Medicare is a healthcare lifeline for many seniors. But, with the ever-expanding cost of medical care, your Original Medicare plan may not be enough.
Fortunately, you have options. Medicare supplement plans, also known as “Medigap” plans, can offer you the extra coverage you need for those vital expenses Medicare doesn’t take on.
Whether you already have Medicare or are considering signing up for it, you’ll want to learn more about gap plans. Here is how to tell which of the Medicare supplement plans fits your needs.
The Benefits of a Medicare Supplement Plan
First, it’s important to understand that you must already have Medicare coverage to sign up for a Medicare supplement plan. You can’t get a supplement plan all by itself.
Secondly, even though Medicare is a government program with standardized rates, Medigap programs are available only through private insurers. The cost of Medicare gap plans varies, so you must shop around.
Once you are officially enrolled in Medicare, supplemental coverage can prove to be one of the biggest investments you can make in your health care. Here is where Medigap plans pick up the slack.
Original Medicare Part A’s deductible is around $1400, and Part B is around $200. These standard deductibles are a shared cost, meaning it’s your part of the overall bill, which you usually have to pay out of pocket.
However, many supplement plans cover this deductible. Coverage for your Part A deductible is standard across all Medigap plans.
Coinsurance is the amount you pay after your deductible has been met. Generally, a percentage, your coinsurance can nevertheless amount to a sizable bill.
For example, if your coinsurance is 20% for a diagnostic procedure, and say the allowable cost for that procedure is $200, that amounts to $40 for you. Not so bad for just one visit, but multiply this by several visits, and you could be looking at hundreds, or even thousands, of dollars in coinsurance costs.
Even the copayments can add up if you’re seeing a physician regularly. Luckily, all supplement plans offer some level of copayment benefit, anywhere from 50% up to 100%.
Not sure what coverage is right for you? We can help guide you through the maze of Medicare supplemental options. You’ll get all the coverage you need without overpaying.
Medicare Supplement Plans
Many seniors find supplemental programs worth the expense and necessary to ensure they get all the care they need. But what plan, or plans, should you choose?
There are ten plans in all, A, B, C, D, F, G, K, L, M, and N. As you’ll see, some benefits, like Medicare Part A deductibles, receive coverage from all the gap plans. Benefits like travel insurance, for example, are more optional,
Before you start spending money on Medigap coverage, it’s best to know what each supplement program involves. Here’s what plans cover:
1. Coinsurance and Copayments
All plans are required to cover coinsurance and copayments for both Original Medicare. Although Original Medicare Parts A and B. Expenses can include hospital stays, per the Medicare Part A “hospital” program, as well as doctors’ visits for Part B.
All ten plans provide full coverage for Every state and insurer is required to offer MediGap plan A (sometimes under a different name). It is important to remember that this is Plan A NOT Part A copayments. Likewise, all Medigap plans, except K and L, cover copayments/coinsurance for Medicare Part B. Plans K and L cover 50% and 75% of these expenses, respectively.
It’s not something one would think of right away. The need for pints of blood during hospital stays can add up. Fortunately, Medicare supplemental programs account for this expense.
All Medigap programs cover the first three pints of blood. Plans K and L cover 50% and 75% of the expense, respectively.
3. Part A Hospice Care
Medicare Part A and Medicare Part B (Original Medicare). Original Medicare Part A includes hospice care. With hospice care comes coinsurance, as well as copayments for certain types of hospice services.
Every Medicare supplemental program covers copayments/coinsurance for hospice care. Plans K and L cover 50% and 75% of the expense, respectively.
4. Skilled Nursing
It’s a need that may not have been around back in the 1960s when Medicare was first developed, but skilled nursing is definitely a need today. Fortunately, all current supplement programs account for this inevitable need as we age.
Except for plans A and B, all gap plans provide coverage for coinsurance expenses involved with skilled nursing. Plans K and L cover 50% and 75% of this expense, respectively.
Having to meet your deductible before you can start receiving coverage can be a hurdle for many seniors. While deductibles tend to be standard for Medicare Parts A and B, some Medigap plans will pay for this expense as well.
Except for plan A, all gap plans offer coverage for Medicare Part A deductibles, with plans K and L providing 50% and 75% coverage, respectively. Benefits for Medicare Part B deductible are more limited. Only plans C and F offer coverage for deductibles related to Part B.
6. Foreign Travel Exchange
If you are fortunate enough to travel as you age, you may be pleased to know that gap plans offer coverage for travel insurance. Even though you won’t receive the benefit of long-term nursing overseas, Medigap can cover emergency care you might need while traveling.
Medigap plans C, D, F, G, M, and N, offer 80% coverage for overseas medical expenses.
The Cost of a Supplemental Plan
The type of plan you choose to purchase will factor into the monthly cost of your Medigap coverage. Other factors include your age, gender, location, and whether or not you are a smoker.
On top of all of this, each insurance company will offer different rates for different plans. How much can you expect to pay for Medicare supplemental insurance with so many factors coming into play?
The answer is somewhere in the ballpark of $150-$300 per month. You can find a breakdown of average monthly costs for Plan F here.
What Plan Is Right For You?
When you compare Medicare supplement plans, you should be asking which one is right for you. At MedicareOnVideo.com, you can find all of the information you need to make a wise decision.
Better yet, contact us, and we can help you navigate your Medicare supplement plan options.