Medicare Supplement Plan Benefits

There are many reasons to consider a Medicare Supplemental insurance plan, and you will ultimately weigh the benefits versus the premium costs involved with maintaining this supplemental coverage.  We will review some of the benefits of Medigap plans, while also providing further information on the costs of Medigap coverage.

Buying a Medicare Supplement plan is entirely a personal decision, where you weigh the potential benefits versus the expected cost. It is 100% optional. Like any insurance purchase, you are at some level buying peace of mind when deciding whether or not to add to your Original Medicare coverage. Certainly, there are expected costs that Medicare Supplements will cover. These include the Part A and Part B deductibles, which are more or less priced into your Medigap premiums. Thus, Part A and Part B deductibles shouldn’t be the primary motivation for purchasing a Medigap plan. The primary rationale for a Medicare Supplement plan is to cover unexpected medical expenses that go beyond deductible payments.

Basic Benefits of Medicare Supplemental Insurance
The following basic Medicare Supplement benefits are shared across all 14 Medigap plans (Plans A-N):

• Hospitalization: Medicare Part A coinsurance plus coverage for 365 additional days after Medicare benefits end.
• Medical expenses: Medicare Part B co-payments and co-insurance (generally 20% of Medicare-approved expenses), and co-payments for hospital outpatient services.
• Blood: First 3 pints of blood each year.
• Hospice Part A: outpatient prescription drug and inpatient respite care coinsurance. Plan K will cover 50% of the costs and Plan L will cover 75% of these costs. (This is a new basic benefit as of June 1, 2010)

While each of the Medigap plans cover these basic benefits, each are not covered at the same percentages. So please be sure to consult with an agent or review the detailed plan summary for a statement of coverage.

Other Medicare Supplement Benefits
On top of the basic benefits listed above, the different Medigap plan types cover most of the following costs listed below.

• Part A Deductible
• Part B Deductible
• Part B Excess Doctor Charges
• At Home Recovery
• Pays for doctor-approved, short-term, at-home assistance with activities of daily living while recovering from an illness, injury or surgery.
• Preventative Medical Care
• Covers the portion not covered by Medicare
• Includes an annual physical examination, lab tests and other preventive measures determined by your physician but not covered by Medicare. The maximum annual benefit is $120.
• Skilled Nursing Facility Care
• Foreign Travel Emergency
• Covers treatments while you are traveling that would have been covered under Original Medicare had they occurred in the United States.

How the different plans treat these expenses is how Plans A-N different from each other. Our Overview of Medigap Plan Types section provides information on the differences between the available plans.