Benefits Included in All Medicare Supplemental Plans in 2011
Medicare Supplemental Plan A – Basic Benefits
Medicare Supplement Plan A - provided by all Medicare Supplemental Insurance Companies who wish to offer Medicare supplemental insurance to provide all benefits that are not covered in Medicare Insurance. The following are the core benefits for Medicare Plan A. These benefits are also included in plans B through N.
• Medicare Part A co-insurance for the 61st through the 90th day in the hospital ($283 a day in 2011);
• Medicare Part A co-insurance for any hospital confinement beyond the 90th day, up to an additional 60 days during the policyholder's lifetime ($566 a day in 2011);
• After using all the Medicare hospital inpatient coverage, including the lifetime reserve days, all Medicare-eligible hospital charges will be covered up to 365 additional days during the policyholder's lifetime;
• The reasonable cost of the first three pints of blood each year under Medicare Part A and Part B;
• The 20% co-insurance amount under Medicare Part B (doctor and other medical bills) after the policyholder pays the Medicare Part B deductible which is $162 in 2011. For outpatient mental health services, the 50% co-insurance amount after the deductible is paid.
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Additional Benefits included with Medicare Supplemental Plans B through Plan N
Medicare Supplemental Insurance plans are standardized in most states. This means that no matter which company a Medicare Insurance recipient chooses for their Medicare Supplemental Insurance, the coverage will be the same from company to company. The list below describes the additional benefits that may be included in plans B through N.
• Medicare Part A Deductible:
Payment for all of the Medicare Part A inpatient hospital deductible. (The Medicare Part A deductible is $1,132 in 2011.
• Skilled Nursing Facility Care:
Coverage up to the co-insurance amount from the 21st day through the 100th day in a Medicare benefit period for post-hospital skilled nursing facility care ($141.50 a day in 2011).
• Medicare Part B Deductible:
Coverage for all of the Medicare Part B deductible ($162 in 2011). Medicare Part B covers doctor and other medical bills.
• One Hundred Percent of the Medicare Part B Excess Charges:
Coverage for all of the difference between the actual Medicare Part B charge as billed and the Medicare-approved Part B charge, not to exceed any charge limit set by the Medicare program or state law.
• Medically Necessary Emergency Care in A Foreign Country:
Coverage for 80% of the billed charges for Medicare-eligible expenses for medically necessary emergency care received in a foreign country. Care must have started during the first 60 days in a row of each trip outside the United States. This benefit has a $250 calendar year deductible and a lifetime maximum benefit paid of $50,000.
• High Deductible Plan "F":
Plan F also has an option called High Deductible Plan F offered by several companies. This high deductible plan offers the same benefits as the regular Plan F, but the benefits do not start until after you pay a calendar year deductible of $2,000 (this deductible can go up every year). Some of the expenses you will have to pay to satisfy this high deductible include the Medicare deductibles for Parts A and B, but does not include the Plan "F" Foreign Travel Emergency deductible. The Foreign Travel Emergency deductible must be paid regardless of whether you have met the $2,000 high deductible. Also, you cannot count the Foreign Travel Emergency deductible toward the $2,000 high deductible.
Medicare Part D
Prescription Drug Coverage
Prescription drug coverage is available through Medicare Part D. Medicare supplement policies with drug coverage are no longer available.
Pre-Existing Conditions
Some policies will not cover pre-existing medical conditions for the first six months the policy is in effect. A pre-existing medical condition is a condition for which you received medical advice or treatment was recommended by or received from a physician six months before the policy is issued. Even if you buy a Medicare supplement policy during your "open enrolment" period, the policy may still not pay for pre-existing conditions for up to six months. The premium comparison chart has a column which shows the policies that do not cover pre-existing conditions.
If you had prior health insurance coverage and replace it with a Medicare supplement policy, you cannot be made to satisfy new pre-existing condition exclusion for similar benefits. This is true whether the prior policy is group coverage through an employer, individual coverage, or another Medicare supplement policy.
Cost for Medicare Supplement Policies
The cost for Medicare supplement policies cannot vary based on your age or gender. Some companies can charge a higher rate if you smoke. Anthem Blue Cross/Blue Shield gives a temporary discount if you purchase a policy no later than three months after either your 65th birthday or your retirement from an eligible group.
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How About Those who Already Have Medigap Policies?
They do not have to make any changes, and their coverage remains in effect as long as they pay premiums. The 1990 policies may, however, become more expensive over time as the number of policy holders declines.
The NAIC's model regulation allows for, but does not require, companies to offer existing policyholders an opportunity to switch to one of the new Medicare Supplement policies without medical underwriting.
| Benefits |
A |
B |
C |
D |
F |
G |
K |
L |
M |
N |
| Medicare Part A Hospital Coinsurance |
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| Lifetime Reserve Days |
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| 365 More Hospital Days |
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| Medicare Parts A and B Blood |
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50% |
75% |
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| Medicare Part B Coinsurance |
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50% |
75% |
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| Medicare Part A Hospice Coinsurance |
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50% |
75% |
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| Skilled Nursing Coinsurance |
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50% |
75% |
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| Medicare Part A Deductible $1,132 in 2011 |
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50% |
75% |
50% |
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| Medicare Part B Deductible $162 in 2011 |
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| Medicare Part B Excess |
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| Foreign Travel Emergency |
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| Preventive Care Coinsurance |
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| Out of Pocket Limit |
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$4,620 |
$2,310 |
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Medicare Supplement Plans/Rates, Just A Click Away
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Considerations When Choosing or Changing Your Medicare Coverage
What is Medicare Coverage?
Medicare Coverage are the services that you need covered in your Medicare Plans.
Other Coverage that you have - Do you have other types of health or prescription drug coverage? If yes, make sure you know how that coverage works with Medicare Insurance. If you have employment-related coverage, or get your health care from an Indian Health or Tribal Health Program, talk to your benefits administrator or insurer before making any changes.
Medicare Costs – You should know, How much your premiums, deductibles, and other expenses in your Medicare Supplemental Plan are costing you? How much do you pay for services like hospital stays or doctor visits? Is there a yearly limit on what you could pay out of pocket for medical services? Make sure you understand any medicare coverage rules that may affect your costs.
Your Choice for Doctor and Hospital - Do your doctors accept the coverage? Are the doctors you want to see accepting new patients? Do you have to choose your hospital and health care providers from a network? Do you need to get referrals?
Prescription Drugs - What are your drug needs? Do you need to join a Medicare drug plan? Do you already have creditable prescription drug coverage? Will you pay a penalty if you join a drug plan later? What will your prescription drugs cost under each plan? Are your drugs covered under the plan's formulary (drug list)?
Quality Care Assurance - The quality of care and services given by Medicare Plans and other Medicare providers can vary. See Medigap 4 Seniors Medicare Plans and compare plans by states and providers.
Convenience - Does the plan include the doctors you see and the pharmacies you use? Can you get your prescriptions by mail? Do the doctors use electronic health records or E-prescribe?
Travel Facility - Will the plan cover you if you travel to another state?
If you're in a Medicare plan, review the Evidence of Coverage (EOC) and Annual Notice of Change (ANOC) your plan sends you each year. The EOC gives you details about what the plan covers, how much you pay, and more. The ANOC includes any changes in coverage, costs, or service area effective as of January 2012. If you don't get an EOC or ANOC, contact your plan.
Medicare Supplement Plans/Rates, Just A Click Away
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What's ON your mind?
Generally, we experienced that our clients think about three situations when they are going to shop Medicare Supplements. Below are the three situations, where we describe what these individual shoulds should be doing.
You are going to shop your first Medicare Supplement
You are choosing your first Medicare Insurance Plan and don’t know enough about medicare. Don’t worry... you have a lot of rights and privileges that make it very simple for you to ensure you get the right plan for your Medicare Supplement. You are in a good situation, where you can choose any Medicare insurance plan, and with any of the insurance companies, that are providing you the best coverage. However, there are few things that you need to remember before choosing the medicare supplemental plan.
Make a decision on how you treat your Medicare benefits. ie... get them through original medicare (Plan A or Plan B) or deal with the Medicare Advantage Plan (Plan C)
In Summary, Original Medicare allows you to see a greater number of doctors and medical facilities, but you will still need to get a Medicare supplement policy and a Part D drug plan, and taat's where our agents can be of great help.
If you go with Medicare Advantage plans, you have less number of doctors and medical facilities in the network and, although they have outlines of coverage, it has been proven that they will sometimes make decisions on medical bills based on whether they feel a particular treatment was necessary and can surprised you.
Medicare supplements are standardized with plan letter designations from A-L. However, there are only 3-4 medicare plans are popular in most people. In 2011, Medicare Supplemental Plan F is the most popular plan on the market. This is probably because plan F covers:
• Part A and Part B Deductibles
• Part B Excess
• Part B and Hospital Coinsurance
• Skilled Nursing Coinsurance
• 365 Additional Days Hospitalization Coverage
• Blood Deductible Coverage
• Travel Facilities
Another supplement plan that was introduced June 2010 is Medicare supplement Plan N, which is proving to be wildly popular due to its lower cost. Medicare supplement plans do not include Part D coverage and it must be purchased separately.
After figuring out all the details, you can take two approaches to shop the medicare plan. First, you can do all the research on your own, and figure out which companies provide which kinds of coverage in which plans. This method is very frustrating and time consuming, and can lead to a less favorable choice anyway. The second approach would be to contact a Medigap4Seniors agent to help choose you choose the correct plan for you. Our agents work with all major medicare insurance providers and can find the right medicare plans within 10 min for you. A Medigap4Seniors agent can also help you to re-evaluate your coverage and help you save hundreds of dollars over your lifetime.
Medicare Supplement Plans/Rates, Just A Click Away
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Call Now for Medigap Supplement Insurance Quotes
888.502.5553
Have a Medicare Supplement Plan, but looking for Better Rates?
It's a very common situation that a medicare insured be experiencing. We have found, in many cases, where medicare agents do not re-evaluate the provided Medicare Insurance Plan. That’s why the Medigap rates may go up, without the client being aware. This leave the client in search of another looking for other, less costly, Medicare Supplemental Plan.
Medigap4seniors agents can help you to find another Medicare provider that can provide the same plan that you currently have, and possibly at a lower cost to you. In any case, It will be best rate available for you. Your Medigap4seniors agent can make the process of switching insurance companies very easy for you, and your agent will handle all situations for you over phone. Simple and convenient.
Go with a Medigap policy
It's simple to purchase a Medigap Plan, you can receive an application by mail, fill it out and send it back to the agent that you are working with, or you can complete it over the phone with the agent, this is called an electronic application. For more details you can visit our Medicare Supplement Guide and call Medicare4seniors agents at 888.502.5553
