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Supplemental Medicare Healthcare

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Supplemental Medicare Health Insurance

Many people who enrolled into the Original Medicare Plan have also opted to enroll into an additional program to obtain insurance that Medicare doesn’t completely cover. Supplemental Health Insurance, also referred to as Medigap, is designed to fill in the “gaps” of Medicare. There are options beyond Medicare to extend the coverage you receive. When evaluating a Medigap plan, you should analyze your current healthcare needs and apply that to the available plans.

First, you will want to evaluate the cost of your healthcare over the course of year. There are many factors to consider when making this calculation. Medicare is broken down into four sections. You must analyze the cost of the additional Medicare parts you are enrolled in. Furthermore, you must include other expenses like blood work, any nursing services, in-home recovery, preventative services, and extra charges for Part B of Medicare.

Your next step will focus on picking the Medigap Plans that are right for you. There are 12 different plans designed to fill in the gaps of Medicare. These plans are labeled A through L and are designed to cover specific gaps in your Medicare coverage. Individuals who obtain coverage through a Medicare Advantage Plan will not need a Medigap policy.

***Residents of Massachusetts, Minnesota, or Wisconsin will have different Standard Medigap Plans***

Medigap Plan Options:

 

  • The Basic Benefits
    • Plans A-J:
      • Includes Medicare Part A coinsurance plus an additional 365 days after your Medicare benefits end.
      • Includes Medicare Part B coinsurance or co-payments for hospital outpatient service.
      • Coverage for the first three pints of blood every year.
    • Plan K:
      • Includes Medicare Part A coinsurance plus an additional 365 days after your Medicare benefits end.
      • Also coverage of 50% of hospice cost-sharing, first three pints of blood every year, and Medicare Part B Coinsurance.
    • Plan L:
      • Includes Medicare Part A coinsurance plus an additional 365 days after your Medicare benefits end.
      • Also coverage of 75% of hospice cost-sharing, first three pints of blood every year, and Medicare Part B Coinsurance.
  • Medicare Part A: Hospital Deductible
    • Plans B-J:
      • Coverage of $1,024 for every period of hospital service.
    • Plan K:
      • 50% coverage of the hospital deductible
    • Plan L:
      • 75% coverage of the hospital deductible
  • Skilled Nursing Home Costs
    • Plans C-J:
      • Cost coverage of $128 for 21 to 100 days in a skilled nursing home.
    • Plan K:
      • 50% Cost coverage of $128 for 21 to 100 days in a skilled nursing home.
    • Plan L:
      • 75% Cost coverage of $128 for 21 to 100 days in a skilled nursing home.
  • Medicare Part B – Deductible
    • Plans C,F,J:
      • Yearly deductible of doctor visits
  • Medicare Part B – Excess Charges
    • Coverage of 100% for Plan F
    • Coverage of 80% for Plan G
    • Coverage of 100% for Plan I
    • Coverage of 100% for Plan J
  • Foreign Travel Emergency
    • Plans C-J
      • Coverage of 80% for emergency care
      • Lifetime maximum of $50,000 with a yearly deductible of $250
  • At-Home Recovery
    • Plans D,G, I, J
      • Coverage includes: help for daily activities (bathing, dressing) if your already receiving in home care. Help for an additional 8 weeks after ending at-home skilled care. Coverage up to $40 per visit with a maximum of $1,600 per year.
  • Non-Medicare-Covered Preventative Services:
    • Doctor ordered services up to $120 per year
 
 
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