Medicare Supplement resource Guide

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Medicare Supplement Insurance Plans

As complicated as Medicare and Medicare Supplements are, Medicare Supplement plans were designed to be as easy as possible for consumers to

  • Decide what coverage they want, and
  • Compare prices between companies

Medicare supplement plans are standardized with letter designations from A-N. (Note that as of June 1, 2010, plans E, H, I and J will no longer be available for purchase). Think of each plan as a different “package” of benefits that are standardized by federal law. For example, any insurance company selling Plan A must include the same package of benefits as dictated by the Medicare department.

 While there are multiple plan types available, there are usually 2-5 plans that will fit best for your personal needs. Plan F is generally most popular plan on the market because of its comprehensive coverage of deductible, coinsurance, co-pay, and excess charges.

Basic Benefits
All Medicare Supplement plans provide these basic benefits:

Hospitalization (Part A Co-Insurance)
  • Daily co-payments for hospitalization expenses from the 61st through the 90th day of any Medicare benefit period
  • Medicare Part A co-payments for any hospital stay beyond the 90th day in a benefit period, up to an additional 60 days during your lifetime. (These are your inpatient reserve days. You may use these days when you require more than 90 days in the hospital during a benefit period. When you use a reserve day, it is subtracted from your lifetime total and cannot be used again.)
  • All Medicare-eligible hospital charges for a period of up to 365 additional days during your lifetime after you have exhausted all your Medicare hospital benefits.

Hospice Care

  • Part A co-insurance or co-payment
  • Outpatient prescription drug and inpatient respite care coinsurance

Blood
  • The reasonable cost of the first three pints of blood, or their equivalent, under Medicare parts A and B.

Part B Co-Insurance
  • 20% of the Part B coinsurance you pay for Medicare-eligible expenses for medical services - including doctor bills, hospital or home health care, and specified higher payments for certain services under the prospective payment system - after you have met your Part B deductible.

Additional Benefits
In addition to the basic benefits, the following can also be covered under your Medicare Supplement:

Skilled Nursing Facility Care Coinsurance:

  • Skilled Nursing Facility care covered by Medicare is a Medicare Supplement benefit
  • Medicare Supplement covers billed charges up to your co-insurance amount from the 21st day through the 100th day for post-hospital skilled nursing facility care eligible under Part A.
  • Note that Skilled Nursing provides medical care in addition to residence. It is not the same as Nursing Home expenses, which are not covered under Medicare. The distinction is based primarily on whether skilled medical or nursing care or rehab services is needed.

Medicare Part A Deductible:

  • Pays the entire Medicare Part A deductible amount per benefit period.

Medicare Part B Deductible:

  • Pays the entire Medicare Part B deductible amount per calendar year.

Medicare Part B Excess Charges:

  • Pays 80% or 100% of the excess fees, which are limited by law to 15% above the Medicare-approved amount. If most of your doctors take Medicare assignment, you may not need this benefit.

Foreign Travel Emergency:

  • Pays 80% of the billed charges for foreign emergency care
  • Covers only expenses that would have been covered by Medicare if it was provided in U.S. (for example, cosmetic or dental procedures are not subject to reimbursement).
  • There is a $250 calendar year deductible on the benefit, along with a $50,000 lifetime maximum benefit

Medicare Preventive Care Part B Coinsurance:

  • Includes an annual physical examination, certain lab tests, and other preventive measures deemed appropriate by your physician. The maximum benefit is $120 per year. These services are beyond other Medicare covered preventive services.

In addition to Plans A-N, there are two additional varieties of Medicare Supplement plans: High-Deductible Medigap Plans and Medicare SELECT Plans.

Important News regarding
June 2010 Update
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