If you want to supplement your Medicare Part A (hospital care) and Medicare Part B (medical care) coverage, you may be able to buy a supplemental insurance plan from a private insurance company. Medicare Supplement (also called Medigap) insurance plans may include basic benefits such as copayments, coinsurance, and deductibles not covered by Original Medicare (Part A and Part B). You will have to pay a monthly Medicare Supplement premium out-of-pocket in addition to your Medicare Part B premium. Medicare will not pay any of the costs of your Medicare Supplement insurance plan.
A Medicare Supplement insurance plan is meant to work alongside Medicare Part A and Part B, not replace them. If you have Original Medicare and a Medicare Supplement insurance plan, generally Medicare will pay its share of Medicare-approved amounts for covered health-care costs and then your Medicare Supplement insurance plan will pay its share.
Keep in mind that:
Medicare Supplement insurance plans are standardized, meaning that all insurance companies must offer the same benefits for the same plan. Up to 10 plans, labeled A, B, C*, D, F*, G, K, L, M, and N, are offered in most states (not Massachusetts, Minnesota or Wisconsin – they have their own standardized plans). Keep in mind that the same insurance plan sold by different companies may have different costs.
If an insurance company offers any Medicare Supplement insurance plan, it must make Plan A available. Plans E, H, I, and J are no longer sold.
Basic benefits for all ten standardized Medicare Supplement insurance plans generally include Medicare Part A coinsurance and hospital costs at 100% (up to an additional 365 days after Medicare benefits are used up). Beyond this one benefit, basic benefits related to Medicare out-of-pocket costs vary among plans. All ten standardized insurance plans may pay for at least part of Medicare Part B coinsurance, the first three pints of blood for a medical procedure, and Part A hospice care coinsurance. Plans A, B, C*, D, F*, G, M and N may pay these three benefits at 100%. Plan K may pay them at 50% and Plan L may pay them at 75%. There are five other basic benefits that some plans include and some do not. These benefits are: skilled nursing facility care coinsurance, Part A deductible, Part B deductible*, Part B excess charges, and foreign travel emergencies (80% up to plan limits).
*Medicare Supplement insurance plans that may cover the Medicare Part B deductible will eventually be discontinued. This change affects Plans C and F (including high-deductible Plan F). You won’t be able to buy Plan C or Plan F if you qualified for Medicare on January 1, 2020 or later. You don’t have to give up Plan C or Plan F if you already have one. If you qualified for Medicare by the end of 2019, you may be able to buy one of these plans.
Medicare Supplement Plan G is very similar to Plan F and has almost as many benefits. A high-deductible Plan G is also now available. Plan F also has a high-deductible version.
In general, Medicare Supplement insurance plan basic benefits do not include routine dental or vision care, long-term care in a nursing home, hearing aids, eyeglasses, or private-duty nursing. However, some plans might include such additional benefits. Medicare Supplement insurance plans sold currently don’t include prescription drug coverage. If you need prescription drug coverage, you may want to enroll in a prescription drug plan through Medicare Part D.
Another type of Medicare Supplement insurance plan is Medicare SELECT. Medicare SELECT insurance plans might cost less than other plans but may limit you to in-network providers.
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What Are Medicare Supplement Plans?
What are the Basic Benefits of Medicare Supplemental Insurance Plans?
You can choose from a number of Medicare Supplement plans, and each plan is required to offer certain standardized, basic benefits. These standardized, basic benefits remain the same no matter the insurance company.
Standardized, basic benefits that must be covered to an extent include:
Why Should You Consider Medicare Supplement Plans?
Supplemental insurance plans allow you to receive private health insurance benefits outside of the federally regulated Medicare plans.
Supplemental insurance plans also open up the opportunity for sicker patients to have a larger amount of their medical expenses covered. Unexpected and regular out-of-pocket expenses can add up quickly. Having supplemental insurance offers a safety net to help keep these expenses from becoming lifelong, major debt.
What Types of Medicare Supplement Plans are Available?
Medicare Supplement Plan A
Not to be mistaken with Medicare Part A, Medicare Plan A covers fewer out-of-pocket expenses than any other supplement plan. Medicare Part A only covers the required basic benefits listed previously.
What coverage does Medicare Plan A offer?
Medicare Part A does not cover:
Medicare Supplement Plan B
Not to be mistaken with Medicare Part B, this plan covers the same costs as Plan A, as well as hospital deductibles associated with Medicare Part A.
What coverage does Medicare Plan B offer?
Medicare Plan B does not cover:
Medicare Supplement Plan C
Plan C covers the majority of expenses not covered by Original Medicare, and it is among the more popular of plans. Note that Plan C is not the same as Medicare Part C.
Looking for Medicare Supplement plans in 2020? Unfortunately, Plan C is one of the two plans that will be going away for new enrollees in 2020. If you are already enrolled in Plan C, you will not be kicked off your plan. If you were eligible for Medicare Part A before 2020, you will also still have the option to enroll in Plan C later.
What coverage does Medicare Plan C offer?
Medicare Plan C does not cover:
Medicare Supplement Plan D
Plan D covers the majority of what Medicare doesn’t, except Part B excess charges and the Part B deductible. Medicare Plan D can best be compared to other benefit-heavy plans, such as Plans D, F and G. Plan D should not be confused with Medicare Part D.
What coverage does Medicare Plan D offer?
Medicare Plan D does not cover:
Medicare Supplement Plan F
Plan F is the most popular plan because it covers all of the costs Medicare does not. Starting in 2020, Plan F, like Plan C, will no longer be available to new beneficiaries.
If you are already enrolled in Plan F, you will not be kicked off your plan. Also, if you were eligible for Medicare Part A before 2020, you will still have the option to enroll in Plan F later.
What coverage does Medicare Plan F offer?
Medicare Supplement Plan G
Plan G covers all additional expenses Medicare does not, except for the deductible paid by Part B beneficiaries.
What coverage does Medicare Plan G offer?
Medicare Supplement Plan K
Plan K is one of two less popular plans (including Plan L) that cover a percentage of certain benefits.
What coverage does Medicare Plan K offer?
Costs 50% covered by Plan K:
Medicare Plan K does not cover:
Medicare Supplement Plan L
Plan L, like Plan K, covers a certain amount of the cost of specific benefits.
What coverage does Medicare Plan L offer?
Costs 75% covered by Plan L:
Medicare Supplement Plan M
Plan M is different from Plans L and K in that it fully covers more out-of-pocket costs. It is similar because it also covers a percentage of one expense.
What coverage does Medicare Plan M offer?
Medicare Plan M does not cover:
Medicare Supplement Plan N
The popularity of Plan N has risen so far in 2020 and is expected to become even more popular. The popularity of this plan is in part due to low monthly premiums and sought-after benefits.
What coverage does Medicare Plan N offer?
Medicare Plan N does not cover:
How Much Do Medicare Supplement Plans Cost?
The cost of Medicare supplemental insurance can vary. What you will pay in monthly premiums, deductibles and out-of-pocket expenses depend on many factors, including location, plan rating, what insurance company the plan is offered through, as well as what costs are covered by the plan.
*Medigap Plan J was discontinued for new enrollees in 2010. Only beneficiaries who enrolled in the plan prior to that time may be currently enrolled in Plan J.
Chart courtesy of www.medicareadvantage.com
Medicare Supplement plans can help reduce your out-of-pocket expenses and keep your health care coverage affordable. It’s important for you to study all of the plans available to you and to research the insurance company selling those plans so you can make the best decision for your health and wallet.
What does a Medicare supplement cover quizlet?
Medicare supplement, or Medigap, policies pick up coverage where Medicare leaves off. These policies supplement Medicare's benefits by paying most, if not all, coinsurance amounts and deductibles and paying for some health care services not covered by Medicare, such as outpatient prescription drugs.
What is Medicare Advantage quizlet?
A Medicare Advantage Plan (like an HMO or PPO). If you join a Medicare Advantage Plan, the plan will provide all of your Part A (Hospital Insurance) and Part B (Medical Insurance) coverage. Medicare Advantage Plans may offer extra coverage, such as vision, hearing, dental, and/or health and wellness programs.
Is Medicare supplement the same as Medicare Advantage?
There are two options commonly used to replace or supplement Original Medicare. One option, called Medicare Advantage plans, are an alternative way to get Original Medicare. The other option, Medicare Supplement (or Medigap) insurance plans work alongside your Original Medicare coverage.