Medigap Health Insurance Plans
The 12 supplemental insurance policies assisting with costs not dealt with with the Original Medicare Plan are called Medigap or Medicare supplement insurance. These plans are all required to deliver certain basic benefits.
The twelve plans are delineated by letters A through L. Each one extends a different list of benefits targeted at filling “gaps” in Medicare insurance coverage. They’re each priced appropriately. Medicare supplement Plans K and L are complementary to the basic benefits offered in Plans A and J, nonetheless, the plans come at a decreased monthly premium but with raised out-of-pocket expenses.
Medicare supplement Plans F and J can be offered with a “high-deductible choice.” Should you decide to select these plans, you’ll be susceptible to a $2,000 insurance deductible in 2009. This deductible has to be paid prior to the plan covering any costs whatsoever. The amount of the deductible on these plans aren’t fixed and, thus, can rise annually. Your premium itself is lower, but your out-of-pocket fee will be much higher.
Take note: Medicare SELECT is really a Medicare supplemental health insurance policy presented in addition to the twelve regular A-L plans. SELECT normally is cheaper compared to standard A-L insurance policies. You’ll find limits to SELECT, nonetheless, like which physicians and hospitals you can use. If you want to learn more about which Medicare SELECT insurance policies are available in your community, contact your state insurance department.
Do you think you’re in a Medicare Advantage Plan today? (Medicare Health Maintenance Organization HMO is a Medicare Advantage Plan.) If you do, you no longer need a Medigap plan.
People of Massachusetts, Minnesota, and Wisconsin have different normal Medigap plans from which to choose.
Covered by Plans A-J:
• Medicare Part A copayments plus insurance coverage for 365 additional days after Medicare benefits end
• Medicare Part B coinsurance (generally 20 percent of Medicare-approved expenses), or copayments for outpatient services
• 1st 3 pints of blood on a yearly basis
Covered by Plan K:
Medicare Part A coinsurance plus coverage for 365 more days after Medicare benefits expire
• 50 percent of hospice expense-sharing
• 50 percent for the 1st three pints of blood each year
• 50 percent Medicare Part B copayments, except 100 % coinsurance for Part B preventive services
Insured by Medigap Plan L:
Medicare Part A copayments plus insurance coverage for 365 more days after Medicare benefits end
• 75 % of hospice expense-sharing
• 75 percent for the first three pints of blood annually
• 75 % Medicare Part B coinsurance, except 100 % coinsurance for Part B preventive services
Medicare Part A Hospital Deductible
Paid for by Medigap Plans B-J:
$1,068 in 2009 for each benefit period for hospital services
Insured by Plan K:
50 percent of the $1,068 Part A hospital deductible
Paid for by Plan L:
75 percent of the $1,068 Part A hospital insurance deductible
Skilled Nursing-Home Costs
Paid for by Medigap Plan C-J:
Your expense ($133.50 in 2009) for the days 21 through 100 in a skilled nursing home
Paid for by Plan K:
50 percent of $133.50 for days 21 through 100 in a skilled nursing home
Covered by Medigap Plan L:
75 % of $133.50 for days 21 through 100 in a skilled nursing home
Medicare Part B Insurance deductible
Insured by Medigap Plans C, F, J:
Yearly deductible for physician services ($135 in 2009)
Medicare Part B Excess Charges
Dealt with by Plan F (100 percent), G (80 percent), I (100 %), J (100 %):
If your physician does not accept assignment, the difference between what your doctor bills and the Medicare-agreed upon amount.
Foreign Travel Emergency
Covered by Medigap Plan C-J:
• Outside the United States: 80 percent of the fee of emergency care
• Up to $50,000 in your lifetime
• Yearly deductible of $250
Insured by Plans D, G, I, J:
• If already receiving skilled home care covered by Medical insurance Help, assistance with daily living activities, such as bathing and getting dressed.
• After you no longer need to have skilled care, assistance for up to 8 weeks
• Will pay up to $40 a visit, seven visits each week, or a sum of $1,600 annually
Non-Medicare-Covered Preventive Services
Paid for by Plans E, J: