Yes, that is correct. Medicare still pays their portion and remains your primary coverage. The hdG Medigap plan is secondary to Medicare, and you pay out of pocket until you have met the hdG deductible. Hope that answers your question – let us know if you have others!

Hi Dolores, No, Medicare Advantage plans take the place of Medicare completely. They don’t pay 80% like Medicare – they have their own set of coverages, co-pays, coinsurance, deductibles, etc. Each Advantage plan is different, and each Advantage plan changes each year. With Medicare and Plan G, you should not be paying co-pays to doctors at the time of the visit. The only out of pocket costs on Medicare + Plan G is the $198/year Medicare Part B deductible.

When I pay the copay to the doctor at the time of visit, is that basically me paying the last 20% out of my pocket?

Medigap plans only pay when something is Medicare-approved. If the surgery was Medicare-approved, any Medigap Plan G would pay what Medicare doesn’t cover (after the deductible). If it is truly an “elective” surgery (i.e. not medically-necessary), that is generally something that would not be covered by Medicare or a Medigap plan.

Yes, Medicare Supplement policies use underwriting. A Medicare beneficiary would need to sign up for a plan when they are in open enrollment (when they first start Medicare or turn 65) in order to guarantee that they are eligible. If they have significant pre-existing conditions, they can be turned down for coverage at a later time. Every company has different requirements for underwriting for plans. If he has had the pacemaker a while, it is possible that some companies would consider him for coverage – it really just depends on his overall health and medical records.

As far as other options, a Medicare beneficiary can always get a Medicare Advantage plan (not what I would recommend in most cases, but may be better than having Medicare-only). You can get in an Advantage plan during the annual election period – Oct 15-Dec 7.

Let me know if you have other questions.