Medicare Supplement (Medigap) Plans Pt 2

Below is a list of other types of insurance. Keep in mind that these types of coverage differ from Medicare supplemental plans:

  • Medicare Advantage Plans (such as an HMO or PPO)
  • Medicare prescription drug plans (Part D)
  • Health insurance
  • Group coverage sponsored by employers or unions.
  • Tricare
  • Benefits for veterans.
  • Long-term care

What benefits are included in Medicare supplemental plans?

There are currently 10 standardized Medigap plans, with each representing a letter such as A, B, C, D, F, G, K, L, M, N, & there is also a Plan F high deductible version. The plans are available in many states such as Massachusetts, Minnesota and Wisconsin which have different standardized Medigap plans.

Premiums and Coverage vary, however the benefits of each plan within a letter category remain the same, regardless of the location or insurance company. For example, the benefits of Plan A in New Jersey are the same as in Oregon. If a Medigap plan includes a specific benefit, it will be covered at 100%, except otherwise indicated.

Generally speaking, all Medicare supplemental plans include the following benefits:

  • Co insurance for Medicare Part A and hospital expenses (up to 365 days after Medicare benefits)
  • Co-insurance or copayment for Medicare Part B *
  • Blood (the first 3 pints)
  • Part A Hospice care co-insurance or additional payment

* The cover may be partial for some plans. Plan N of Medigap covers Part B coinsurance for up to $ 20 for some office visits and up to $ 50 for emergency rooms that have not been hospitalized.

Some types of Medigap plans also include:

  • co insurance for skilled nursing facility
  • Medicare Part A Deductible
  • Deductible for Medicare Part B
  • Surcharge for Medicare Part B Excess (the amount a non-participating provider can charge over the cost of a Medicare-approved service
  • Emergency of international travel (up to the limits of the plan)

Two Medigap plans (Plan K and L) include a payment limit. Once your Medicare coverage expense reaches a certain amount, the Medigap plan covers 100% of the costs covered by Medicare for the rest of the year.

As already mentioned, the services vary according to the type of plan. For an overview of the benefits offered by standard Medicare supplement plans, see this Medigap plan performance overview.

What are the benefits not included in Medigap plans?

Medigap guidelines generally do not include the following health care services and offers:

  • Hearing aids
  • Long-term care (in a nursing home)
  • Dental care or Routine vision.
  • lenses
  • Prescription medications
  • Private-duty nursing

More information about Medicare supplements.

  • You will need Medicare Part A and B to get a Medicare supplemental plan.
  • Each Medigap policy must be clearly marked as “Medicare Supplement Insurance”.

A Medigap plan can only cover one individual. If married, both couples must purchase separate insurance policies.

In general, you can use your Medicare gap plan with any provider that accepts Medicare.