Medicare Supplement Insurance Explained

Medicare Supplement Insurance Plans

What you need to know about Medicare Supplement Insurance Plans: Medicare supplement plans otherwise known as Medigap plans, are policies designed to cater for certain out-of-the pocket expenses such as coinsurance, deductibles and co-payments not covered by the Original Medicare Parts A and B. For instance, if Medicare covers for 80% of your medical expenses, then the other 20% will be paid for by a Medigap.

Choosing a Medicare Supplement Plan

Most states offer 10 different types of plans, each labelled with a specific letter, ranging from A through to N, that represents a different level of coverage. Note that since 2010, Plans E, H, I and J are no longer available to new members. To access a Medigap policy, you’ll need to pay a monthly premium. Having Medicare Part A and Medicare Part B, which fund hospital services and doctor services respectively, is also a requirement. Medigaps do not work with Medicare Advantage plans. Medigap plans in most states, usually offer the same standardized benefits based on the category identified by the letter. This means that the Plan B coverage provided by an insurance company in one location, is the same one offered across several other locations. What may vary however, is the premium costs among the insurance firms. Wisconsin, Massachusetts and Minnesota are the only states that standardize their Medicare Supplement plans differently.
Although it is not a requirement for insurance companies to provide all Medigap plan types, they are legally required to provide Plan A. In case an insurance company is looking sell additional Medigap plans, then it must choose between offering Plan C or Plan F.

Plan A covers the basic benefits such as hospitalization, hospice care and medical costs; and is usually charged at a lower monthly premium.

Plan B offer the same coverage as A, in addition to Part A deductible coverage.

Plans C and F are the most popular, as they cover key areas, at the most affordable rates compared to other plans.Plan C covers all the Plan A benefits, plus Part A and Part B deductibles coverage.

It also caters to emergency care abroad and skilled nursing care.

Plan F offers everything provided in Plan C, in addition to 100% of Part B excess charges- these are charges beyond what Medicare covers. Plan F also offers a highly deductible option, which can lower your premium. Plan G covers basic benefits, Part A deductible, skilled nursing care plus additional costs such as Part B excess charges and emergency care abroad.

Plans K and L also have lower monthly fees, although unlike the other Medigap plans, they only caters to a portion of the cost of most Medicare deductibles and coinsurances, until an annual out-of-pocket maximum is attained.

Plan N provide similar basic benefits, with 100% of the Part B coinsurance and copayments of up to 20% and 50% for office and emergency room expenses respectively. It also offers coverage for skilled nursing care, Part A deductible and emergency care abroad.

If you plan to buy a Medigap plan, then your enrollment period will be six months from the first day of the month of your 65th birthday, if you have already have a Medicare Part B; otherwise it will be within six months of your Medicare Part B subscription. Medigap plans are guaranteed renewable irregardless of your health or age, as long as you pay your premiums. The best way to compare plans before you buy is to work with independent broker like Alex Wender with Bluewave Insurance Services. He has a very informative website with reviews on popular Medicare Supplement Insurance carriers.

Author: Craig Mathes

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