be more beneficial for you. You can use the Medigap insurance to cover copayments, deductibles, and coinsurance expenses.

Note that Medicare does not cover the healthcare costs if a senior develops an illness when traveling abroad. This can also be covered by some Medigap insurance policies, but not all insurance providers include this in their supplemental insurance plans. On the other hand, Medigap insurance will not cover the monthly costs for long-term senior care just like Medicare. It does not offer any cover for the expenses for dental care, eye care, hearing aids, or non-medical home care either.

How Can a Medigap Policy Help You?

If you ever experience a situation that requires you to be hospitalized in a local healthcare unit, then you can use your Medigap insurance to pay the bills. You can also use Medicare Part A coverage to settle most of the expenses incurred during your hospitalization as long as you are admitted to an inpatient care center.

According to the current stipulations, you will be required to pay around $1,400 of your hospital expenses while Medicare will cover the rest of the expenses mentioned in the bill for a period of up to 60 days. After the designated period, you will need to pay a certain portion of the daily expenses of the hospital, which will increase after a period of 90 days of hospitalization. Currently, the coinsurance rates for healthcare expenses after day 60 is around $350 per day up to 90 days, and then around $700 per day for each lifetime reserve day.

Once you have used all of the lifetime reserve days during your hospitalization in the inpatient senior care facility, you will become responsible to pay for all the costs incurred when you are hospitalized for over 90 days the next time. You may be required to pay the first specified amount of the hospital bill as well if you are admitted back for inpatient care within the same year.

As for the outpatient diagnostic procedures and tests, they are covered by Medicare Part B. You will need to pay a monthly premium for Medicare Part B coverage alongside a deductible. As per the current stipulations, you will be required to pay the first $200 for your outpatient medical expenses plus 20% of the remainder of the costs while Medicare Part B will cover the rest. As these costs can add up quickly, it may lead to added stress on your finances.

Using the Medigap policy can be a viable option to pay for the deductibles, co-pays, as well as other expenses that can come up in the above scenarios. If you are nearing your retirement age and have a chronic health condition or any kind of senior illness or injury, then the expenses not covered by Medicare can take a big chunk out of your retirement savings. That is why getting a supplemental Medigap insurance policy is always considered a wiser choice to enjoy premium healthcare services.

Contact The Falls Home to see how we can help your senior loved one.

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