Medicare Supplement policies are standardized plans sold by private insurance companies; the federal government requires companies to cover core benefits on all Medigap plans. So, no matter which option you choose, there are guaranteed benefits. Let’s dive deep into the Medicare benefits you can expect to have coverage through Medigap insurance.
Which Medicare Supplemental policies have core benefits?
All Medicare Supplement plans include core benefits. Every Medigap policy must cover the four core benefits.
Medigap Plan A is a core benefit policy that only covers these basic benefits. Other Medicare Supplement plans cover additional benefits.
For example, Medigap Plan G covers foreign travel emergencies, Part A deductible, Part B excess charges, and skilled nursing facility care coinsurances.
The four core benefits that every Medigap policy must cover
Core benefits are essential because, without these benefits, Medicare enrollees otherwise pay quite a few medical bills out of pocket. Let’s look at these benefits and review the costs when you only have Original Medicare.
The core benefits include the following:
- Medicare Part A coinsurance
- Part A hospice care coinsurance
- Medicare Part B coinsurance
- First three pints of blood per year
The Medicare Part A coinsurance
In , an inpatient hospital stay is $0 from days 1-60. However, days 61-90 cost [GCBB#part-a-inpatient-coinsurance-days-61-90] each day.
Then, days 91-150 cost [GCBB#part-a-inpatient-coinsurance-days-91-120] daily, using 60 lifetime reserve days. After day 150, you pay all fees. A skilled nursing facility stay costs $0 per day for days 1-20. Days 21-100 are [GCBB#part-a-snf-copay-days-21-100] per day. You pay all costs after day 100.
Part A hospice care coinsurance
For home healthcare and hospice care services, you pay $0 in out-of-pocket costs. It costs 5% of the Medicare-approved amount for inpatient respite care.
Medicare Part B coinsurance
The Part B coinsurance is 20% of the cost for each Medicare-covered service or item. When providers accept Medicare assignments, there are no Part B excess charges.
Part B covers 80% of approved durable medical equipment, doctor visits, and outpatient care. Clinical lab services have a $0 cost to you.
First three pints of blood
Unless the blood you have a blood donor, you may need to pay for the first three units of blood you get in a calendar year. After you pay the first three pints, Medicare pays the rest.
Benefits that are not core in a Medicare Supplement policy
There are plenty of Medigap plans that offer benefits beyond Medicare’s requirements. Some optional benefits that Medicare Supplement insurance companies offer include covering the Part A deductible, Part B deductible, foreign travel emergencies, or other additional benefits.
Plan F is the most comprehensive policy, offering Medicare beneficiaries coverage on all the gaps, but this policy is only available to those Medicare eligible before 2020. Plan G is another great option that covers everything except for not covering the Part B deductible.
Adding non-core benefits means you’ll have better insurance which is necessary for an emergency. However, the more benefits you add, the higher the monthly premium.
What are the benefits that are not part of a Medicare Supplement policy?
Medicare Supplement insurance policies don’t include prescription drug coverage, long-term care, vision, hearing aids, or dental care. However, you can enroll in separate insurance for these benefits. Part D is a prescription drug plan. Anyone can enroll in a stand-alone dental, vision, or hearing policy.
FAQs
What is a Medicare Supplement basic benefit?
Core benefits and basic benefits are the same things. These are the bare minimum of coverage allowed for Medigap insurance.
What are Medicare Supplement policies?
A Medicare Supplement policy covers gaps in Medicare medical costs. For example, instead of you paying the Part B coinsurance, a Medigap plan covers that for you. Medicare Supplement plans are letters Plan A through Plan N with high-deductible options.
When is the best time to enroll in a Medicare Supplement Plan?
The best time to sign up for Medigap coverage is during your Medicare Supplement Open Enrollment Period. Your insurance is guaranteed issue during this time because underwriting isn’t allowed.
The above means no premiums increase and no medical exam hassle. Also, delaying enrollment in creditable coverage can mean a pre-existing condition waiting period; this is a six-month period where the insurance won’t cover services relating to your pre-existing condition.
How to compare Medicare Supplement policy basics
The easiest way to compare Medigap policies is with the help of a licensed insurance agent. Our insurance agents can explain health insurance plan copays, coinsurances, monthly premiums, etc. We can even walk you through the process of becoming a Medigap policyholder.
Call us at the number above to get started finding the right plan. Or, fill out an online rate form to compare your plan options.
