Florida 2-15 Life, Health and Variable Annuity AgentGeneral Knowledge of Health InsuranceMedium
A client, age 68, is enrolled in Medicare Part A and Part B. They are considering a Medicare Supplement (Medigap) policy. Which of the following statements about Medigap policies is FALSE?
- AMedigap policies are designed to cover services not covered by Medicare, such as long-term care.
- BIt is illegal for an insurer to sell a Medigap policy to someone who is enrolled in a Medicare Advantage Plan.
- CMedigap policies generally cover Medicare Part A and B deductibles and coinsurance.
- DMedigap policies are standardized and identified by letters A through N.
Show answer & explanationAnswer & explanation
Correct answer: A. Medigap policies are designed to cover services not covered by Medicare, such as long-term care.
Medigap policies are designed to fill the 'gaps' in Original Medicare (Parts A and B) by covering deductibles, coinsurance, and some other out-of-pocket costs. They do NOT cover services outside of Medicare, such as long-term care, private-duty nursing, or prescription drugs (unless purchased before 2006).
Why the other options are wrong
- B. This is TRUE. It's illegal to sell a Medigap policy to someone already enrolled in a Medicare Advantage plan, as MA plans are an alternative to Original Medicare, not a supplement.
- C. This is TRUE. Covering deductibles and coinsurance for Parts A and B is the primary function of Medigap.
- D. This is TRUE. Medigap plans are standardized by federal law, identified by letters.
Medigap Policy Exclusions
Services and costs that Medicare Supplement (Medigap) policies are specifically NOT designed to cover, as they only supplement Original Medicare.
- Long-term care.
- Hearing aids, eyeglasses, dental care.
- Private-duty nursing.
- Prescription drugs (if purchased after 2006).
Memory trick: Medigap fills Medicare's holes, but doesn't build new rooms.