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MedicareSupplemental.com is an information portal and quote provider for Medicare Supplemental Insurance, also called "Medigap" insurance. If you are visiting us, you are likely to be either looking for or contemplating the purchase of a Medicare Supplemental policy.

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Medicare Information and Terms Defined

Coinsurance - This is an amount of money that you may be required to pay as your share of the costs for medical services after you pay any deductibles. Coinsurance is usually calculated as a percentage. For example, your coinsurance calculation could be 20% of the costs accrued after you pay your deductible.

Copayment - This is an amount you may be required to pay as your share of the cost for medical services or supplies, like a doctor's visit or for some prescriptions. A copayment is usually a set amount, rather than a percentage. For example, you might pay $20 or $30 for a doctor's visit or for a prescription. These costs can vary depending on the type of prescription or doctor's visit.

Deductible - This is the amount you must pay for health care or prescriptions, before Medicare, your prescription drug plan, or your other insurance begins to pay. If your deductible is $500 then you must pay that much for medical costs before your insurance begins to take effect.

Excess Charge - If you have Medicare, and the amount a doctor or other health care provider is permitted to charge you is higher than the Medicare-approved amount, the difference is called the excess charge. If you have no other medical health coverage you will be responsible for the excess charge.

Guaranteed Issue Rights - These are also called "Medigap Protections". They are defined as the rights you have when insurance companies try to sell or offer you a Medicare supplemental insurance policy during open enrollment. In these situations, an insurance company can't deny you a supplemental policy, or place conditions on a policy, such as denying you for pre-existing conditions. The insurance company also cannot charge you more for a supplemental insurance policy because of a past or present health problem.

Guaranteed Renewable - This is defined as an insurance policy that can't be terminated by the insurance company unless you make untrue statements to them, commit fraud, or don't pay your premiums. All Medicare supplemental policies issued since 1992 are guaranteed renewable.

Medical Underwriting - This is the process that an insurance company uses to decide, based on your medical history, whether or not to take your application for insurance. They can also decide whether or not to add a waiting period for pre-existing conditions (depending on where you live) and how much to charge you for that insurance.

Medicare SELECT - This is a type of supplemental insurance policy that may require you to use hospitals and, in some cases, doctors within a specific network to be eligible for full benefits.

Open Enrollment Period - For Medicare supplemental insurance, this is a one-time-only, 6-month period when Federal law allows you to buy any supplemental policy you want that is sold in your state. It starts in the first month that you are covered under Medicare Part B and you are 65 or older. During this period, you can't be denied a Medicare supplemental insurance policy or charged more due to past or present health problems.

Pre-existing Condition - This is a health problem that a doctor has diagnosed you with before the date that a new insurance policy starts.

Premium - This is the periodic payment to Medicare, an insurance company, or a health care plan for health care or prescription drug coverage. Usually premiums are charged monthly, but sometimes you can also pay in larger sums.

State Insurance Department - This is a state agency that regulates insurance and can provide information about Medicare supplemental policies and other private insurance.

For additional Medicare information, please visit Medicare Supplemental Insurance 101.

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