AAA Medicare Supplement Plans
IN THE BEGINNING: Original Medicare, Parts A and B, pays for many of your health-care services and supplies, but it doesn’t pay for everything. That’s why you may want to consider getting a Medicare Supplement insurance policy, also called Medigap or MEDICARE SUPPLEMENTAL PLANS. A Medigap policy is sold by private insurance companies. These plans help pay some of the hospital and medical costs that Original Medicare doesn’t cover, such as copayments, coinsurance, and yearly deductibles. Some Medigap policies also help pay for a few services that Original Medicare doesn’t cover. Basically, a Medigap policy fills the “gaps” in Original Medicare coverage.
How do Medicare Supplement Plans work with Medicare?
Medicare Supplements do just that they supplement your Original Medicare benefits, which is why these policies are also called Medicare Supplement plans. If you have Original Medicare and a Medigap policy, Medicare will pay first, as your primary insurance, and your Medigap policy will fill in the cost gaps.
Medicare Supplement Payment Example
For example, suppose you have a $5,000 ambulance bill and have not yet met the yearly Medicare Part B deductible. Medicare Part B will pay 80% of your ambulance bill, minus the deductible amount. The Medigap policy would then pay your remaining 20% coinsurance of your $5,000 ambulance bill. Some Medigap policies also pay the remainder of the Medicare Part B deductible you still owe.
Plans that don’t supplement Medicare coverage (aren’t Medigap policies)
It’s important to be aware of which plans are not supplements to your Original Medicare:
- Medicare Advantage plans (like an HMO or PPO)
- Medicare prescription drug plans (Part D)
- Employer’s or union’s plans
- Veterans’ benefits
- Long-term care insurance policies
What benefits do MEDICARE SUPPLEMENT have?
Currently, there are 10 standardized Medigap plans, each represented by a letter (A, B, C, D, F, G, K, L, M, N; there’s also a high-deductible Plan F).
What states have different rules for Medicare Supplements?
These are sold in most states (Massachusetts, Minnesota, and Wisconsin each have their own different set of Medicare supplement plans). Coverage levels and premiums vary, but the benefits of each plan within a lettered category remain the same despite the insurance company or location. For example, Plan A benefits are the same in New Jersey as they are in Oregon.
In general, Medigap policies cover the following benefits:
- Medicare Part A coinsurance and hospital costs (up to an additional 365 days after Medicare benefits are used)
- Medicare Part B coinsurance or copayment*
- Blood (first 3 pints)*
- Part A hospice care coinsurance or copayment*
(*Coverage may be partial for some plans.)
Some types of Medicare Supplements policies also cover:
- Skilled nursing facility care coinsurance
- Medicare Part A deductible
- Medicare Part B deductible
- Medicare Part B excess charges
- Foreign travel emergency
What benefits are not covered by Medicare Supplement policies?
Medicare SUpplement policies don’t cover the following health services and supplies:
- Long-term care (care in a nursing home)
- Vision or dental care
- Hearing aids
- Private-duty nursing
Additional facts about Medicare supplement policies
- You must have Medicare Part A and B to get a Medicare supplement policy.
- Every Medigap policy must be clearly identified as “Medicare Supplement Insurance.”
- A Medigap policy can only cover one person, so if you are married, you and your spouse would need to buy separate policies.
- Not all types of Medigap policies may be available in your state.
Now that you know more about Medigap plans, you may be wondering if one of these plans is right for you. I always enjoy helping people figure this out. To get to know me better, take a look at my photo and profile below (see my profile by clicking on the “View profile” link). If you’d like to start out by getting some more information in front of you, use the links below, which let you schedule a phone appointment or have me email you information about plans. To take a look at all available Medicare plans right now, use the Compare Plans buttons on this page. Or, if you need assistance right away, just call me or another licensed insurance agent at the contact details below.
Call Medicare.com’s licensed insurance agents at 1-800-MEDIGAP or 1-800-633-4427