Medicare Supplement – Basic Coverage

Medicare supplement insurance can help with your health care budget.

The purpose of a Medicare Supplement plan is to close gaps in Medicare. The purpose of supplement insurance is not to add on to Medicare.  Instead, Medigap policies pay your part of any hospitalization or medical treatment costs paid by Medicare.

    

Medicare supplemental insurance is not replacement insurance. It is not different medical insurance. If Medicare does not cover the hospital stay or medical treatment, neither will the Medicare supplement plan.

Medicare supplemental plans are standard. There are nine plans labeled A through N. Plans E, H, I and J are no longer available. Existing policies, however, are still continued. Each letter represents a standard level of coverage.

Standard means that each insurance company provides the same minimum coverage for that plan. regardless of the seller. They may add extra coverage, but they may not take away.

All Medicare supplemental insurance pay for the following:

  • Medicare Part A hospital co-insurance
  • Hospital coverage for 365 days after your Medicare stops paying
  • Some or all the cost for blood transfusions
  • Some or all the Medicare Part B co-insurance
  • Some or all the out-of-pocket costs for hospice care. This is true for policies issued after June 1, 2010

Medicare Supplement for Part A

Every plan pays all the Medicare Part A co-insurance amounts for the first ninety days of a benefit period. Plus, it pays for any reserve days.  After you use your reserve days, every plan pays hospital charges for 365 days. They pay only the entire Medicare approved amount.

Medicare does not pay for the first three pints of blood. All MediGap plans pay for some amount of this.

All plans, except MediGap plan A, pay the Part A deductible.

Medicare Supplement for Part B

Every plan pays some of the 20% co-insurance required by Medicare Part B.

A few plans pay for the Part B deductible.

Fewer plans pay the 15%  for charges above the Medicare approved amount.

Medicare Supplement Premiums

Medicare standardized the coverage of the MediGap plans. They did not, and do not, set the prices. Prices vary widely. Age affects the price. There are different prices for various ages.

Prices also vary state to state. The cost reflects the regional health care cost. Also, the number insurers vary by state. This affects competitive pricing. Fewer insurers means that they can charge higher prices.

Prices can still vary within the state. Often you pay a more for “brand name” insurance without getting anything extra.

Another thing you need to know: premium raises. The insurance company can raise how much they charge you (your premium). Make sure that there is a limit on premium raises. Understand the terms under which the supplemental medicare insurance premiums increase.

Next: See Medicare Supplement Plans