Medicare Supplement

 

 

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Medicare Supplements

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Medicare Supplements
There are 12 standard Medicare Supplement plans, A through L. Medicare Supplements cover gaps in Medicare benefits. Each plan has a unique benefit structure.  At the bottom of this page is a chart that summarizes benefits of all 12 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 $1,024 Deductible $1,024 Deductible $0
Hospital - 61-90 days All but $256 per day $256 per day $0
Hospital - 91-150 days All but $512 per day $512 per day $0
Hospital - 365 days after lifetime reserve $0 100% $0
Hospital - 151 days or more $0 $0 All
Skilled Nursing Facility - first 20 days All eligible expenses $0 $0
Skilled Nursing Facility - 21 to 100 days All but $128 per day $128 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 $0 $125 $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 $124 $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
 
Medigap Benefits A B C D E F* G H I J* K L
Medicare Part A Coinsurance and Medigap Coverage for Hospital Benefits x x x x x x x x x x x x
Medicare Part B Coinsurance or Copayment x x x x x x x x x x 50% 75%
Blood (First 3 Pints) x x x x x x x x x x 50% 75%
Hospice Care Coinsurance or Copayment                     50% 75%
Skilled Nursing Facility Care Coinsurance     x x x x x x x x 50% 75%
Medicare Part A Deductible   x x x x x x x x x 50% 75%
Medicare Part B Deductible     x     x       x    
Medicare Part B Excess Charges           x 80%   x x    
Foreign Travel Emergency (Up to Plan Limits)**     x x x x x x x x    
At-Home Recovery (Up to Plan Limits)       x     x   x x    
Preventive Care Coinsurance (Included in the Part B Coinsurance) x x x x x x x x x x x x
Preventive Care not Covered by Medicare (up to $120)       x           x    
                      $4,440
***		 $2,220
***

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.
   
* Medigap Plans F and J also offer a high-deductible option. You must pay the first $1,900 (high-deductible in 2008) in Medigap covered costs before Medigap pays anything.
** You must also pay a separate deductible for foreign travel emergency ($250 per year)
*** After you meet your out-of-pocket yearly limit and your yearly Part B deductible ($135 in 2008), the plan pays 100% of covered services for the rest of the calendar year.