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Medicare Supplement Outline

Medicare Supplements

Medicare (part A) and (part B) | Medicare Outline | Medicare Supplement Quote | Glossary

Medigap Policies

     A Medigap policy is a health insurance policy sold by private insurance companies to fill "gaps" in Original Medicare Plan coverage. Medigap policies must follow federal and state laws. These laws protect you. The front of the Medigap policy must clearly identify it as "Medicare Supplement Insurance."

     In all states, except Massachusetts, Minnesota, and Wisconsin, a Medigap policy must be one of twelve standardized policies so you can compare them easily. Each policy has a different set of benefits. Two of the standardized policies may have a high deductible option. In addition, any standardized policy may be sold as a "Medicare SELECT" policy. Medicare SELECT policies usually cost less because you must use specific hospitals and, in some cases, specific doctors to get full insurance benefits from the policy. In an emergency, you may use any doctor or hospital.

Click image to view guide to Medigap Policies

 

Outline of Medicare
Supplement Coverage

(Benefit Plans A-L)

Medicare Supplement Insurance can be sold in only twelve standard plans. This chart shows the benefits included in each plan. Every company must make available Plan "A". Some plans may not be available in your state as indicated below.
  A B C D E F G H I J K L
Hospital Coinsurance
CoInsurance for days 61-90 ($248) and days 91-150 ($496) in hospital; Payment in full for 365 additional lifetime days.
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    Part B Coinsurance
    Coinsurance for Part B services, such as doctors' services, laboratory and x-ray services, durable medical equipment, and hospital outpatient services.
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    		•  50%* 75%*
    First 3 pints of blood
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    		•  50%* 75%*
    Hospital Deductible
    Covers $992 in each benefit period    		  
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    		•  50%* 75%*
    Skilled Nursing Facility(SNF) Daily CoInsurance
    Covers $124 a day for days 21-100 each benefit period.    		    
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    		•  50%* 75%*
    Part B Annual Deductible
    Covers $131.    		    
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    Part B Excess Charges Benefits
    80% or 100% of Part B excess charges. (Under federal law, the excess limit is 15% more than Medicare's approved charge when provider does not take assignment; under New York State Law, the excess limit is 5% for most services.)    		           100% 80%   100% 100%    
    Emergency Care Outside the US
    80% of emergency care costs during
    the first 60 days of each trip, after an
    annual deductible of $250, up to a
    maximum lifetime benefit of $50,000.    		    
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    At Home Recovery Benefit
    Up to $40 each visit for custodial care after an illness, injury, or surgery, up to a maximum benefit of $1,600 a year.    		      
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    Preventive Medical Care
    Up to $120 a year for non-Medicare covered physicals, preventive tests and services.    		        
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    Preventive Medical Care
    100% of coinsurance for Part B covered preventive care services after the Part B deductible has been paid.
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    Hospice Care
    Coinsurance for respite care and other Part A covered services.    		                     50%* 75%*
    Outpatient Prescription Drugs                        
    *Out-of-Pocket Maximum
    Pays 100% of Part A and B coinsurance after annual maximum has been spent.    		                     $4,000 $2,000
    Plans A-L are standardized by the federal government. Not all plans may be available in your area. Consider the benefits offered by each plan and look for one that best meets your individual needs.

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    Further Information

    If you have any questions about medicare, medicare supplements or would just like further information, please contact us here.

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