What You Need to Know about Medicare Supplement Plans
by Himani Mathur Content WriterOriginal 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.
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
Additional facts regarding Medigap policies
- Medicare Part A and Part B are essential to get a Medicare supplement plan
- Every Medigap policy must be clearly identified as “Medicare Supplement Insurance”
- A Medicare supplement plan is meant for one person only
- For married couples, separate policies have to be bought for each partner.
- 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
- Cost of premium differ according to plan and location
Exclusions under Medicare supplement plans
- 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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Created on Oct 17th 2018 08:01. Viewed 429 times.
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