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An insurance policy that is issued to a Medicare
beneficiary, specifically as
secondary to Medicare
. It
is issued to Medicare beneficiaries with the
understanding that depending on the plan selected, it
only pays the percentage that is not paid by
Medicare.
This is true!
Medigap policies are considered to be
part of the patient’s Medicare coverage, therefore an
EGHP would always follow Medicare/Medigap, if
Medicare is primary.
Medigap Policies
Employer Group Health Plan (EGHP), Group Health Plan
(GHP), Large Group Health Plan (LGHP)
Supplemental Policy
An insurance policy that is secondary to Medicare. It could be an EGHP
that has met the COB period or a Medigap policy. It is important to
find out which when discussing coverage with an insurance company.
Example:
1.
Medicare
2.
Medigap
3.
EGHP
An insurance policy that is provided by an employer to an active or
retired employee. This type of plan is not available to the general
public for purchase. The premiums are typically paid by the employer
and employee. COB may apply if patient has Medicare and an EGHP.