Which of the following is not covered under plan a in medigap insurance

Learn more about the Medigap changes here.

10 Things You Should Know About Buying A Medigap Policy


  • Know why you might need a Medigap policy. A Medigap policy is health insurance sold by private insurance companies to fill the “gaps” in an original Medicare Plan coverage. Medigap policies help pay some of the health care costs that the original Medicare Plan does not cover. If you are in the original Medicare Plan and have a Medigap policy, then Medicare and your Medigap policy will each pay their share of covered health care costs.
  • Some examples of “gaps” in Medicare: You may want to buy a Medigap policy because Medicare does not pay for all of your health care. There are “gaps” or “out-of-pocket” costs that you must pay in the original Medicare Plan. Some examples of costs not covered are hospital stays, skilled nursing facility stays, blood, Medicare Part B yearly deductible, and Medicare Part B covered services.
  • Some examples of care not covered by Medigap: Long-term care, vision or dental care, hearing aids, and private-duty nursing are things that a Medigap policy will not cover.
  • Eligibility requirements: To buy a Medigap policy, you generally must have Medicare Part A and Part B. You are guaranteed the right to buy a Medigap policy if you are in your Medigap open enrollment period or covered under a Medigap protection. You might not be able to buy a Medigap policy if you are in a Medicare Advantage Plan, have Medicaid, already have a Medigap policy, or are under the age of 65 and you are disabled or have End-Stage Renal Disease.
  • Pre-existing conditions: A pre-existing condition is a health problem you had before the date a new insurance policy starts. In some cases, if you have a health problem before your Medigap policy started, a Medigap insurance company can refuse to cover that health problem for up to six months. This is called a "pre-existing condition waiting period." The insurance company can only use this kind of waiting period if your health problem was diagnosed or treated during the six months before a Medigap policy started.
  • In most cases, you cannot be dropped from Medigap. If you bought your policy after 1990, the policy is guaranteed renewable. This means your insurance company can drop you only if you stop paying your premium, you are not truthful about something under the policy, or the insurance company goes bankrupt. Insurance companies in some states may be able to drop you if you bought your policy before 1990. If this happens, you have the right to buy another Medigap policy.
  • Shop around for the best Medigap policy. Look for a Medigap policy that you can afford and that gives you the coverage you need most. As you shop for a Medigap policy, keep in mind different insurance companies may charge different amounts for exactly the same Medigap policy, and not all insurance companies offer all of the Medigap policies.
  • Make sure the insurance company is reliable. To help you find out if an insurance company is reliable, you can take the following actions: Stop before you sign anything and call the Department of Insurance at 803-737-6180 to confirm that the insurance company is licensed to do business in our state. You can also call the Department of Insurance for more information.
  • Watch out for illegal insurance practices. You should know it is illegal for anyone to pressure you into buying a Medigap policy, lie or mislead you to switch to another company, or sell you a second Medigap policy when they know that you already have one. It is also illegal to sell you a policy that cannot be sold in our state.
  • Understand your Medigap rights and protections. You need to know that under federal law, you have rights and protections regarding your Medigap coverage. These include your right to buy Medigap coverage, protections if you lose or drop your health care, and protections for people with Medicare under the age of 65. Contact the Department of Insurance to better understand these rights and protections.

Medigap is extra health insurance that you buy from a private company to pay health care costs not covered by Original Medicare, such as co-payments, deductibles, and health care if you travel outside the U.S. Medigap policies don't cover long-term care, dental care, vision care, hearing aids, eyeglasses, and private-duty nursing. Most plans do not cover prescription drugs.

You pay a monthly premium for a Medigap policy. A Medigap policy covers only one person. If you and your spouse both want a Medigap policy you will each need to buy one.

Medigap policies are only available to people who already have Medicare Part A, which helps pay for hospital services, and Medicare Part B, which covers the cost for doctor services. People who have a Medicare Advantage plan cannot get a Medigap plan.

To learn about Medigap plans offered in your area, you can use the online Medicare Plan Finder or contact your state's department of insurance.

Standard Medigap plans are labeled A through N and offer different levels of health coverage. Plans C, E, F, H, I, and J are no longer available to new subscribers.

Premiums vary among insurance companies, but the benefits of each standard Medigap plan are always the same. For instance, a Medigap Plan C policy offers set benefits no matter which company you buy it from. However, standard Medigap policies are different in Massachusetts, Minnesota, and Wisconsin.

If you are going to buy a Medigap plan, the open enrollment period is six months from the first day of the month of your 65th birthday -- as long as you are also signed up for Medicare Part B -- or within six months of signing up for Medicare Part B. During this time, you can buy any Medigap policy at the same price a person in good health pays. If you try to buy a Medigap policy outside this window, there is no guarantee that you'll be able to get coverage. If you do get covered, your rates might be higher.

For a Medigap plan, you pay a monthly premium to the insurance company in addition to your Medicare Part B premium. The cost of your Medigap policy depends on the type of plan you buy, the insurance company, your location, and your age. A standardized Medigap policy is guaranteed renewable -- even if you have health problems -- if you pay your premiums on time.

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However, you may have to wait up to six months for coverage if you have a pre-existing health condition. The insurer through which you buy your Medigap policy can refuse to cover out-of-pocket costs for pre-existing conditions during that period. After six months, the Medigap policy must cover the pre-existing condition. The exception to this rule is if you buy a Medigap policy during your open enrollment period and have had continuous "creditable coverage," or a health insurance policy for the six months before buying a Medigap policy. The Medigap insurance company cannot withhold coverage for a pre-existing condition in that case.

Insurance companies set their own prices and rules about eligibility, so it's important to shop around.

Most Medigap plans help pay for many of your Medicare co-payments, co-insurance for hospital stays, and some other services.

Less expensive plans have fewer benefits and higher out-of-pocket costs. More expensive plans include extra benefits, like some Medicare deductibles, additional hospital benefits, at-home recovery, and more. You have to decide what sort of plan makes the most sense for you. If you drop your Medigap policy, there is no guarantee you will be able to get it back.

Some Medigap plans used to cover prescription drugs. Since the introduction of the Medicare Prescription Drug Plan (Part D), you can no longer sign up for these plans. If you already have a Medigap plan that covers prescriptions, however, you can keep it.

For more information about Medigap plans, see the Medicare web site at www.medicare.gov or call 800-MEDICARE (1-800-633-4227). For help in choosing a Medigap plan, visit your local State Health Insurance Assistance Program (also called SHIPs). SHIPs offer free, unbiased advice on Medicare.

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What is not covered under Plan A and Medigap insurance?

Medigap is extra health insurance that you buy from a private company to pay health care costs not covered by Original Medicare, such as co-payments, deductibles, and health care if you travel outside the U.S. Medigap policies don't cover long-term care, dental care, vision care, hearing aids, eyeglasses, and private- ...

What does Medigap plan a cover?

Medigap Plan A covers: 100% of your Medicare Part A hospital and coinsurance costs. 100% of your Medicare Part B copays and coinsurance. The first three pints of blood that you may need.

What is not covered in Medicare Part A?

A private room in the hospital or a skilled nursing facility, unless medically necessary. Private nursing care. A television or telephone in your room, and personal items like razors or slipper socks, unless the hospital or skilled nursing facility provides these to all patients at no additional charge.

What is not covered under Plan A in Medigap insurance quizlet?

Which Of the following is NOT covered under a "core" policy, Plan A in Medigap Insurance? The Medicare Part A deductible.