Medicare Supplement
What are Medicare Supplements
Medicare in general is a health insurance system established by the US Government. Its purpose is to aid US citizens in paying the costs of their healthcare.
Medicare is broken up into 4 categories:
- Medicare Part A
- Medicare Part B
- Medicare Part C
- Medicare Part D
Medicare Supplements are also referred to as Medigap Plans. These plans are sold by private insurance companies and their purpose is to help offset some of the costs that Original Medicare does not cover. Some of these costs include:
- Deductibles
- Co pays
- Coinsurance
Medicare Supplements are generally categorized by the following letter: A, B, C, D, F, F*, G, K, L, M and N. In this way all Medigap companies cover the exact same benefits under each of these letter categories.
What is covered under Medicare Supplements
Medigap Plans or Medicare Supplements cover all of your Medicare Part A and Medicare Part B services. Please refer to Medicare Part A and Medicare Part B for a list of covered services. Here is a general list of what is covered: (these are a list of general services and is not an all inclusive list)
- Hospital care
- Skilled Nursing Facility Care
- Hospice
- Home Health Services
- Doctors Services
- Durable Medical Equipment
- Emergency Room Services
- Laboratory Services
- Chemotherapy
- Diabetes Supplies
- Prosthetics
- Ambulance Services
- Ambulatory Surgical Centers
- Blood
- Rehabilitative Therapies
Some Medicare Supplements also cover services that Original Medicare does NOT cover such as travel while outside of the U.S.
What is NOT covered under Medicare Part A
When it comes to Medicare Supplements, generally speaking, anything that is covered under Medicare Part A and Medicare Part B is covered by Medigap Plans. Usually Medigap policies don’t cover the following services:
- Long-Term Care
- Vision
- Dental Care
- Hearing Aids
- Eyeglasses
- Private-Duty Nursing
How do I qualify for Medicare Supplements
There are several different ways you can qualify for Medicare. The most common requirement is if you are a US citizen and you are 65 or older. However, being a US citizen age 65 or older is not the only way you can qualify to receive Medicare benefits. You may also qualify to receive Medicare benefits if you are under the age of 65 if you meet certain requirements. Certain disabilities, permanent kidney failure and other conditions can also make you eligible for Medicare benefits. You can always call your local Social Security administration if you need further assistance with Medicare Eligibility.
As it pertains to Medicare Supplements, you can enroll into a Medicare Supplement if you are enrolled in Medicare Part A and Medicare Part B and you live in the plans service area.
How much do Medicare Supplements cost
The cost of Medicare Supplements varies from company to company and also from region to region. One insurance company may charge $800 more than the next company for the exact same plan. This is why if you are leaning towards a Medigap Plan it is very important to shop around. If you pay $800 more for the same exact plan you don’t get any extra benefits for the $800 they are literally the same plan.
With a Medigap Plan you will pay a monthly premium for that plan. You will also continue to pay your Medicare Part B premium and your Medicare Part A premium if you have one. You will also need to get a Medicare Part D Plan for your Prescription Drug coverage to avoid any penalties if you don’t already have Part D coverage.
What you can expect to pay for services while on Medicare Supplements
The following chart is a list of the different Medicare Supplements available. On this chart you will see the amount the company pays for services leaving the remaining percentage your responsibility.
| Benefits | A | B | C | D | F* | G | K | L | M | N |
|---|---|---|---|---|---|---|---|---|---|---|
|
Medicare Part A Coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up |
100% |
100% |
100% |
100% |
100% |
100% |
100% |
100% |
100% |
100% |
|
Medicare Part B Coinsurance or Copayment |
100% |
100% |
100% |
100% |
100% |
100% |
50% |
75% |
100% |
100%*** |
|
Blood (First 3 Pints)
|
100% |
100% |
100% |
100% |
100% |
100% |
50% |
75% |
100% |
100% |
|
Part A Hospice Care Coinsurance or Copayment |
100% |
100% |
100% |
100% |
100% |
100% |
50% |
75% |
100% |
100% |
|
Skilled Nursing Facility Care Coinsurance |
|
|
100% |
100% |
100% |
100% |
50% |
75% |
100% |
100% |
|
Medicare Part A Deductible |
|
100% |
100% |
100% |
100% |
100% |
50% |
75% |
50% |
100% |
|
Medicare Part B Deductible |
|
|
100% |
|
100% |
|
|
|
|
|
|
Medicare Part B Excess Charges |
|
|
|
|
100% |
100% |
|
|
|
|
|
Foreign Travel Emergency (Up to Plan Limits) |
|
|
100% |
100% |
100% |
100% |
|
|
* Plans F and G also offer a high-deductible plan in some states. With this option, you must pay for Medicare-covered costs (coinsurance, copayments, and deductibles) up to the deductible amount of $2,340 in 2020 before your policy pays anything. (Plans C and F aren’t available to people who are newly eligible for Medicare on or after January 1, 2020.)
** For Plans K and L, after you meet your out-of-pocket yearly limit and your yearly Part B deductible ($198 in 2020), the Medigap plan pays 100% of covered services for the rest of the calendar year.
*** Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don’t result in inpatient admission.
