Understanding the Difference Between Medicare Supplement Plans

NEW YORK, August 20, 2021 (Newswire.com) - Medicare Parts A and B have significant gaps that Medicare Supplement plans can cover. Medicare supplement plans are provided by private insurance companies and they supplement the Medicare that you already have. Medicare Supplement plans are not the same as Medicare Advantage plans, which replace Medicare Parts A and B, also known as Original Medicare.

Medicare Supplement plans are commonly known as "Medigap policies" and must adhere to federal and state laws designated to protect you. Insurance companies sell standardized policies that are identified by the letters

How to compare Medicare Supplement plans

Here are some of the main factors to consider when comparing Medicare Supplement plans and what they mean

Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up.

All Medigap plans offer this feature as of 2021. Without it, Medicare will only cover so much of any hospital costs you incur.

Part B coinsurance or copayment

After you hit your deductible for Medicare Part B, you typically pay a coinsurance or copayment equal to 20% of the Medicare-Approved Amount of services rendered (plus any excess charges). All Medicare Supplement plans will cover 100% of the coinsurance or copayment except for Medigap K and L, which cover 50% and 75% of it respectively.

Bloodwork and Transfusions (first 3 pints)

Unless you are donating blood or having the blood donated to you, or unless the hospital or provider gets it from a blood bank at no charge, you may be responsible for the cost of the first three units. All Medicare Supplement plans will cover this at 100% except Medigap plan K and L which cover 50% and 75% respectively.

Skilled nursing facility care coinsurance

Original Medicare fully covers skilled nursing facility (SNF) care only for the first 20 days. It offers partial coverage for days 21-100, and then afterwards the entire cost burden falls on you, unless you are enrolled in a Medicare Supplement plan that offers coverage indefinitely.  

Part A and Part B deductible

In 2021, the deductible is $1,484 for Medicare Part A and $203 for Medicare Part B. Some Medicare Supplement plans will meet the deductible for you. For example, if you enrolled in Medigap D you would not have to meet the $1,484 deductible for part A, but you would still have to meet $203 for part B. The only plans that cover Medicare Part B deductible are plans C and F, and you can no longer sign up for those unless you were eligible before 2020.

Part B excess charge

There are doctors who accept "assignment" which means they agree to accept Medicare-approved amounts as full payment for services rendered. Doctors who don't accept "assignment" may charge up to an additional 15% than the Medicare-approved amount, and this additional amount is called an "excess charge." Only Medigap F and G will cover such charges.

Foreign travel exchange

Medicare generally will not cover any fees associated with medical treatments or services outside the United States, but some Medigap coverage plans offer up to 80% additional coverage. 

Out-of-pocket limit

The out-of-pocket limit is the maximum amount you would pay for covered services in a given year. Premiums do not count towards your out-of-pocket limit.

Plans K and L are the only plans with an out-of-pocket limit of $6,220 and $3,110 in 2021, respectively, while other plans do not currently have out of pocket limits. After meeting your out-of-pocket yearly limit and your yearly Part B deductible covered services will be paid for at a rate of 100% for the rest of the calendar year.

The bottom line

Original Medicare offers great coverage, but for many people, a Medicare Supplement Plan can help provide more coverage for their specific needs, including needs that may come up as you age. Comparing your options can help you choose the right Medicare Supplement Plan for you.
 

Source: iQuanti, Inc.