Medicare supplement plans pay some of the costs that Medicare does not pay. Medicare beneficiaries buy this coverage form private insurers. A Medicare supplement policy does not replace Medicare. They are designed to supplement the coverage that is offered through Original Medicare.
Other names for these policies include Medigap, Med sup and Gap. Medicare beneficiaries can get their medical bills covered by other polices that have similar names. Medicare Advantage policies provide benefits to Medicare beneficiaries, but they deliver these benefits differently.
You can get rates for Medicare Supplemental policies via this website. You will get premium information as well as much of the other information you will need to carefully compare the plans and make a decision.
It is important to note that the full cost of the medical care you receive will not always be covered by insurance. Original Medicare covers costs in the hospital with Part A. Part B covers costs in doctors’ office. There are copays, coinsurance and deductibles you may need to pay when you need care for a medical condition.
Another important issue to be aware of is that not every Medicare beneficiary is a senior. Some are many years too young to be a senior and qualify by virtue of having a disability.
The person who buys a Medigap policy will generally have less to pay because they can file a claim for the costs the Medicare does not take care of. However, no combination of policies pays the full cost every time.
These blog posts should give you a good overview of what is and is not covered by the various Medicare supplement policies. However, the information is not comprehensive and, depending on when you read this, it may not be entirely current. The information is based on the way Medicare and Medigap work in 2012.
There are ten Medigap or Medicare Supplement plans. No matter which insurance carrier you purchase a Medigap Plan B from, you will get the same benefits when claims are file for you. The same is true for the other nine plans.
Medicare Supplement Plan B
Plan B pays for the Medicare Part A coinsurance. It also pays for hospital costs for up to an additional 365 days after Medicare hospital benefits are exhausted.
Unlike Plan A it does pay the hospital deductible. This is separate from the hospital coinsurance. For 2012, the hospital deductible is $1,156. Unlike many other health insurance deductibles, this deductible is not an annual deductible. It is a per benefit period deductible. This means that you can pay it more than once during the same twelve-month period.
Hospital costs not covered by Medicare:
- Hospital Deductible- $1,156 in 2012
- Coinsurance for days 61 through 90 of a hospital stay. $289 per day in 2011.
- Coinsurance for days 91 through 150 of a hospital stay. $578 per day in 2011. (Lifetime reserve days)
- All costs for each day beyond 150 days.
With a Medicare supplement plan B, your costs are mostly covered for the first sixty days of a hospital admission during each benefit period.
Some costs are not covered. These costs include the cost of a TV or telephone in your room. Neither the insurance companies nor the federal government are willing to increase their rates to cover these costs for people.
If your stay lasts more than 60 days you will be responsible for $289 per day for days 61 through 90. These costs will be paid by a Medicare supplement plan B. Medicare will pay the rest.
If your hospital admission lasts more than 90 days, you will start using your lifetime reserve days. Medicare gives you 150 lifetime reserve days. For each of these days that you use, you will be responsible for $578 per day.
If you use all of your lifetime reserve days, Medicare stops paying entirely. However, a Medicare supplement plan B will pay the cost for another 365 days once in your lifetime.
In Your Physician’s Office
A Medicare supplement plan B will pay for doctors’ coinsurance unless a doctor charges more than the Medicare approved amount. The current coinsurance amount is 20%.
This plan will not, however, pay for your Medicare Part B deductible. This deductible is $140 in 2012. Medicare does not pay towards your deductible. It pays 80% of the approved amount of your expenses in excess of your annual deductible.
Without a Medicare supplement you will be responsible for $5.00 for each prescription drug given to you for hospice care. You will also pay 5% of the cost of inpatient care. A Medicare supplement plan B will pay these costs for you.