A Medigap Insurance policy (also called a Medicare Supplemental policy) is
health insurance whose purpose is to fill gaps in your original
Medicare coverage.
Medigap policies are used to help assist you in paying for your copayments or
deductibles from Medicare covered services.
Medicare Supplement Insurance companies can only sell you a "standardized"
Medigap policy identified by letters A, B, C, D, F,G, K, L, F, M, and N.
Since a Medicare Supplement Insurance company can only sell you a "standardized"
Medigap policy each policy must offer the same basic benefits, no matter which
insurance company provides the insurance. Cost is usually the only
difference between Medigap policies sold by different insurance companies.
That is why it is so important to get the best price on your Medigap coverage.
The Medicare Open Enrollment Period begins on the first day of
the month in which you are both 65 years of age (or older) and
you are enrolled in Medicare Part B. This period lasts 6
months.
This 6 month period is the best time to purchase a Medicare supplement because an insurance
company cannot turn you down, apply any conditions, or charge more due to a
health problem. Insurance companies can apply a waiting period for pre-existing
conditions to your Medigap policy, but that can be eliminated or shortened if you
have had prior credible coverage.
How to read the Medigap chart below: If a check mark appears in
the column, this means that the Medigap policy covers that benefit up to 100% of
the Medicare-approved amount. If a column lists a percentage, this means the
Medigap policy covers that benefit at that percentage rate of the
Medicare-approved amount. If no percentage appears or if the column is blank,
this means the Medigap policy doesn't cover that benefit. Note: The coverage of
coinsurance only begins after the deductible has been satisfied.
|
Medigap Benefit |
A |
B |
C |
D |
F* |
G |
K |
L |
M |
N |
| Medicare Part A Coinsurance and Medigap Coverage for Hospital Benefits |
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| Medicare Part B Coinsurance or Copayment |
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50% |
75% |
 |
*** |
| Blood (First Three Pints) |
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50% |
75% |
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| Part A Hospice Care Coinsurance or Copayment |
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50% |
75% |
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| Skilled Nursing Facility Coinsurance |
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50% |
75% |
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| Medicare Part A Deductible |
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50% |
75% |
50% |
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| Medicare Part B Deductible |
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| Medicare Part B Excess Charges |
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| Foreign Travel Emergency (Up to Plan Limits) |
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| Medicare Preventative Care Part B Coinsurance |
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2010 out-of-pocket limit: |
$4,620** |
$2,310** |
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*Plan F has a high deductible option. You must pay the first $2,000 (deductible in 2010) in Medigap-covered costs before the Medigap policy pays anything. You must also pay a separate deductible for foreign travel emergency ($250 per year).
**After you meet your out-of-pocket yearly limit and your $155 yearly Part B deductible, the plan pays 100% of covered services for the rest of the calendar year.
*** Plan N pays 100% of the Part B coinsurance except up to $20 copayment for office visits and up to $50 for emergency department visits. |
Basic Benefits
> Coinsurance for days 61-90 ($275 per day) and days 91-150 ($550 per day) in hospital
> Payment in full for 365 additional hospital days
> 20% coinsurance for physician and other Medicare Part B services
Medicare Part A Hospital Deductible
> The 2010 deductible is $1,100
Skilled Nursing Facility (SNF) Coinsurance
> $137.50 a day for days 21-100 in a Skilled Nursing Facility in 2010
Medicare Part B Yearly Deductible
> The 2010 deductible is $155
Medicare Part B Excess Charges
> Difference between doctor's charge and Medicare's approved amount
> Up to 15% above the Medicare approved charge which is the doctor's maximum charge
Foreign Travel Emergency
> Pays 80% of the cost of emergency care during the first two months of each trip after you pay a $250 deductible
> Lifetime maximum of $50,000
Get a Medicare supplemental insurance quote.
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