Understanding the Medigap trap is crucial for long-term healthcare planning. In the Medicare Advantage model, you save money when you are healthy, but face a “trap” if you become ill and want to switch to the more predictable original Medicare/Medigap model, only to find you no longer qualify for Medigap coverage due to your health.
For a healthy 65-year-old, Medicare Advantage looks like a win. You save $2,000+ per year in Part D and Medigap premiums and get “free” dental and vision care. However, if you develop a chronic condition, such as cancer or heart disease, at age 72, you may suddenly be drowning in costly copays that add up.
When you try to switch to Medigap to stop those bills, the insurance company “underwrites” you. Because of your diagnosis, they can legally deny your application, leaving you stuck in the higher-cost plan.
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You’ll want to know those rules as you navigate Medicare. Don’t worry if you miss an answer; you can follow the links below the quiz to brush up on your knowledge.