Medigap: What is it and Why it Works for Physical Therapy

2 min read

woman working on physical strength through physical therapy

Many older adults that have the original Plan A & B policies with Medicare don’t realize that they can get supplemental coverage, better known as Medigap. For those using Original Medicare, Medigap helps cover the costs that Plan A & B wouldn’t, meaning that you’ll always have the opportunity to receive quality care.

We put together a quick resource guide below to help inform you about the important points of Medigap, costs, how to get it, and how it’s especially beneficial to those who need physical therapy.

What is Medigap?

Medigap is exactly what it sounds like — it covers the gaps in your Medicare coverage by partnering up with the original Part A & B sections. You can think of it as supplemental insurance with what you already have with the original Medicare.

Medigap comes in a number of policies, Plans A-N, meaning that you have many options with choosing supplemental care. Each plan varies in the level of amount you pay, types of care, and much more.

The main points older adults need to remember before investing in Medigap is that the plans don’t generally cover things like long-term care, eye or dental care, eyeglasses, hearing aids, or in-home care.

What Does it Cost?

Medigap costs depend on which state you reside in and how old you are. So, the older you are, the more you’ll have to pay for your supplemental policy, and this cost can increase based on where you live.

Because the costs vary so much, the best thing you can do is to figure out what policy would be best for you first, get a quote, and then compare it to this list here. Remember: this list is based on how much the most popular plan, Plan F, costs in various states, so this can serve as a great basis for you to understand how prices compare to your state, your age, and the plan you want.

How Does it Work with Physical Therapy?

For those needing extensive physical therapy and are worried about coverage running out, investing in Medigap should definitely be considered because:

  1. Medicare removed the cap on physical therapy
  2. If you have Medigap Plan C or F, you have first dollar coverage for physical therapy

This means that as long as your doctor deems it medically necessary, you can continue getting physical therapy with your Medicare plan. The first dollar coverage with Medigap means they cover the Plan B deductible, so you don’t have out-of-pocket costs or copays before coverage begins. The insurer covers your costs immediately. Plan F will also cover excess charges with Plan B.

Ultimately, this all means that for as long as you need physical therapy, you’ll be able to receive it.

How to Get Started

To get a Medigap policy, you will need to decide which section will work with your needs best. You can access the Medicare website here to see the benefits of Plans A-N and to find a Medigap policy based on your zipcode.

The best part about utilizing the website above is that they break down the buying process into just 3 steps. Once you pick the policy you want and find what’s available in your area, all you have to do is contact companies for quotes. It’s literally that easy!

Additional Resources

Learn How to Choose the Right Medigap Plan

Basic Benefits of Medigap Plans A-N

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