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Standardized Medicare Supplement plans
There are 10 Standardized
Medicare Supplement plans called “A” through “J” |
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There are 10 standardized
Medicare Supplement plans called “A” through “J”. The benefits of each plan are different, with the exception that all plans cover the “Basic Benefits”
which are identified below. Medicare standardized the plans to limit the consumer’s confusion when comparing coverage
offered by different companies. With standardization, the consumer can easily compare the benefits and the cost being offered.
Descriptions of benefits follow the table below. |
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Medigap Benefit |
A |
B |
C |
D |
E |
F |
G |
H |
I |
J |
| Medicare Basic Benefits |
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| Part A Deductible |
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| Part B Deductible |
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| Skilled Nursing
Coinsurance |
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| Foreign Travel Emergency |
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Part B Excess
- Above Medicare's Approved Amount |
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| Basic Drug Benefit ($1,250 Limit) |
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| Extended
Drug Benefit ($3,000 Limit) |
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| At-Home Recovery |
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| Preventative Care |
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| 365 Extra Days of Hospital Coverage |
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| 3 Pints of Blood |
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*Plans F and J also have a high deductible
option. If you choose this option, you must pay $1,730 out-of-pocket per year before the plans pay anything. Insurance policies
with a high deductible option generally cost less than those with lower deductibles.
Your out-of-pocket costs for services
may be higher if you need to see your doctor or go to the hospital.
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Medigap Benefit Term |
Description of Medigap Benefit |
| Part A Deductible |
Medicare Part A
Hospital Deductible
You may need this benefit if you have to stay in the hospital.
The Part A deductible for 2007 is $956. This amount can change every year. You have to pay this deductible for each benefit
period.
Benefit covers: •
$956 in 2007.This amount can change every year.
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| Part B Deductible |
Medicare Part B
Hospital Deductible
You may want to consider this benefit (which is $131 in
2007) if you have Medicare Part B. Each year you must pay the Part B deductible before Medicare starts to pay its share. If
you have this benefit, the Medigap plan would pay this amount each year.
Benefit covers: •
$131 per year.
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| Part A and B Coinsurance |
Part A and B Coinsurance
Benefit covers: •
The Part A coinsurance amount for days 61-90 ($228 per day in 2005) and days 91-150 ($456 per day in 2005) of a hospital stay. • The
coinsurance or copayment amount for Part B services after you meet the $131 yearly deductible.
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| Part B Excess - Above Medicare's Approved Amount |
Medicare Part B
Excess Charge
Under federal law, doctors who don't accept "assignment
" (take Medicare's approved amount as payment in full) may charge up to 15% more than the approved amount. You might want
to think about this benefit if your doctors don't accept assignment. You may also want this benefit if you have to stay in
the hospital and can't control whether the doctors you see accept assignment.
Benefit covers: •
Plans F, I and J pay all of the excess charges. • Plan G pays 80% of the
excess charges.
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| Foreign Travel Emergency |
Foreign Travel
Emergency
If you travel outside the United States, this benefit could
save you money for emergency care.
Benefit covers: •
80% of the cost of emergency care during the first 60 days of each trip (after you pay the $250 deductible). • Up to $50,000 in your lifetime.
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| At-Home Recovery |
At-Home Recovery
This benefit covers additional care at home if you are already
getting Medicare-covered home health services. It pays up to $40 a visit and $1,600 a year. This benefit may cost a lot and
may not be worth the additional premiums you pay for it.
Benefit covers: •
The cost of at-home help with daily activities like bathing and dressing if you are already getting Medicare-covered home health visits. • Up to 8 weeks of at-home help after skilled care is no longer
needed. • Will pay up to $40 each visit and $1,600 each year.
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| Skilled Nursing Coinsurance |
Skilled Nursing
Coinsurance
You may want to consider this benefit if you need to go
to a Skilled Nursing Facility (SNF) after a hospital stay and stay in the SNF longer than 20 days.
Benefit covers: •
Up to $114 a day for days 21-100 in a Skilled Nursing Facility
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| Preventative Care |
Preventative Care
This benefit helps pay for routine yearly check-ups and
tests (such as routine yearly check-ups, serum cholesterol E and screening, hearing tests, diabetes screening, thyroid function
test) that may be important to you to keep you healthy.
Benefit covers: •
Up to $120 each year.
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365 Extra Days of Hospital Coverage |
365 Extra Days
of Hospital Coverage
Under federal law, doctors who don't accept "assignment"
(take Medicare's approved amount as payment in full) may charge up to 15% more than the approved amount. You might want to
think about this benefit if your doctors don't accept assignment. You may also want this benefit if you have to stay in the
hospital and can't control whether the doctors you see accept assignment.
Benefit covers: •
100% of the cost for up to 365 more days of a hospital stay during your lifetime after you use up all Medicare hospital benefits.
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| 3 Pints of Blood |
3 Pints of Blood
Benefit covers: •
The first 3 pints of blood or equal amounts of packed red blood cells per calendar year, unless this blood is replaced.
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Basic Benefits
• Coinsurance for days 61-90 ($228 per day) and days 91-150 ($456 per day) in hospital
• Payment in full for 365 additional hospital days
• 20% coinsurance for physician and other Medicare Part B services
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