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Feds Adopt NAIC Standards for Medigap Insurance

By Wiley Long

Republish: EasyPublish™ Published: 24Aug2009 Word count: 688 Viewed: 235 time(s) Get Free Content For Your Site

In early May 2009, the federal government adopted new standards for Medicare supplement insurance. The standards were developed by the National Association of Insurance Commissioners (NAIC) and were set by the Centers for Medicare and Medicaid Services in order to apply the Medicare Improvements for Patients and Providers Act of 2008.

The Medicare supplement insurance standards were originally set by the NAIC in 1979 and have been advised numerous times since then. The recent changes to the standards include changes to the Medicare Supplement plan options that were believed to be confusing and duplicate benefits that are available in the Medicare Part B - physician and outpatient services - plan. These changes include the following:

- The addition of hospice benefits to each Medicare Supplement plan option - The elimination of preventative and at-home recovery benefits for all Medicare Supplement plan options

More About Medigap Insurance

Medigap insurance, also known as supplement insurance, is an insurance policy that Medicare subscribers can take out in order to cover healthcare expenses that are not already covered by Medicare. Medigap insurance policies are offered by private insurers and are available for all Medicare subscribers that are interested in enrolling in such programs.

All Medicare subscribers should be aware of how Medigap insurance policies work with their existing Medicare policies. For example, some Medicare subscribers that have Medicare Plan D may be able to have Medigap insurance cover the cost of prescription medications that are not covered by Plan D.

Other Medicare Changes

In addition to the addition of hospice benefits and the elimination of preventative and at-home recovery benefits to the Medicare program, the system will undergo several other changes in 2010. These additional changes include the elimination of four Medicare Plans and the addition of two new plans.

All Medicare subscribers should review their existing plans and learn more about the changes that will impact them. Some Medicare subscribers will want to make changes to their Medicare accounts after they learn more about the new option available to them. These changes need to be made during the open enrollment period from November 15 to December 31, 2009 in order to be applied to the 2010 Medicare year.

More Information about Medicare

Medicare is a federal healthcare program that is available to all U.S. citizens over the age of 65. Additionally, individuals under the age of 65 are eligible for Medicare coverage if they have a qualifying disability or if they have End-Stage Renal Disease - a disease in which an individual has permanent kidney failure and requires a kidney transplant or dialysis treatments.

Individuals that are enrolled in a Medicare program receive coverage for many healthcare-related expenses, including healthcare services and supplies. However, there are some healthcare expenses that are not covered by Medicare, including co-insurance, copayments, and deductibles. Some prescription drugs and treatments are also not covered by the Medicare program.

Medicare Subscribers have many options when it comes to selecting the right plan for their needs. Subscribers are first required to select from four plans: Medicare Part A, Medicare Part B, Medicare Part C, and Medicare Part D. In some cases, they can combine these plans together in order to receive the right coverage for their needs.

In the event that a subscriber selects a plan that does not cover some or all of their healthcare needs, the individual may elect to purchase Medigap insurance. Medigap insurance is designed to cover the cost of many healthcare expenses that are not already covered by Medicare. Coverage options vary based on the plan and the plan provider that an individual selects.

Often, when an individual has Medicare Part B coverage, the individual will purchase Medigap coverage as well. Medicare Plan B covers 80 percent of the medically necessary healthcare charges that an individual may incur as a result of treatment by a physician or a hospital. When bills are particularly high, Medigap insurance can cover all or some of the remaining 20 percent that is not covered by Medicare.

Medicare also does not generally pay for preventative services, such as routine exams. Medigap insurance plans may cover the cost of these non-covered services, depending on the plan that a subscriber purchases.

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