Florida 2-15 Life, Health and Variable Annuity AgentGeneral Knowledge of Health InsuranceMedium
A client is 68 years old, retired, and enrolled in Medicare Part A and Part B. They are looking for additional coverage to help with out-of-pocket costs. They are particularly interested in a plan that covers the Part A deductible, skilled nursing facility coinsurance, and the Part B 20% coinsurance. Which type of policy is designed to cover these specific gaps in Medicare coverage?
- AMedicaid
- BEmployer-sponsored group health plan
- CMedicare Advantage Plan (Part C)
- DMedigap Policy
Show answer & explanationAnswer & explanation
Correct answer: D. Medigap Policy
Medigap policies, also known as Medicare Supplement Insurance, are specifically designed to fill the 'gaps' in Original Medicare (Parts A and B) coverage, such as deductibles, coinsurance, and copayments.
Why the other options are wrong
- A. Medicaid is a state and federal program for low-income individuals, not a supplement to Medicare for general out-of-pocket costs.
- B. An employer-sponsored plan is typically primary coverage, not a supplement for a retired individual already on Medicare.
- C. Medicare Advantage plans are an alternative to Original Medicare, offering combined benefits, but they do not supplement Original Medicare.
Medigap Policy
Medicare Supplement Insurance policies sold by private companies to fill 'gaps' in Original Medicare coverage. They help pay for out-of-pocket costs like deductibles, coinsurance, and copayments.
- Supplements Original Medicare (Parts A & B).
- Standardized plans (A-N).
- Covers deductibles, coinsurance.
- Does NOT replace Medicare Advantage.
Memory trick: Medigap: Bridges the Gaps in Medicare's Map.