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What is Medicare Supplemental Insurance?

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Medicare Supplemental Insurance, is a type of senior health insurance plan sold by private insurance companies to fill the “gaps” in Original Medicare Part A and your Medicare Part B coverage.

You may be able to choose up to 12 different standardized medicare supplemental plans, plus additional high deductible plans.

These policies must follow Federal and State laws. These laws protect you. A medicare supplement policy must be clearly identified on the cover as “Medicare Supplemental Insurance.” Each plan, A through L, has a different set of basic and extra benefits.

Most Medicare Supplemental Insurance plans pay these basic benefits:

  • Medicare Part A hospital deductible ($1,100 per illness for 2010), coinsurance plus coverage for 365 additional days after Medicare benefits end
  • Medicare Part B The 2010 Part B deductible is $155, up $20 from 2009. coinsurance (generally 20% of Medicare approved expenses)
  • First three pints of blood each year

Additional benefits, depending on the plan you choose, pay you for:

  • Medicare Part B deductible ($155 in 2010)
  • Medicare Part B excess charges
  • At-home recovery visits
  • Foreign travel emergency care

How to Select the Right Medicare Supplement Plans

It’s important to compare different medicare supplemental plans because costs can vary. The benefits in any Medigap Plan A through L are the same for any insurance company. Each medicare supplemental insurance company decides which Medigap policies it wants to sell.

Medigap policies must follow federal and state laws. These laws protect you. The front of a Medigap policy must clearly identify it as " Medicare Supplemental Insurance" . You need both Medicare Part A and Medicare Part B to buy a Medigap Policy.

Mutual of Omaha Medicare Supplement Plans

Buying a Medigap Policy

Buying a “Medicare Supplement Insurance”) policy is a very important decision. You will first need to decide if a Medigap policy is the best way for you to supplement your Original Medicare coverage.

Medicare supplemental insurance plan providers set their monthly premiums. How they choose to set their prices can have an affect on how much you will pay now and in the future. You should consider all these factors, before you buy the policy. There are three common ways that a provider can choose to base their charges on:

  1. Community-rated : No matter how old you are, the policy costs the same. Premiums may go up due to inflation or other factors, but not due to age.
  2. Issue-age-rated : The charges are related to your age at the time of purchase - which means when you buy your policy, you will be charged the same amount as others in your community who are the same age.
  3. Attained-age-rated : The charges automatically go up in price as you age.

The price of buying a Medigap policies can vary between different medicare insurance companies. ;Make sure you compare the same type of Medigap policy from one company to another.

For example, compare a Medigap Plan D from one medicare supplement insurance plan provider with a Medigap Plan D from another medicare supplement insurance provider.

How Do I Choose the Best Medigap Plan?

Paying a higher premium for a standardized Medicare Supplemental insurance plan will NOT get you anything more — except perhaps a nice smile from the medicare insurance agent.Before you purchase a medicare supplement policy, compare all your options, and premium costs from each provider of medicare supplemental insurance.

The following is a list of common questions you should answer before you secure your plan:

  • How much can you afford to spend on monthly premiums for your Medigap coverage?
  • How does the plan's premium compare to other exact plans for the same benefits?
  • What coverage and benefits do you really need?
  • How hard is it to file my medicare claims? Can your doctor file the necessary paperwork for you?
  • Is there any type of ;waiting period to cover my pre-existing conditions? If so, how long ? And do you have any previous coverage that applies toward reducing the waiting period?

Medicare Supplement Policies: Listing by Plans

There are 12 standard policies that help pay the majority of the out of pocket costs that the original Medicare plan does not cover. (If you are in Medicare Advantage plan, such as a Private Fee For Service plan, you do not need a Medicare supplement policy.)

Each standard supplemental plan, labeled A through L, offers a different set of benefits, fills different "gaps" in coverage, and varies in price. There are insurers that offer the "high deductible option" on Medicare supplement plans F and J.

Every supplemental policy are obligated to cover certain basic benefits. These benefits are as follows:

Medicare Part A coverage:

  • Coinsurance for hospital days 61-90 ($256 in 2008) and 91-150 ($512 in 2008)
  • Cost of 365 more hospital day in your lifetime, once you have used the entirety of hospital policy benefits

Medicare Part B coverage:

  • Generally, 20% of doctor bills and fifty percent of mental health medical services
  • The first three pints of blood

Medicare Supplement Plan A

  • Basic Benefits

Medicare Supplemental Plan B

  • Basic Benefits
  • Medicare Part A Hospital Deductible: $1,024 in 2008 for each benefit period for in-patient hospital policy services

Medicare Supplement Plan C

  • Basic Benefits
  • Medicare Part A Hospital Deductible
  • Skilled Nursing Home Costs: Your cost ($128 in 2008) for days 21-100 in a skilled nursing home.
  • Medicare Part B Deductible: Yearly deductible for doctor services ($135 in 2008).
  • Foreign Travel Emergency:
    • 80% of cost of emergency care outside U.S.A borders
    • Up to $50,000 during your lifetime
    • There is a yearly deductible of $250

Medicare Supplement Plan D

  • Basic Benefits
  • Medicare Part A Hospital Deductible
  • Skilled Nursing Home Costs
  • Foreign Travel Emergency
  • At Home Recovery
    • Help for activities of daily living, such as bathing and dressing, for those receiving skilled home care that is Medicare approved.
    • There is an extension of eight weeks after patient no longer receiving skilled care.
    • Benefit of up to $40 per visit, seven visits per week. Maximum benefit is $1,900 per year.

Medicare Supplemental Plan F*

  • Basic Benefits
  • Medicare Part A Hospital Deductible
  • Skilled Nursing Home Costs
  • Medicare Part B Deductible
  • Medicare Part B Excess Charges: Pays 100% of the difference between your doctor's charge and the Medicare approved amount to a non-Medicare assignment doctor.
  • Foreign Travel Emergency

    High Deductible Plan "F":
    Plan "F" has an option called High Deductible Plan "F". This high deductible plan offers the same benefits as the regular Plan "F" but the benefits do not start until after you pay a calendar year deductible of $1,900 in 2008 (this deductible goes up with inflation).

    Some of the expenses you will have to pay to satisfy the deductible include the Medicare deductibles for Parts A and B, but does not include the Foreign Travel Emergency deductible. The Foreign Travel Emergency deductible must be paid regardless of whether you have met the $1,900 deductible. Also, you cannot count the Foreign Travel Emergency deductible toward the $1,900 deductible.

Medicare Supplement Plan G

  • Basic Benefits
  • Medicare Part A Hospital Deductible
  • Skilled Nursing Home Costs
  • Medicare Part B Excess Charges: Pays 80% of the difference between your doctor's charge and the Medicare approved amount, if your doctor does not accept assignment.
  • Foreign Travel Emergency
  • At Home Recovery

Medicare Supplement Plan H

  • Basic Benefits
  • Medicare Part A Hospital Deductible
  • Skilled Nursing Home Costs
  • Foreign Travel Emergency
  • Prescription Drugs: fifty percent of prescription drug costs up to $1,250 each year after a yearly deductible of $250. (If purchased before 2005)
* If you choose the "high deductible option" on supplemental Medicare Plan F and J, you will first have to pay a $1,900 deductible in 2008 before the plan pays anything. This amount goes up every year with inflation. This high deductible option is less expensive, but getting medical attention will cost you more money.
In addition to the A-L standard supplemental Medicare (Medigap) plan, Medicare SELECT is a type of supplement policy that is more affordable than a traditional Medicare supplement policy.

However, you can only go to certain doctors and hospitals to receive medical care. Please contact today to find the suitable Medicare Select or supplement policy that is available in your area

*Plans K and L involves cost-sharing for medical expenses and services. In these plans, once you reach the annual expense limit ($4,440 for Plan K and $2,220 for Plan L), the plans pays 100% of the Medicare co-payments, coinsurance, and deductibles for the rest of the calendar year.

The out-of-pocket annual limit does NOT include charges from your provider that exceed Medicare-approved amounts, called "Excess Charges." The client will be responsible for paying excess charges. The out-of-pocket annual limit will increase each year with inflation.