Articles

What You Need to Know about Medicare Supplement Plans

by Himani Mathur Content Writer
Original Medicare, Part A and B, provides many healthcare services, but it has its limitations. For this reason, it is advisable to go for a Medicare Supplement plan, also called the Medigap. Dissimilar to Original Medicare, Medicare Supplement plans can only be availed through private insurance companies.

Medicare Supplement Plans

As the term suggests, Medicare Supplement Plans act like add-ons to your Part A and Part B coverage. They help you pay for many of the out-of-pocket Medicare expenses, such as co-payments, coinsurance, and deductibles. They are applied separately from Medicare Advantage plans and it is against the law to use both at the same time. Despite Medicare supplement plans being offered by private insurance providers, these plans have to follow Medicare regulations and guidelines. Medicare supplement plans are classified according to the alphabetical order, starting from A-N. Coverage offered by a specific type of plan is identical, irrespective of carrier. It has to be kept in mind that some kinds of plans may no longer be available. Also, Medicare supplement plan types are different for residents of Massachusetts, Minnesota, and Wisconsin.

What is covered under Medicare supplement plans?

The degree of coverage and premiums of the plan may vary; however, the benefits of each plan remain the same, notwithstanding the insurance company or location. For instance, benefits under Plan A are the same in New Jersey as they are in California. If a Medicare supplement plan has a particular benefit, this benefit will apply, unless otherwise specified.

  • Medicare Part A coinsurance and hospital costs (up to an additional 365 days after Medicare benefits are used)
  • Medicare Part B coinsurance or co-payment
  • Blood (first 3 pints)
  • Part A hospice care coinsurance or co payment

Though Medicare supplement plans do not have any provision for extra health care services, there are exceptions, like foreign travel emergency care. The plans mostly assist in the pay out of some of the costs that you may incur with Medicare Part A and Part B. For example, deductibles, copays/ coinsurance, and hospital and skilled nursing facility expenses after you have been through your Medicare-covered days. The plans do not provide prescription drug coverage and long-term care, dental care, vision care, hearing aids, eyeglasses, or private duty nursing.

Additional facts regarding Medigap policies

  1. Medicare Part A and Part B are essential to get a Medicare supplement plan
  2. Every Medigap policy must be clearly identified as “Medicare Supplement Insurance”
  3. A Medicare supplement plan is meant for one person only
  4. For married couples, separate policies have to be bought for each partner.
  5. Medicare supplement plans can be availed at any provider that accepts Medicare. But certain Medigap policies like Medicare SELECT plans mandate you to only use doctors and hospitals falling in network of the provider
  6. Cost of premium differ according to plan and location

Exclusions under Medicare supplement plans

Medigap plans usually do not cover the following health services and supplies:
  • Long-term care (care in a nursing home)
  • Routine vision or dental care
  • Hearing aids
  • Eyeglasses
  • Private-duty nursing
  • Prescription drugs

So, Medigap plans are supplementary to Original Medicare to fill in cost gaps. If you already have a Medicare Advantage plan, you should not use the plans in conjunction with a Medicare supplement plan.


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About Himani Mathur Advanced     Content Writer

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Joined APSense since, October 9th, 2017, From Delhi, India.

Created on Oct 17th 2018 08:01. Viewed 429 times.

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