If a person has a Medigap policy, he is most concerned with paying the bills of Medicare Part B. The policies provide additional coverage for Part A as well, but most people do not plan on needing a lot of additional hospitalization coverage. Even if they do need it, most people do not go out buying insurance policies because the want to spend a lot of time in the hospital.
A person may ask how a Medigap policy pays their Medicare Part B bills. People who ask themselves this are asking the wrong question. A Medigap policy does not pay a person’s Medicare Part B bills, it pays for coverage that Medicare Part B won’t cover or does not cover enough of.
How All Medigap Policies Work
The existence of Medicare and supplemental policies brings the idea of primary and secondary payer into America’s health care system. The primary payer for many senior citizens is Medicare and the Medigap policy he has, if he has one, is secondary.
When a patient goes to a doctor’s office on an outpatient basis, he is covered under Medicare Part D. The doctor will send the first claim to Medicare and then will supplement an additional claim to Medigap, if he performed a service that is not covered under Part B. Medigap will determine if it can pay the coverage and does.
What Is The Patient’s Responsibility?
Depending on the service performed and whether or not a patient has paid the deductible, the Medicare recipient will have to pay a small co-pay determined by his Medigap plan. If the service performed falls outside of the coverage of both plans, he has no choice to pay for the service out-of-pocket. Of course, he can choose not to pay the bill if he wants to take the credit hit.