Medicare Supplement Health Care Benefits

Medicare Supplement Insurance Benefits Described

If you are in the original Medicare Plan, you may want to buy Medicare supplement health care insurance, also called Medigap. This is a health insurance plan that helps pay for some of your costs in the original Medicare program and for some care Medicare does not cover. If you are in a Medicare Advantage plan, such as a Medicare Health Maintenance Organization (HMO), you don't need a Medicare supplemental health care insurance policy.

 

Medicare supplement health care plans are sold by private companies.

There are 12 standard Medicare supplement health care policies— named plan A - plan L.

Some Medicare supplement health care companies offer a "high deductible option" on Medicare supplemental health care plans F .

 

In addition to the standard Plan A-L Medicare supplement health care policies, Medicare SELECT is a type Medicare supplement health care policy that can cost less than standard Medicare supplemental. However, you can only go to certain doctors and hospitals for your care. Check with your individual state insurance department to find out if Medicare SELECT plans are available in your state.

 

Each plan offers different Medicare supplement health care benefits, fills different gaps in Medicare and leads to price variables. However, all Medicare supplement health care plans must cover certain basic benefits.

If you live in Massachusetts, Minnesota or Wisconsin, you have different standard Medicare supplemental health care plans to buy. Check with your state insurance department or the guide to health insurance for people with Medicare: Choosing a Medicare supplement health care policy.

 

No matter which insurance company offers the Medicare insurance, all plans with the same letter designation cover the same benefits. For example, all plan F policies covers up to part B excess charges, no matter who sells the Medicare supplement health care policies. However, the premiums may vary.

 

Study all the Medicare supplemental health care plans before deciding which is best for you. Each Medicare supplement health policy offers different benefits. For instance, some plans cover deductibles and coinsurance*. Other plans also cover some home health care and prescription drugs.

 

Deductible: The amount you pay for your health care before Medicare begins to pay. Coinsurance: The amount you pay (usually a percentage) for your care, after you pay the deductible.

 

Read Complete Guide to Medicare Insurance

 

None of the Medicare supplement health care covers:

•Long-term care to help you bathe, dress, eat or use the bathroom
•Vision or dental care
•Hearing aids
•All your prescription drugs
•Private-duty nursing
•Medicare supplement basic benefits

The Basic Benefits

Medicare supplement plan A is the most basic plan. Every Medicare supplement health care policy must offer it's basic benefits.

 

Medicare Part A

After you have paid your hospital deductible ($1,024 in 2010), the original Medicare plan pays all your hospital care costs for up to 60 days in a benefit period*. If you stay in the hospital more then 60 days, you pay $256 (in 2010) a day for days 61 through 90. Days 91 through 150 cost you $512 (in 2010.)

All ten Medicare supplement health care plans cover (pay) your costs for days 61 through 150. In addition, once you use your 150 days of Medicare hospital care benefits, all Medicare supplement health care plans cover the cost of 365 more hospital days in your lifetime.

 

*A benefit period begins the day you go to the hospital and ends when you have been out of the hospital for 60 days in a row. If you go into the hospital again after 60 days have passed, you begin a new benefit period.

 

Medicare Part B

 

After you pay your yearly Part B deductible ($135 in 2010), Medicare generally pays 80 percent of doctor and other medical care services. It pays 50 percent of mental health care services.

All Medicare supplement health care policies cover your share of these services — 20 percent of the Medicare approved amount for doctor services and 50 percent for mental health care services. (The Medicare approved amount is the amount that Medicare decides is a reasonable payment for a health care service).

 

Blood

 

The original Medicare plan does not cover the first three pints of blood you need each year.

All Medicare supplement health care plans pay for these first three pints. Medicare will pay for any additional blood.

Medicare Supplement additional Benefits
Medicare supplement plan A only covers the basic benefits. For some people, Plan A is all they need. Other people want to have the additional supplemental benefits offered by plans B through J and are willing to pay for them.Supplemental Medicare plans B through J also cover all the basic benefits of Plan A.

For a higher monthly cost, you can buy a Medicare supplement policy with the following additional benefits:

 

Medicare Part A Hospital Deductible

Medicare supplement health care plans B through J cover the hospital deductible ($1,024 in 2008) for each benefit period. This benefit usually saves you money if you have to stay in the hospital.

 

Skilled Nursing Home Costs

The original Medicare plan only pays all of your skilled nursing home costs for the first 20 days of each benefit period. If you are in a nursing home for more than 20 days, you pay part of each day's bill.

Medicare supplement health care plans C through L pay your share of the bill ($128 a day in 2010) for days 21 through 100. Neither Medicare nor any Medicare supplement health care plan pays for any skilled nursing home stay longer than 100 days in a benefit period.

 

Medicare Part B Deductible

You must pay a deductible each year for doctor and other medical services before Medicare pays.

Medicare supplemental health care plans C, F, and J pay this deductible. (In 2010, the deductible is $135)

 

Medicare Part B Excess Charges

When you see a doctor who does not "accept assignment," he or she does not accept Medicare's approved amount as payment in full. The doctor can charge you up to 15 percent more than Medicare's approved amount.

Medicare supplement plans F, I and J pay 100% of these excess charges. Supplemental Medicare health care plan G pays 80 percent of the excess charges. You might want this benefit if you don't know whether the doctors you see accept assignment, such as when you are in the hospital.

 

Foreign Travel Emergency

Medicare does not cover any health care you receive outside of the United States. supplemental Medicare health care plans C through J cover some emergency care outside the United States. After you meet the yearly $250 deductible, this benefit pays 80 percent of the cost of your emergency care, up to $50,000 in your lifetime.

At Home Recovery

Medicare covers some skilled home health care given by a nurse or a physical, occupational or speech therapist. It does not pay for at home help for activities of daily living such as bathing and dressing. You pay for this type of care.

Medicare supplement health care plans D, G, I, and J cover this type of at home help if you already are receiving skilled home health care that is covered by Medicare. These plans cover at home help for up to eight weeks after you no longer need skilled care. However, they will not pay more than $40 per visit, seven visits a week up till $1,900 each year.

Preventive Care

Supplemental Medicare health care plans E and J offer this benefit, which is limited to $120 each year. It helps pay for care such as routine yearly checkups and hearing tests. Since Medicare now covers more preventive care, make sure this benefit is helpful to you

Important: You may only be able to buy Medicare Advantage plans that have prescription drug benefits within 6 months of when you first sign up for Medicare Part B. After these 6 months, your choice of plans may be limited.