YourInsuranceStore.com

        

 

          

 

Raonbow Line.gif (4491 bytes)

Med Sup.gif (31651 bytes)  Medicare Supplement

What Is A Medicare Supplement Plan?

Also known as Medigap, Medicare Supplements are specifically designed to supplement Medicare's benefits and are regulated by federal and state law. They must be clearly identified as Medicare supplemental insurance, and must provide specific benefits that help fill the gaps in your Medicare coverage.

Standard Medigap Plans

To make it easier for you to compare Medigap insurance policies, California among 
other states limits the number of different Medigap policies that can be sold to no more than ten standardized Medigap plans. The plans were developed by the National Association of Insurance Commissioners and incorporated into state and federal law. They have letter designations ranging from "A" through "J", with plan "A" being the "basic" benefit package. Each of the other 9 plans includes the basic package plus a different combination of additional benefits. Plan "J" provides the most coverage of all the plans, and is also the most expensive. Insurance companies are not permitted to change the combination of benefits or the letter designations of any of the plans.

What Medigap Plans Cover

Medigap policies pay most, if not all Medicare Co-ins. amounts and may provide
coverage for Medicare's deductibles. Some of the 10 standard plans pay for services 
not covered by Medicare such as outpatient prescription drugs, preventive screenings, and emergency medical care while traveling outside the U.S.A. Coverage is also provided in some plans for health care provider charges in excess of Medicare's approved amount and for some care in your home. Here is a summary of all 10 plans as shown in the 2000 "GUIDE TO HEALTH INSURANCE FOR PEOPLE WITH MEDICARE" prepared by the Health Care Financing Administration.

STANDARD MEDIGAP PLANS
Following is a list of the 10 standard plans and the benefits provided by each:

Plan "A" Basic Policy

Consists of these basic benefits:
Coverage for the Part A Co-ins. amount ($194 per day in 2000) for the 61st through the90th day of hospitalization in each Medicare benefit period.
Coverage for the Part A Co-ins. amount ($388 per day in 2000) for each of Medicare's
60 non-renewable lifetime hospital inpatient re- serve days used.
After all Medicare hospital benefits are exhausted, coverage for 100% of the Medicare Part A eligible hospital expenses. Coverage is limited to a maximum of 365 days of additional in-patient hospital care during the policyholder's lifetime. This benefit is paid either at the rate Medicare pays hospitals under its Prospective Payment System (PPS) or under another appropriate standard of payment for hospitals not subject to the PPS. Beneficiaries may be responsible for payment when Medigap hospital benefits are exhausted.
Coverage under Medicare Parts A and B for the reasonable cost of the first 3 pints of blood or equivalent quantities of packed red blood cells per calendar year unless replaced in accordance with federal regulations.
Coverage for the Co-ins. amount for Part B services (generally 20% of approved amount; 50% of approved charges for outpatient mental health services) after $100 annual deductible is met.
Plan "B"
Includes the basic benefits (Plan "A") plus:
Coverage for the Medicare Part A inpatient hospital deductible ($776 per benefit period in 2000).

Plan "C"

Includes the basic benefits (Plan "A") plus:
Coverage for the Medicare Part A inpatient hospital deductible ($776 per benefit period in 2000).
Coverage for the skilled nursing facility care Co-ins. amount ($97.00 per day for days 21 through 100 per benefit period in 2000).
Coverage for the Medicare Part B deductible ($100 per calendar year in 2000).
80% coverage for medically necessary emergency care in a foreign country, after a $250 deductible, to a lifetime maximum benefit of $ 50,000.

Plan "D"

Includes the basic benefits (Plan "A") plus:
Coverage for the Medicare Part A inpatient hospital deductible ($776 per benefit period in 2000).
Coverage for the skilled nursing facility care Co-ins. amount ($97.00 per day for days 21 through 100 per benefit period in 2000).
80% coverage for medically necessary emergency care in a foreign country, after a $250 deductible, to a lifetime maximum benefit of $ 50,000.
Coverage for at home recovery. The at home recovery benefit pays up to $1,600 per year for short- term, at home assistance with activities of daily living (bathing, dressing, Includes the basic benefit plus: personal hygiene, etc.) for those recovering from an illness, injury or surgery.

Plan "E"

Includes the basic benefits (Plan "A") plus:
Coverage for the Medicare Part A inpatient hospital deductible ($776 per benefit period in 2000)
Coverage for the skilled nursing facility care Co-ins. amount ($97.00 per day for days 21 through 100 per benefit period in 2000).
80% coverage for medically necessary emergency care in a foreign country, after a $250 deductible, to a lifetime maximum benefit of $ 50,000.
Coverage for preventive medical care. The preventive medical care benefit pays up to $120 per year for such things as a physical examination, serum cholesterol screening, hearing test, diabetes screenings, and thyroid function tests.

Plan "F"

Includes the basic benefits (Plan "A") plus:
Coverage for the Medicare Part A inpatient hospital deductible ($776 per benefit period in 2000)
Coverage for the skilled nursing facility care Co-ins. amount ($97.00 per day for days 21 through 100 per benefit period in 2000).
Coverage for the Medicare Part B deductible ($100 per calendar year in 2000).
80% coverage for medically necessary emergency care in a foreign country, after a $250 deductible, to a lifetime maximum benefit of $ 50,000.
Coverage for 100% of Medicare part B excess charges*

Plan "G"

Includes the basic benefits (Plan "A") plus:
Coverage for the Medicare Part A inpatient hospital deductible ($776 per benefit period in 2000)
Coverage for the skilled nursing facility care Co-ins. amount ($97.00 per day for days 21 through 100 per benefit period in 2000).
Coverage for 80% of Medicare part B excess charges*
80% coverage for medically necessary emergency care in a foreign country, after a $250 deductible, to a lifetime maximum benefit of $ 50,000.
Coverage for at home recovery. The at home recovery benefit pays up to $1,600 per year for short- term, at home assistance with activities of daily living (bathing, dressing, Includes the basic benefit plus: personal hygiene, etc.) for those recovering from an illness, injury or surgery.

Plan "H"

Includes the basic benefits (Plan "A") plus:
Coverage for the Medicare Part A inpatient hospital deductible ($776 per benefit period in 2000)
Coverage for the skilled nursing facility care Co-ins. amount ($97.00 per day for days 21 through 100 per benefit period in 2000).
80% coverage for medically necessary emergency care in a foreign country, after a $250 deductible, to a lifetime maximum benefit of $ 50,000.
Coverage for 50% of the cost of prescription drugs up to a maximum annual benefit of $1,250 after the policyholder meets a $250 per year deductible 

Plan "I"

Includes the basic benefits (Plan "A") plus:
Coverage for the Medicare Part A inpatient hospital deductible ($776 per benefit period in 2000)
Coverage for the skilled nursing facility care Co-ins. amount ($97.00 per day for days 21 through 100 per benefit period in 2000).
Coverage for 100% of Medicare part B excess charges*
Coverage for 50% of the cost of prescription drugs up to a maximum annual benefit of $1,250 after the policyholder meets a $250 per year deductible 
80% coverage for medically necessary emergency care in a foreign country, after a $250 deductible, to a lifetime maximum benefit of $ 50,000.
Coverage for at home recovery. The at home recovery benefit pays up to $1,600 per year for short- term, at home assistance with activities of daily living (bathing, dressing, Includes the basic benefit plus: personal hygiene, etc.) for those recovering from an illness, injury or surgery.

Plan "J"

Includes the basic benefits (Plan "A") plus:
Coverage for the Medicare Part A inpatient hospital deductible ($776 per benefit period in 2000)
Coverage for the skilled nursing facility care Co-ins. amount ($97.00 per day for days 21 through 100 per benefit period in 2000).
Coverage for the Medicare Part B deductible ($100 per calendar year in 2000).
Coverage for 100% of Medicare part B excess charges*
80% coverage for medically necessary emergency care in a foreign country, after a $250 deductible, to a lifetime maximum benefit of $ 50,000.
Coverage for preventive medical care. The preventive medical care benefit pays up to $120 per year for such things as a physical examination, serum cholesterol screening, hearing test, diabetes screenings, and thyroid function tests.
Coverage for at home recovery. The at home recovery benefit pays up to $1,600 per year for short- term, at home assistance with activities of daily living (bathing, dressing, Includes the basic benefit plus: personal hygiene, etc.) for those recovering from an illness, injury or surgery.
Coverage for 50% of the cost of prescription drugs up to a maximum annual benefit of $3,000 after the policyholder meets a $250 per year deductible 
*Plan pays a specified percentage of the difference between Medicare's approved amount for Part B services and the actual charges (up to the amount of charge limitations set by either Medicare or state law).

All 10 Medicare Supplement Plans are Summarized Below:

CHART OF TEN STANDARD MEDICARE SUPPLEMENT PLANS

Medicare supplement insurance can be sold in only 10 standard plans. This chart shows the benefits included in each plan. Every company must make available plan A. Some plans may not be available in your state.

Basic Benefits: Included in All Plans.
Hospitalization: Part A Co-ins. plus coverage for 365 additional days after Medicare benefits end.
Medical Expenses: Part B Co-ins. (generally 20% of Medicare-approved expenses).
Blood: First 3 pints of blood each year.  (N/A = Not Available in That Plan).

A B C D E F G H I J
Basic
Benefit
Basic
Benefit
Basic
Benefit
Basic
Benefit
Basic
Benefit
Basic
Benefit
Basic
Benefit
Basic
Benefit
Basic
Benefit
Basic
Benefit
N/A N/A Skilled
Nursing
Co-ins.
Skilled
Nursing
Co-ins.
Skilled
Nursing
Co-ins.
Skilled
Nursing
Co-ins.
Skilled
Nursing
Co-ins.
Skilled
Nursing
Co-ins.
Skilled
Nursing
Co-ins.
Skilled
Nursing
Co-ins.
N/A Part A
Deductible
Part A
Deductible
Part A
Deductible
Part A
Deductible
Part A
Deductible
Part A
Deductible
Part A
Deductible
Part A
Deductible
Part A
Deductible
N/A N/A Part B
Deductible
N/A N/A Part B
Deductible
N/A N/A N/A Part B
Deductible
N/A N/A N/A N/A N/A Part B
Excess
(100%)
Part B
Excess
(80%)
N/A Part B
Excess
(100%)
Part B
Excess
(100%)
N/A N/A Foreign
Travel
Emergency
Foreign
Travel
Emergency
Foreign
Travel
Emergency
Foreign
Travel
Emergency
Foreign
Travel
Emergency
Foreign
Travel
Emergency
Foreign
Travel
Emergency
Foreign
Travel
Emergency
N/A N/A N/A At Home
Recovery
N/A N/A At Home
Recovery
N/A At Home
Recovery
At Home
Recovery
N/A N/A N/A N/A N/A N/A N/A Basic Drug
Benefit
$1,250 Limit
Basic Drug
Benefit
$1,250 Limit
Extended Drug
Benefit
$3,000 Limit
N/A N/A N/A N/A Preventive
Care
N/A N/A N/A N/A Preventive
Care

How do I get a "Free Quote" on Medigap Insurance?

To receive a free quote, simply click on the button immediately below this paragraph, then complete the form that appears on your screen while following the instructions on the form.
You can also request a quote for you spouse on the same form. Requesting a free quote does not place you under any obligation.

Raonbow Line.gif (4491 bytes)

For More Information Contact:

Henry Best Insurance Services
25820 Tennyson Lane, Stevenson Ranch, CA 91381
Tel: (818) 613-5380 in Los Angeles
FAX: (661) 284-3520

email: info@yourinsurancestore.com

 

Raonbow Line.gif (4491 bytes)

For More Information Contact:

Henry Best Insurance Services
25820 Tennyson Lane, Stevenson Ranch, CA 91381
Tel: (818) 613-5380
FAX: (661) 284-3520

email: info@yourinsurancestore.com

Send E-mail to hbest@yourinsurancestore.com with questions or comments about this website.

Copyright 1998-2003 Henry Best Insurance Services
Last modified:  November 11, 2003