A
Medicare Supplement Insurance (Medigap) policy helps pay some of the health
care costs that Original Medicare doesn't cover, like:
·
Copayments
·
Coinsurance
·
Deductibles
Medigap policies are sold by private
companies.
It is very important to pay
attention to various rules that apply to Medicare Supplement eligibility and
enrollment. I have quite a few videos on this channel about Medicare supplement
enrollment times, as well as important things to know about these plans, so
please feel free to check it out.
Also, I have to mention this –
Medicare supplements no longer cover prescription drugs. So, Individuals
who are enrolled in Medigap plans may only obtain Medicare drug coverage (Part
D) through a stand-alone prescription drug plan.
Most
Medigap plans pay for some or all of the following costs:
Part
A
- Part A Coinsurance and Hospital Benefits
- Part A Deductible
- Coverage for 365 Additional Hospital Days when Medicare coverage ends
- Hospice Care Coinsurance or Copayment
- Skilled Nursing Facility Care Coinsurance
Part
B
- Part B Coinsurance or Copayment
- Part B Deductible (some plans still cover it)
- Part B Excess Charges
- Blood (First 3 pints) (also under part A)
Other
- Foreign Travel Emergency not covered by Medicare
- Non-Medicare-covered Preventive Services
Now, it is important to note that
Medigap policies are standardized
Every Medigap policy must follow
federal and state laws designed to protect you, and it must be clearly
identified as "Medicare Supplement Insurance." Insurance companies
can sell you only a "standardized" policy identified in most states
by letters.
All
policies offer the same basic benefits but
some offer additional benefits, so you can choose which one meets your needs.
The Medigap policy
covers coinsurance only
after you've paid the deductible (unless
the Medigap policy also pays the deductible).
Very often my clients ask me to explain the difference
between all those plan letters. The best way to understand them is by comparing
side by side. So let’s go over various plans and benefits:
There are 10 different Medigap
policies, and each one comes with standard benefits across the nation. The
exceptions to this rule are Massachusetts, Minnesota, and Wisconsin, which
standardize Medigap policies differently.
In order to buy a Medicare
Supplement plan, you must also have Original Medicare. This
includes Part A and Part B.
You can buy a Medigap policy from
any private insurance company that’s insured in your state. Not all insurance
providers offer every Medicare Supplement plan, but every health care provider
who accepts Medicare must also accept your Medigap policy.
How To Find the Least Expensive Medicare Supplement Insurance
While the 10 Medigap policies feature standard benefits in 47
states, the costs for these plans can vary substantially. That’s because each
insurance company establishes its own premiums and pricing structure. Factors
such as gender, tobacco usage, and marital status typically affect rates.
Now, remember the least expensive time to buy a Medigap policy is as
soon as you’re eligible. Your Medigap open enrollment period starts when you
turn 65. During this six-month period, Medigap policies do not
require health underwriting. This also means that you will not pay more than
you should for you Medicare Supplement in certain cases.
So, let’s start comparing these plans:
·
First, we will take a look at Medicare Part A coinsurance and
hospital costs. As you can see all of the plans cover Medicare Part A
coinsurance and hospital costs up to an additional 365 days after Medicare
benefits are exhausted
§ Medicare Part B Coinsurance or Copayment: Generally, Medicare pays 80% of these costs. All plans
pay for some or all of the remaining 20% as indicated on the comparison chart.
§ Blood, First Three Pints: All
plans pay for some or all of the fist three pints as indicated on the
Comparison Chart. Medicare pays 100% of any additional blood needed.
§ Part A Hospice Care Coinsurance or Copayments: All plans pay for some or all of the Medicare
copayment or coinsurance as indicated on the Comparison Chart. Medicare
pays for all remaining approved hospice care costs.
§ Skilled Nursing Facility Care Coinsurance: Medicare pays all of the first 20 days. Then it pays a fixed amount per day of the
21st through the 100th day of approved costs. Medicare pays nothing after the
100th day. The plans pay all, some or none of the first 100 days
deductibles or copays as indicated on the Comparison Chart.
§ Part A Deductible: This
is a hospital stay deductible. The plans pay for all, some, or none of
the deductible as shown on the Comparison Chart.
Part B Deductible: This is a yearly deductible you must pay before
receiving any covered Part B benefits like doctor visits and most other
outpatient services. Now, I want to mention One more thing which
is very, very important for individuals newly eligible to Medicare, the Part B
deductible will no longer be covered by the Medicare Supplement Insurance
starting with year 2020. Therefore, Plans C and F will no longer be an option
for newly eligible individuals starting January 1, 2020. However,
individuals who already have Plans C and F will be able to keep their current
versions of the plans and individuals eligible for Medicare prior to January 1,
2020, can purchase the current version of Plans C and F on or after January 1,
2020.
§ Part B Excess Charges: This
is an amount that a health care provider is allowed to charge above
the Medicare approved amount. Only Plans F and G pay this
benefit as shown on the Comparison Chart.
§ Foreign Travel Emergency: This is medically necessary emergency care not covered by
Medicare. The benefit is generally 80% and has a lifetime maximum with a $250
deductible.
Although
these supplemental plans can offer more comprehensive coverage than Medicare
Parts A and B alone, they generally don't cover long-term care, vision or
dental care, hearing aids, eyeglasses, or private-duty nursing.
Please
make sure to watch my upcoming video where I compare various Medicare
Supplement Plans and Costs.
Comments
Post a Comment