Medicare

Medicare Supplement

2010 Plan Changes

Medicare Supplements
At the bottom of this page is a chart that summarizes benefits of all plans. Following is an example of how one of the plans, Plan F, integrates with Medicare benefits. This is an approximation. Refer to policy language for exact benefits.

Part A Service	Medicare Pays	Plan F Pays	Insured Pays
Hospital - 1-60 days	All but $1,100 Deductible	$1,100 Deductible	$0
Hospital - 61-90 days	All but $275 per day	$275 per day	$0
Hospital - 91-150 days	All but $550 per day	$550 per day	$0
Hospital - 365 days after lifetime reserve	$0	100%	$0
Hospital - Thereafter	$0	$0	All
Skilled Nursing Facility - first 20 days	All eligible expenses	$0	$0
Skilled Nursing Facility - 21 to 100 days	All but $137.50 per day	$137.50 per day	$0
Skilled Nursing Facility - After 100 days	$0	$0	All
Blood - First 3 Pints	$0	3 Pints	$0
Blood - After 3 Pints	100%	$0	$0
Hospice	All eligible	$0	$0
Part B Service	Medicare Pays	Plan F Pays	Insured Pays
Medical expense deductible $137.50	$0	$137.50	$0
Additional eligible medical expenses	80%	20%	$0
Excess medical charges	$0	100%	$0
Blood - first 3 pints	$0	100%	$0
Diagnostic tests	100%	$0	$0
Part A and B Services	Medicare Pays	Plan F Pays	Insured Pays
Home Health Care Services	100%	$0	$0
Durable equipment deductible $135	$0	$135	$0
Excess durable medical equipment	80%	20%	$0
Home Health Care	$0	$0	100%
Other Plan F Benefits	Medicare Pays	Plan F Pays	Insured Pays
Foreign Travel Deductible	$0	$0	$250
Foreign Travel 60 days up to $50,000	$0	80%	20%

MEDIGAP (MEDICARE SUPPLEMENT) STANDARD PLANS

Starting June 1, 2010, the types of Medigap Plans will change:

There will be two new Medigap Plans offered—Plans M and N.
Plans E, H, I, and J will no longer be sold.
People who have Plan E, H, I, or J before June 2010, can keep that plan.
Plans that must be offered in each state: A and either C or F.

Medigap Benefits

Medicare Part A Coinsurance and Medigap Coverage for Hospital Benefits

Medicare Part B Coinsurance or Copayment

50%

75%

$20 Dr office / $50 ER copays

Blood (First 3 Pints)

50%

75%

Hospice Care Coinsurance or Copayment

50%

75%

Skilled Nursing Facility Care Coinsurance

50%

75%

Medicare Part A Deductible

50%

75%

50%

Medicare Part B Deductible

Medicare Part B Excess Charges

80%

Foreign Travel Emergency (Up to Plan Limits)**

At-Home Recovery (Up to Plan Limits)

Preventive Care Coinsurance (Included in the Part B Coinsurance)

Preventive Care not Covered by Medicare (up to $120)

2010 Out of Pocket Limit ►

$4,620
***

$2,310
***

Plans K and L provide different cost-sharing for items and services than Plans A through J. After the annual limit, the plan pays 100% of the Medicare co-payments, coinsurance, and deductibles for the rest of the calendar year. The out-of-pocket annual limit does NOT include provider charges that exceed Medicare-approved amounts, called "Excess Charges". Insured will be responsible for paying excess charges. The out-of-pocket annual limit will increase each year for inflation.


Hospice Benefit Today, Medicare offers a hospice benefit that pays eligible expenses with a drug copay and inpatient respite care coinsurance, but these are not covered by Medicare supplement plans. The modernized plans will cover these expenses as a core benefit:
$5 copay for outpatient prescription drugs for pain and symptom management 5% of the Medicare‐approved amount for inpatient respite care (short-term care given by another caregiver so the usual caregiver can rest). Does not include room and board
*	Medigap Plans F and J also offer an optional $2,000 (in 2010) deductible
**	Separate $250 foreign travel emergency deductible
***	Pays 100% of calendar year covered services after meeting out-of-pocket yearly limit and Part B deductible.