Medicare Supplemental (Medigap) Insurance Policies ReviewedSep 29th, 2010 | By Sharon Shaw Elrod MSW EdD | Category: Dr Jerry Elrod's Senior Moments Blog
Medicare was not designed to cover all health care needs you may encounter in retirement. Many of us are in original Medicare and we have supplemental policies, also known as Medigap Policies. (Some seniors choose the Medicare Advantage Plan, in which case you don’t need a supplemental policy; you can compare Original Medicare with Medicare Advantage here) We’re getting close to the time of year when we can look at changing, if we want to do that. That time period is coming up, November 10 through the end of the year.
Supplemental plans are offered by private insurance companies throughout the country. Some states have different regulations for supplemental policies, so you should check online regarding what your state may require.
This is a good time to review your supplemental policy and take a look at what’s out there that you may want to consider changing. All supplemental policies have some things in common, so here are some things to consider:
- Medicare Part A Coverage covers hospital stays and hospice care; nothing to decide here;
- Medicare Part B Coverage covers care with your physician, lab work, diagnostic testing, preventive services, outpatient care, etc; again, nothing to decide here
- Supplemental/Medigap Plans number 10; until May 31, 2010, there were 14, but four of them were discontinued for new enrollees; these plans vary in covered services and cost. They are summarized here:
- Medigap Plan A offers basic benefits;
- Plan B: basic benefits plus Medicare Part A Hospital Deductible
- Plan C: covers Plan B plus skilled nursing home coinsurance; Medicare Part B deductible; foreign travel emergency;
- Plan D: essentially the same as Plan C
- Plan E: no longer available to new enrolees
- Plan F: covers plan C plus excess charges from Medicare Part B (doctor visits, outpatient care, etc)
- Plan G: covers plan F without the high deductible option
- Plan H: no longer available to new enrollees
- Plan I: no longer available to new enrollees
- Plan J: no longer available to new enrollees
- Plan K: basic benefits, 100% of hospital coinsurance, plus 365 day hospital coverage after Medicare benefits end; 50% of hospice, medicare-eligible expenses for three pints of blood, Part B coinsurance after deductible has been met, skilled nursing home coinsurance, hospital deductible; annual out of pocket limit in 2010 is $4620; preventive services are covered at 100%
- Plan L: plan K except that the 50% coverage becomes 75%; annual out of pocket limit is $2310 in 2010
- Plan M: basic benefits, 50% of hospital deductible, skilled nursing home coinsurance; foreign travel emergency
- Plan N: basic benefits, hospital deductible, co-payments for doctor visits are $20 and for emergency room visits are $50 after deductible has been met; foreign travel emergency.
Why so many supplemental policy options? You would be surprised how many different kinds of needs there are among retirees for medical care. The 10 plans are an attempt to provide options to meet the individual and unique medical care services that we seniors need. It is really important for each of us to take a look at the options and ensure we have the supplemental policy that is right for us. Medicare enrollment and eligibility information, including supplemental/Medigap policy options, is available online, and SCJ readers are encouraged to make use of this valuable resource.