What Does a Medicare Supplement Cover?

A Medicare Supplement, also referred to as a Medigap Policy, is basically an insurance plan that is secondary to original Medicare. You must be enrolled in Parts A and B in order to be eligible to enroll in a Medicare Supplement Plan.

Original Medicare has four parts. Part A is hospital insurance with a deductible of $1156.00 for 2012. Part B is medical insurance with a deductible of $140.00 for 2012. Part C is known as a Medicare Advantage Plan. Medicare Advantage Plans replace your original Medicare insurance. They include hospital insurance, medical insurance, and some plans include prescription drug coverage. Part D is prescription drug coverage. If your Part C plan does not include prescription drug coverage, you can enroll in Part D.

If you choose to keep original Medicare (Parts A and B), most of your expenses will be covered by also having a Medicare Supplement Plan in place. Currently, the Medicare Supplements to choose from are labeled as Plans A, B, C, D, F, F (high-deductible), G, K, L, M, and N. All plans require paying a premium and some require paying additional deductibles before any coverage is provided.

Depending on the plan, each benefit below is either fully or partially covered:

• Medicare Part A Co-insurance and hospital costs up of an additional 365 days after Medicare benefits are used up
• Medicare Part B Co-insurance or Co-payment
• Blood (first 3 pints)
• Part A Hospice Care Co-insurance or Co-payment
• Skilled Nursing Facility Care Co-insurance
• Medicare Part A Deductible
• Medicare Part B Deductible
• Medicare Part B Excess Charges
• Foreign Travel Emergency (up to plan limits)

Detailed plan coverage for each benefit is provided in the official Medicare publication, 2012 Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare.

All Medicare Supplement Plans must follow federal and state laws and must be identified as Medicare Supplement Insurance. Insurance companies can only sell standardized policies. In other words, they must all provide the same basic benefits but some plans offer additional benefits so you can choose the one that fits your needs. Usually the only difference between the policies is price so it pays to compare apples to apples through different insurance companies when shopping for a particular plan.

Current Medicare Supplement Plans do not cover your prescription drugs. To receive this coverage, you must enroll in Part D by contacting Medicare at 1-800-633-4227 or through the Medicare website during an open enrollment period.

Plans E, H, I, and J have been discontinued. If you currently have one of these plans, you can keep it but if you change plans, you will no longer be able to get one of these plans.

The author is a licensed life and health insurance agent for the state of Illinois. She is an independent agent that is contracted with several companies to get the best products with the lowest premiums. She focuses on providing necessary coverage for seniors. Her specialties are medicare supplement insurance and final expense policies. Visit http://www.illinoisinsuranceproducts.com if you are a resident of Illinois.

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