Medicare Supplement Plans and Coverage
Medicare supplement insurance plans are the gap insurance policies that are not sold by the government but by private insurance carriers, and these plans are regulated by state insurance regulators. A Medicare supplement plan helps you in paying some part of the costs from your own traditional Medicare (both A & B), that includes the coinsurance, co-payments as well as deductibles. In most states, plans consist of 10 letters (A-N) are there. Every plan provides separate coverage.
To understand these insurance plans , and how it saves you from large medical bills, there is also a need for you to understand how it works with and affects your Medicare benefits. This is a simple chart that explains Medicare Supplement plan coverage in an easy to read manner.
Medicare Supplement Plans Comparison Chart
The following chart gives you the opportunity to compare the Medicare supplement plans and also their benefits provided.
Fast Facts About Medicare Supplement Policies
Every plan has its own basic benefits like a Plan A policy that is sold in California by Casper, will have similar benefits as compared to a Plan A sold in Florida by Eva. All of these plans usually have similar coverage at the basic level, that includes Medicare (A & B) coinsurance coverage, blood testing, and any other hospital perks. In many areas, you can buy a different supplement policy that is known as Medicare SELECT. All these policies usually follow a standard of regular Medicare Supplement plans. The only difference here is that the provider needs you to use their own network providers. This benefit significantly saves costs on your monthly premium.
Expenses Covered by Part A:
- Hospital stays: These plans provide the coinsurance amount on hospital costs, for an extra 1 year after your hospital benefits related to Medicare are finished.
- Hospice care: Medicare supplement plans cover up to 50-100 % of all of your coinsurance as well as copayments, for Part A hospice care expenses, as per the option of the place that you decide.
- Medicare Part A deductible: Plan A usually does not cover all the deductible.
Expenses Covered by Part B:
- Coinsurance or Copayment: They cover up to 50-100% of Part B expense amounts (depending on the plan).
- Medicare Part B deductible: The two Plans (C & F) cover the deductible, these are the most popular plans.
- Part B excess charges: Whenever a healthcare provider doesn’t accept Medicare’s “assignment” for a doctor visit, Part B excess coverage is incurred.
Foreign Travel Coverage
Medicare coverage is available in the USA only. That is the only reason that some of the Medicare supplement plans provide coverage to foreign travel emergencies.
Your Medicare plan pays for blood until you need more than the third pint. Most of the hospitals get blood at no cost. But, in any case, if a hospital has to buy any additional blood for you, you have to pay extra. Mostly all Medicare supplement plans cover 100% of the expense of the first 3 pints of blood.
These are healthcare facilities providing short-term and long-term care for individuals with critical conditions that can never be managed at home. While coinsurance for skilled nursing care is not covered by Plans A or B, all other plans cover 50 to 100 percent of these costs.
Medicare Supplement Plan does not cover:
The following are the services that are not covered by your own Original Medicare or Medicare Advantage coverage:
Long-term hospital care
- Private-duty nursing care
- Hearing aid devices
- Vision-related issues
- Usual dental care
How does Medicare Supplement Plans and Medicare Work Together?
These are designed to work with your Original Medicare benefits. Medicare plans just pay a portion of it. The most important thing is, if your own Medicare is unable to cover any service then your Medicare Supplement plan won’t cover it as well. Foreign travel healthcare coverage is the only exception to this rule.
Protecting from Medical Bills
The main theme behind these supplemental Medicare plans is the protection from large medical care bills due during or other medical emergencies. For example, if you have an accident and you have to be carried to the hospital by ambulance, then you have to be admitted into the hospital. This process uses both Medicare Part A as well as Medicare Part B coverage.
Eligibility for Medicare Supplement Insurance:
Basically, this is health insurance that is usually sold by private companies, in order to cover the things lacking in your Original Medicare. All of these supplements the normal Medicare coverage (A & B). Therefore, you need to qualify for both Parts (A & B) to be eligible for supplemental coverage. Your age is also one of the qualifying factors.
Medicare Supplement Plans for disabled persons:
If you have any disability and qualify for Medicare benefits for this, you can also buy Medicare supplement insurance. Every state has a specific board of insurance that is regulating the purchase and sale of these insurance policies. Federal law is also established nation-wide for Medicare policy.
Medicare Supplement Plans vs Medicare Advantage
While purchasing a Medicare plan, most people are needed to know that there is a difference between Medicare supplements and Medicare advantage plans. These are very different things, however, they protect you from the high cost of illness or hospitalization charges. Following are some prominent differences:
- Medicare Advantage plan replaces your own Medicare expenses with care. This may include services that you need that Medicare does not cover
- Medicare Supplement insurance covers up the remaining things in your own Medicare coverage and works on it. One must purchase these for prescriptions, hearing, vision, and hearing.
Another basic difference is that with a Medicare supplement, you usually pay the amount in advance, even without any medical services. But with Medicare Advantage, you only pay at the point of service. Sometimes these both are not compatible with each other. In very few cases, you may be eligible to purchase a Medicare Advantage Plan and can be enrolled in a Medicare Supplement Plan .
You can also buy a supplemental policy when:
- You disenroll out of the services from your Medicare Advantage plan
- You have to leave a plan due to being misled or broken rules
- Stoppage of services by your own Medicare Advantage plan in your area
Medicare Supplement VS Medicaid:
Medicare and Medicaid benefits are not the same. Therefore, receiving Medicaid does not make you eligible for having a Medicare supplement plan. But, if you are qualified for both, there is no reason to get a Medicare Supplement plan. Medicaid covers the gaps in normal Medicare for those who are eligible for both.
Changing supplement plans:
Follow these steps in order to change your supplement plan if you need to do so:
Contact the new company that is selling you the plan and complete the application of the new company
- In case of acceptance of application, contact your current insurance company and find out how to end coverage.
Cost of Medicare Supplement Plans:
The cost of the plans is of primary concern for comparing Medicare supplement plans. Payments are dependent on the plan that you choose as well as the insurance company you are contracted with.
Pros and Cons of Medigap Plans:
Following are the reasons that people purchase it:
- Freedom – in choosing healthcare providers
- Better coverage (for both coinsurance and coinsurance)
- Traveling coverage
Many carriers offer plans. It’s important to compare the plans before purchasing. Make sure that you are comparing the same plane from different companies.
Prescriptions and Medicare Supplement Plans:
Prescription drug coverage can be obtained via Medicare in one of two ways:
- Buy a Medicare Part D Plan (PDP) plan
- Get enrolled in any Medicare Advantage Plan that includes Part D plan.
Options other than Prescription Drug Coverage:
These are the other options:
- Keep the insurance supplement and also buy a Medicare plan that you need
- Cancel the Medigap plan and then receive coverage via Medicare Advantage plan
Saving money with a Medicare Supplement:
The premiums of these supplement plans are increasing continuously. The increases have changes brought about by the Affordable Care Act. Consequently, many people ask what are the ways that they can save money on the purchase of supplement plans.
These policies cover the gap in your Medicare insurance. Basically, the rule is, if you have paid your deductible, Medicare has to cover up to 80% of the remaining charges.
Choosing your Plan:
This is easy to save some money on coinsurance and is very smart. It’s also significant to understand the expenses and benefits regarding the supplemental Medicare policy fully. The best plan is dependent on your medical needs, a budget. You can’t buy extra insurance than they can afford. Likewise, you can’t put all of your savings at risk of not getting proper coverage in the event that you need to be hospitalized. So do your homework and choose wisely.
Standardized Medicare Supplement Plan Benefits:
By law, all of the Medicare Insurance policies are required to provide some basic benefits of coverage. These all include most Medicare (A & B) coinsurance amounts, blood, and any other hospital perks that do not get coverage by Original Medicare.
- Part A
- 61-90 days of stay at the hospital
- 91-150 days of a hospital stay
- Additional Hospital Benefits
- An additional 1 year of hospital care than your own Medicare benefit offered by your hospital
- Part B Coinsurance
- Covers for coinsurance of Part B
Getting a Medicare Supplement Plan:
These plans are policies of supplemental insurance that are bought via insurance carriers that have licenses from the government. The initial step is to shop for policies that are available in your state. Be a smart senior and look around and compare your plan yearly to make sure that you’re still paying a good rate.
You can purchase a policy from any of the licensed agents, otherwise, you can also directly purchase from the insurance carriers. Moreover, independent agents can also help you in comparing the different policies offered by different carriers.
Frequently Asked Questions About Medicare Supplement Plans
The Best Supplement Plan for This Year:
In the case of the most coverage, the Medigap Plan F is the best. However, there are other factors that should be taken into consideration which include financial status and health. Most healthy individuals can afford to take a bit of risk. In this case, the Medigap Plan N is the best way for saving your money. but, if you are over the age of 65 this year, Medigap Plan G is the plan that you should get.
The Most Cost Effective Medicare Supplement Plan:
Medigap Plan F is the best comprehensive plan, but it might not be the best in cost-effectiveness. Plan F covers Medicare deductibles and all the coinsurance, which means that you don’t need to pay anything out of pocket. However, many healthy individuals think that they save more via a Medigap Plan N policy.
Differences in Medicare Supplement Plans:
The main differences between Medicare Supplement plans are the gaps that they cover. With Original Medicare (both A & B) you usually pay various deductibles, copays, and coinsurances while using your health care services. These costs usually add to about 20% of the total cost. That’s good for 1-2 doctor visits every year but not for hospitalization.