Medicare Supplement Plans
Understanding Medicare Supplemental Insurance Plans
Medicare supplement plans offer many options. But before you can choose, you will need to understand Medicare supplemental insurance plans and what they cover. Medicare supplement rates vary between companies but the general coverage is the same.
Understanding all the terminology used to describe Medicare Supplemental Insurance Plans is most likely the first step. Any Medicare term that has "supplement" in it is most likely referring to Medicare supplemental insurance.
Each supplemental Medicare insurance plan is delineated by a letter. Each plan letter provides the same coverage across the board with all the different private insurance companies.
Medicare supplement rates vary between companies, but the level of coverage they provide does not vary. The only difference between companies is the price, or premium, they charge. The most expensive plan through the most expensive company does not mean you will be getting more coverage.
The best time to purchase a Medicare supplemental insurance plan is within the first 6 months of your Medicare eligibility period. During this time period, the private insurance companies are obligated to accept you, even if you are considered high risk or have pre existing conditions. And you policy cannot be canceled provided you continue to pay your premiums on time.
has a great chart showing what coverage is available at each level of Medicare supplemental insurance. The first step is to understand what these terms mean. We will go through each of the Plan Letter and describe what coverage is offered.
Medicare Supplement Plans : The Basics - Plan A
All Medicare supplemental plans have the following benefits. These are considered the "base" benefits and a plan that has only the following benefits is usually has the lowest Medicare supplement rates. An easy way to remember these is that the base benefits of a Medigap policy cover coinsurance, but not deductibles.
- Medicare Part A Coinsurance: Your Medigap plan will cover your Part A coinsurance for inpatient hospital stays, but does not cover your Part A deductible, which in 2011 is $1,132. Coinsurance is the amount you pay when you are hospitilized. The basic Plan A will pay your coinsurance rates, once deductible is met and up to an additional 365 days after Part A benefits are used up.
- First 3 pints of blood: It is not uncommon for an elderly person to need blood for surgeries, trauma and even some illnesses. Without a Medicare supplement insurance plan, those 3 pints of blood could end up costing you approximately $450.00
- Part A Hospice Care Coinsurance: Your Medicare supplement plan will pick up your hospice coinsurance, or the portion you would have to pay if you didn't have a supplemental plan. This benefit is available for both inpatient hospice care and home hospice care.
- Medicare Part B Coinsurance: Part B covers physician services, outpatient therapies, ambulance, chiropractic care, XRays, labs, home health services and more. Your supplemental plan will cover your co-insurance, or the amount you owe.
- Medicare Preventive Care Part B Co-insurance: Covers the coinsurance for preventative visits, after your Part B deductible is met, including things like mammograms, diabetes screening, prostate exams and many more.
Additional Benefits to Medicare Supplement Plans
Each one of these benefits, alone or in combination with others, can be added to the basic benefits provided in Plan A to provide Medicare supplemental insurance that can meet many needs. Not all insurance companies will offer all combinations of plans, so you will still have to contact them individually and see what plans they offer than meet your individual needs.
Listed below you will find a definition of each additional benefit and also what plan letters they are included in. Understanding what the benefit is should help you determine the best Medicare supplement plan for you.
- Skilled Nursing Facility Coinsurance: This will cover your coinsurance while you are receiving skilled care in a Medicare approved nursing facility. It does not, however, cover custodial care in the same facility. This benefit is available in Plans C, D, F, G, M and N and covers a percentage of your coinsurance in plans K and L.
- Medicare Part A Deductible: This benefit will cover your Part A deductible. In 2011, that deductible is $1,132.00. Available in plans B, C, D, F, G and N. It pays a percentage in plans K, L and M.
- Medicare Part B Deductible: For 2011, your deductible will be $162.00. This benefit is available in plans C and F.
- Medicare Part B Excess Charges: Medicare only pays a set amount for certain services. If the amount owed is more than Medicare covers, it is considered an excess charge. This benefit, available in plans F and G, will cover those excess charges.
- Foreign Travel Emergency: This benefit, in plans C, D, F, G, M and N, will cover you in a foreign country during the first 60 days of your travel, after a deductible. There is an annual limit of $50,000 and you will stay have to pay 80% of charges.
Understanding Medicare Supplement Plans and the variety of benefits is important in choosing the right plan that will cover your health care needs at a cost you can afford.
Medicare supplemental insurance plans, along with standard Medicare coverage, seem to be in a state of flux right now. New laws and regulations could change what is available, and premiums can always change. Deductibles can change every year as well. The best website to keep track of all of the changes will be
Consumer Reports has a book out entitled
Complete Guide to Health Services for Seniors
, which covers not only Medicare and Medicare Supplement Plans, but also Long Term Care Insurance and other options as well.
Supplemental Medicare insurance can provide you with the peace of mind that if anything happens, you will be adequately covered and your personal finances will not be too adversely affected.
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