FAQs
Does Medicare or Medicaid cover long-term care?
Medicare typically covers only short-term skilled nursing (up to 100 days). Medicaid covers long-term care only after you’ve spent down your assets—eligibility varies by state .
Does Medigap cover prescription drugs?
No—Medigap policies sold after 2005 don’t include drug coverage. You’ll need a separate Part D drug plan.
Does Medigap cover travel outside the U.S.?
Many plans (like C, F, G, and N) include foreign travel emergency coverage, paying up to a specified limit abroad.
Does Medigap have an out-of-pocket limit?
No. Medigap doesn’t set an annual cap—instead, it covers cost-sharing per service. This differs from Medicare Advantage, which has an OOP maximum .
Does my health insurance or Medicare cover me internationally?
Original Medicare (Parts A & B) generally doesn’t cover care outside the U.S., with only rare exceptions. Some Medigap plans (C, D, F, G, M, N) include foreign travel emergency (typically 80% after a $250 deductible, up to $50,000 lifetime, and usually for the first 60 days of a trip). Some Medicare Advantage plans may offer limited worldwide emergency benefits—check your plan. Travel medical insurance is still recommended.
Disclaimer: Not all plans offer all these benefits. Availability of benefits and plans varies by carrier and location. Deductibles, copays and coinsurance may apply
Does STD/LTD cover mental health or pregnancy?
Yes—most STD and LTD plans include pregnancy recovery, mental health issues, elective surgeries, and common illnesses like cancer or heart conditions.
Does travel insurance cover flight delays and extra expenses?
Yes—trip delay benefits can reimburse lodging, meals, ground transport, and rebooking after delays that meet the policy’s hour threshold and covered reasons.
How affordable are hospital/medical indemnity plans?
Hospital indemnity premiums are generally low—frequently $10–$30/month—depending on coverage level, selected benefits, and whether dependents are added.
How and when do I pay for my ACA plan coverage?
You pay the insurance company directly, not the Marketplace. Your coverage won’t begin until the first premium is paid.
How are accident insurance benefits paid?
Benefits are paid directly to you and can be used however you choose—medical bills, rent, everyday expenses—without any restrictions .
How are MA networks determined?
MA plans typically use HMO or PPO networks. HMO plans restrict you to in-network providers; PPOs allow out-of-network access at higher cost.
How are Medicare Part D costs structured?
Costs include a monthly premium, a deductible (up to $590 in 2025), copayments/coinsurance, and a $2,000 annual out-of-pocket cap, under the 2025 Inflation Reduction Act.
Disclaimer: Premiums, deductibles, and cost-sharing amounts vary by plan and location.
How are pre-existing conditions handled?
Policies can exclude them unless you meet waiver rules (commonly: buy within a set days-from-deposit window, insure 100% of prepaid nonrefundable costs, and be medically able to travel at purchase). Insurers must clearly disclose any pre-existing condition exclusions.
How are premiums determined for Medigap?
Premiums depend on the insurer and pricing method (community, issue-age, attained-age), plus your location, age, gender, and smoking status.
How do hospital/medical indemnity benefit payments work?
After a covered event, you receive a fixed daily or lump-sum payment directly, which you can use for anything—deductibles, bills, living expenses, or travel for care.