medicare supplement ebook from healthcare.com

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HOW TO PICK A MEDICARE

SUPPLEMENT PLANA GUIDE TO CHOOSING A MEDICARE SUPPLEMENT

INSURANCE PLAN THAT’S RIGHT FOR YOU

A free ebook from HealthCare.com

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Introduction: Why Medicare supplement insurance?

Medicare supplement must-knows

When to buy Medicare supplement insurance

Meet Plan A

Meet Plan B

Meet Plan C

Meet Plan F

Meet Plan G

Meet Plan K

Meet Plan L

Meet Plan N

Putting it all together

Where to buy Medicare supplement insurance

References

Table of contents

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Why Medicare supplement insurance?

Tens of millions of Americans rely on Medicare for health insurance coverage. While the federal program provides affordable benefits to those age 65 and older, as well as others who meet certain criteria, those benefits are limited.

As we age, our household budgets tend to become more fixed while our healthcare needs often increase. Medical expenses exceeding what Medicare Part A hospital insurance and Medicare Part B medical insurance cover can strain finances. That’s where Medicare supplement health insurance comes in.

Also known as Medigap plans, Medicare supplement plans help pay for healthcare expenses beyond what Medicare covers. Depending on the Medicare supplement plan selected, these expenses may include copayments, coinsurance, deductibles, and even emergency medical care received when traveling outside of the United States.

http://www.healthcare.com/medicare-supplemental

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Why Medicare supplement insurance?

As a matter of fact, unless otherwise specified, Medicare supplement plans will pay for 100 percent of covered expenses after original Medicare pays its share.

Buying Medicare supplement insurance can be a savvy financial move. However, it can also be a bit overwhelming. There are a lot of letters and the plans kind of look the same. This guide will explain the plans available in most states and help you determine which is best for you.

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Before you shop for and enroll in a Medicare supplement insurance plan, you should understand the basics. Unlike regular Medicare (aka Part A and B), Medicare supplement plans are sold by private companies. Furthermore, Medicare supplement plans are standardized. They are labeled A through N and cover the same basic benefits as well as additional benefits to meet your personal healthcare and financial needs.

Before you shop for and enroll in a Medicare supplement plan, keep the following in mind:

You must have Medicare Part A and Part B to enroll in a Medicare supplement plan.

Medicare supplement plans may only be used with Medicare Part A and Part B, not with Medicare Advantage policies.

https://www.healthcare.com/info/medicare/buying-medicare-supplement-insurance-65-smart-financial-decision

https://www.healthcare.com/info/medicare/buying-medicare-supplement-insurance-65-smart-financial-decision

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Medicare supplement coverage is only available to individuals; you and your spouse must complete individual applications.

You will pay a private insurance company for Medicare supplement coverage; this payment will be separate from your Medicare payment.

Medicare supplement plans sold after Jan. 1, 2006, do not include prescription drug coverage.

You cannot buy a Medigap policy if you have a Medicare Medical Savings Account Plan (and it’s illegal for anyone to sell you one).

Medicare supplement insurance does not typically cover long-term care, dental, vision, hearing aid or other types of lifestyle bills. Contact your insurance company to confirm benefits.


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Because Medicare supplement plans are standardized, you will want to compare options based on premium cost and provider network. Make sure you enroll in a Medicare-approved supplement plan from a company you trust, one with good financial strength and high-quality customer service.


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When to buy Medicare supplement insurance

If you buy Medicare supplement insurance during your six-month Medicare open enrollment period, you cannot be denied coverage due to preexisting health conditions or health history. Reminder: Your six-month open enrollment period automatically begins the month you turn age 65 and become enrolled in Medicare Part B.

If you buy Medicare supplement insurance outside your open enrollment period, you will be subject to underwriting. That means you can be denied coverage or charged more due to preexisting health conditions or health history.

Once you have a standardized Medicare supplement plan, it is guaranteed renewable, even if you have health problems. As long as you pay the premium, your policy cannot be cancelled.

https://www.healthcare.com/info/medicare/why-every-senior-needs-medicare-supplement-insurance

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Meet Plan ADon’t confuse Plan A with Part A. Part A is your regular Medicare hospital coverage. Plan A is a supplemental product. If you want some extra coverage beyond what original Medicare offers, Medicare supplement Plan A provides the basics:

Plan A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are exhausted

Part B coinsurance or copayment

Your first three pints of blood

Part A hospice care coinsurance or copayment

Choose Plan A if: You do not expect a lot of medical expenses and want to keep your Medicare supplement premiums low. However, should you require some extra healthcare, you may wind up paying more out of pocket with Plan A.

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What’s the premium cost? Medicare supplement plan premiums vary by carrier. In general, plans with less comprehensive coverage will cost the least in terms of premium, and those with the most comprehensive coverage will cost the most. Keep in mind that out-of-pocket costs are typically lower with more comprehensive coverage and higher with less comprehensive coverage.

Meet Plan A

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Plan A Benefits

* Up to an additional 365 days after Medicare benefits are exhausted

** Up to plan limits

Part A coinsurance and hospital costs* 100%

Part B coinsurance or copayment 100%

Blood (first three pints) 100%

Skilled nursing facility care coinsurance ------

Part A deductible ------

Part B deductible ------

Part B excess charges ------

Foreign travel emergency coverage** ------

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Meet Plan BAs with Plan A, Plan B is not the same as regular Medicare Part B. You could have Plan B supplement insurance along with Medicare Part A and Part B. Medicare supplement Plan B is also fairly basic and exactly like Plan A, but with a key difference: Plan B benefits include your Part A deductible. That can be a big savings since the Part A hospital inpatient deductible is $1,260 per benefit period, as of 2015 (1).

Choose Plan B if: You anticipate few medical expenses but expect the extra hospital coverage could come in handy. Again, premiums will likely be lower with Plan A than others, but unexpected medical care may cost you more out of pocket.

What’s the premium cost? Medicare supplement plan premiums vary by carrier. In general, plans with less comprehensive coverage will cost the least in terms of premium, and those with the most comprehensive coverage will cost the most. Keep in mind that out-of-pocket costs are typically lower with more

(1) Medicare.gov. “Medicare 2015 Costs at a Glance.”

http://www.medicare.gov/your-medicare-costs/costs-at-a-glance/costs-at-glance.html

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Plan B Benefits

* Up to an additional 365 days after Medicare benefits are exhausted** Up to plan limits

Part A coinsurance and hospital costs* 100%



Part A hospice care coinsurance or copayment 100%

Skilled nursing facility care coinsurance ------

Part A deductible 100%




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Meet Plan CAgain, don’t confuse Plan C with Part C (also referred to as Medicare Advantage). Plan C is yet another supplemental plan option. This one picks up everything your original Medicare plan doesn’t, except Part B excess charges. You won’t have to pay a single Medicare Part A or Part B copayment or your share of coinsurance; Plan C takes care of it.

Choose Plan C if: You want comprehensive coverage to help cut healthcare costs but do not expect to accrue Part B excess charges—Part B excess charges apply when you use non-participating providers; these charges can be up to 15 percent over the amount non-participating providers are paid. (2) With Plan C, you will be responsible for paying any Part B excess charges.

(2) Medicare.gov. “Lower costs with assignment.”

http://www.medicare.gov/your-medicare-costs/part-a-costs/assignment/costs-and-assignment.html

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Meet Plan CWhat’s the premium cost? Medicare supplement plan premiums vary by carrier. In general, plans with less comprehensive coverage will cost the least in terms of premium, and those with the most comprehensive coverage will cost the most. Keep in mind that out-of-pocket costs are typically lower with more comprehensive coverage and higher with less comprehensive coverage.

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Plan C BenefitsPart A coinsurance and hospital costs* 100%




Skilled nursing facility care coinsurance 100%


Part B deductible 100%


Foreign travel emergency coverage** 80%


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Meet Plan FA real crowd pleaser, Plan F earns ranking as the most popular Medicare supplement plan. The reason: You get the whole enchilada. Plan F offers the most comprehensive coverage. Once Medicare pays its share of covered charges for hospital and doctor care, Plan F picks up the rest of them at 100 percent—the exception being foreign travel emergency coverage, which leaves you responsible for 20 percent of covered charges.

That means, with Plan F, your total out-of-pocket cost for covered hospital and doctor charges should be $0. Of course, as with all Medicare and Medicare supplement coverage, you are still responsible for your plan premiums.

A high deductible Plan F also exists. With this option, in 2015, you pay Medicare-covered costs up to $2,180 before your Medicare supplement plan kicks in. (3)

(3) Medicare.gov “ How to Compare Medigap Policies.”

http://www.medicare.gov/supplement-other-insurance/compare-medigap/compare-medigap.html

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Meet Plan FChoose Plan F if: You want protection from high out-of-pocket costs associated with hospital and medical care. Plan F may be a good fit if you anticipate a lot of healthcare expenses or simply desire the peace of mind that comes with knowing you have the coverage should you need it.

What’s the premium cost? Medicare supplement plan premiums vary by carrier. In general, plans with less comprehensive coverage will cost the least in terms of premium, and those with the most comprehensive coverage will cost the most. Plan F tends to be the most expensive supplement plan because it offers the most robust benefits. However, you will pay the least out of pocket when you add Plan F supplemental coverage to your original Medicare coverage. High deductible Plan F should have a lower monthly premium than traditional Plan F.

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Plan F BenefitsPart A coinsurance and hospital costs* 100%






Part B deductible 100%

Part B excess charges 100%



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Meet Plan GPlan G looks a lot like Plan F. It’s almost as popular, too. The key difference between the two is Plan G doesn’t include your Part B deductible.

Choose Plan G if: You want robust supplemental coverage but don’t mind paying your Part B deductible, which amounts to $147 per year.(4) Beyond that—and your share of foreign travel emergency coverage, should you need it—you will pay $0 for medical expenses covered by original Medicare and Plan G.

What’s the premium cost? Medicare supplement plan premiums vary by carrier. In general, plans with less comprehensive coverage will cost the least in terms of premium, and those with the most comprehensive coverage will cost the most. Plan G will be more expensive than some Medicare supplement plans because it offers more comprehensive coverage; however, because it does not include Part B deductible benefits, it will cost less in monthly premium than Part F.

(4) Medicare.gov. “Medicare 2015 Costs at A Glance.”

http://www.medicare.gov/your-medicare-costs/costs-at-a-glance/costs-at-glance.html

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Plan G BenefitsPart A coinsurance and hospital costs* 100%







Part B excess charges 100%



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Meet Plan KPlan K splits the bill on covered services. It pays Part A coinsurance and hospital costs (up to an additional 365 days after Medicare benefits are exhausted) at 100 percent, then covers the following at 50 percent:




Skilled nursing facility care coinsurance

Part A deductible

Plus, there’s a cap on what you’ll owe. If you exceed Plan K’s $4,940 out-of-pocket spending limit, the plan pays for additional covered expenses.

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Meet Plan KChoose Plan K if: You want lower monthly premiums and some cost-sharing to help alleviate out-of-pocket healthcare expenses.

What’s the premium cost? Medicare supplement plan premiums vary by carrier. In general, plans with less comprehensive coverage will cost the least in terms of premium, and those with the most comprehensive coverage will cost the most. Plan K tends to have the lowest monthly premiums.

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Plan K BenefitsPart A coinsurance and hospital costs* 100%









Out-of-pocket limit $4,940


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Meet Plan LPlan L picks up a portion of covered expenses, too, but it picks up more. It pays Part A coinsurance and hospital costs (up to an additional 365 days after Medicare benefits are exhausted) at 100 percent, then covers the following at 75 percent:




Skilled nursing facility care coinsurance

Part A deductible

Again, there’s a cap on what you’ll owe. If you exceed Plan L’s $2,470 out-of-pocket spending limit, the plan pays for additional covered expenses.

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Meet Plan LChoose Plan L if: You still want lower monthly premiums but prefer a little added cost-sharing to help alleviate out-of-pocket healthcare expenses.

What’s the premium cost? Medicare supplement plan premiums vary by carrier. In general, plans with less comprehensive coverage will cost the least in terms of premium, and those with the most comprehensive coverage will cost the most. Plan L tends to have the second-lowest monthly premiums.

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Plan L BenefitsPart A coinsurance and hospital costs* 100%









Out-of-pocket limit $2,470


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Meet Plan NPlan N combines comparably low premiums with fairly comprehensive coverage. It does not include benefits for Part B deductible or Part B excess charges. However, it covers everything else at 100 percent—the exception being foreign travel emergency coverage, which is covered at 80 percent.

Choose Plan N if: You still want lower monthly premiums but prefer a little added cost-sharing to help alleviate out-of-pocket healthcare expenses.

What’s the premium cost? Medicare supplement plan premiums vary by carrier. In general, plans with less comprehensive coverage will cost the least in terms of premium, and those with the most comprehensive coverage will cost the most. In terms of premium and coverage, Plan N tends to fall somewhere in the middle.

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Plan N BenefitsPart A coinsurance and hospital costs* 100%

Part B coinsurance or copayment** 100%







Foreign travel emergency coverage*** 80%

* Up to an additional 365 days after Medicare benefits are exhausted** Plan N pays 100 percent of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don’t result in inpatient admission. *** Up to plan limits

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Putting it all togetherThe chart below compares the most commonly available Medicare supplement insurance plans. Unless otherwise specified, benefits are covered at 100 percent.

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Benefits A B C F G K L N

Part A coinsurance and hospital costs* Y Y Y Y Y Y Y Y

Part B coinsurance or copayment Y Y Y Y Y 50% 75% Y***

Blood (first three pints) Y Y Y Y Y 50% 75% Y

Part A hospice care coinsurance or copayment Y Y Y Y Y 50% 75% Y

Skilled nursing facility care coinsurance N N Y Y Y 50% 75% Y

Part A deductible N Y Y Y Y 50% 75% Y

Part B deductible N N Y Y N N N N

Part B excess charges N N N Y Y N N N

Foreign travel emergency coverage** N N 80% 80% 80% N N 80%

Out-of-pocket limit N/A N/A N/A N/A N/A $4,940 $2,470 N/A

* Up to an additional 365 days after Medicare benefits are exhausted** Up to plan limits*** Plan N pays 100 percent of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don’t result in inpatient admission.

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Ultimately, it’s all about striking the balance between affordability and benefits. You will need to assess your financial situation and healthcare needs and select a plan with reasonable monthly premiums and benefits that reduce out-of-pocket spending.

Putting it all together

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You can buy Medicare supplement through a health insurance agent or broker or directly from an insurance company that sells Medicare supplement plans. You may also use websites such as HealthCare.com to shop for and compare multiple Medicare supplement plans from various providers.

It is important to keep in mind that not all Medicare supplement plans are available in all states. Furthermore, not all health insurance companies sell all Medicare supplement plans; though, companies that offer Medicare supplement plans must sell Plan A, as well as Plan C or Plan F.

http://www.healthcare.com/

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If you need help selecting a Medicare supplement plan or have questions about Medicare supplement insurance, call 855-895-8412 to talk to a licensed agent from one of our trusted health insurance partners.


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Centers for Medicare & Medicaid Services. 2015 Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare. Revised February 2014.

Retrieved from http://www.medicare.gov/pubs/pdf/02110.pdf.

HealthCare.com

References


http://www.medicare.gov/pubs/pdf/02110.pdf

A free ebook from HealthCare.com

Copyright 2015 HealthCare, Inc.



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