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Medicare Insurance Supplements

Medicare insurance supplements offer options to seniors of all backgrounds who need an extra form of coverage to pay for their medical expenses. Many seniors who rely on Medicare have likely discovered that their original policy cannot cover 100 percent of their medical needs. Medicare can cover a significant portion of your expenses, at 80 percent of an approved total cost, but this still leaves a big part of these expenses up to you. Medicare insurance supplements can help you fill the gaps in your original coverage to make your overall health care more affordable.

Types of Insurance Supplements

Medicare insurance supplements are available through 10 different standardized plans, which are also called Medigap policies. These plans are labeled Plan A through Plan N. Medigap does not replace your Medicare coverage. Rather, it works with your original insurance so you can still see any doctor that accepts Medicare. The right plan for you can depend on many factors, including your age, savings, lifestyle and desired standard of living. Even the most basic of Medicare supplements, Medigap Plan A, covers your coinsurance for regular services, so most seniors find value in purchasing some kind of supplemental coverage. As supplements increase by letter, they typically increase in coverage. Plan B, for example, covers all the benefits of Plan A plus your deductible for inpatient hospital care and in-home services. Plan C adds your deductible for outpatient hospital services and general doctor care, your skilled nursing facility coinsurance, and foreign travel emergency insurance.

The most comprehensive of traditional Medicare insurance supplements is Plan F. This policy covers all the benefits of Plan C plus your excess charges. Medical providers can legally charge a limited percentage, often 15 percent, more than the Medicare-approved amount in some cases. This difference in the actual expense and the Medicare-approved expense is called an excess charge. Excess charges are typically limited to services covered under Medicare Part B, which includes doctors' visits, emergency room care, outpatient hospital care and some preventative services. Counter-intuitively, Plan G offers slightly less coverage than Plan F by not covering the Part B deductible. Plan D is a step down from Plan G, covering everything from Plan F but the Part B deductible and excess charges.

The remaining available Medicare insurance supplements work slightly differently than traditional Medigap supplements. Plans E, H, I and J are no longer available to purchase, so this leaves Plans K, L, M and N. Plans K and L are high deductible options, offering a low monthly premium but a higher annual deductible that seniors must pay before receiving coverage. There is also a high deductible version of Plan F, which has an annual deductible of $2,000. The out-of-pocket limit is $4,640 for Plan K and $2,320 for Plan L.

Plans M and N are the newest Medicare insurance supplements available, introduced in 2010. These plans work on a cost-sharing basis, featuring a low monthly premium with concessions in sharing the cost of care. For example, under Plan N you would have a $20 copay for doctors' visits and a $50 copay for emergency room visits that don't result in inpatient treatment. Meanwhile, Plan M only covers 50 percent of your deductible for inpatient hospital services. Neither Plan M nor Plan N cover Part B deductibles or excess charges.

The Right Plan for You

The best Medicare insurance supplements for you will first depend on your desired lifestyle when you reach retirement. If you expect to remain physically active, you will probably want a comprehensive policy that covers you should you have an accident or sustain an injury. If you hope to travel internationally, it would be wise to consider insurance supplements that include foreign emergency travel insurance. Beyond your lifestyle, your medical history and preexisting conditions are also factors to consider. Even if you are in good health now, considering treatments you might need in the future can help you determine the best insurance supplements for you. For example, if you have a history of diabetes in your family, you might consider Medicare insurance supplements with coverage for your Part B deductible, like Plan C or Plan F.

While you research Medicare insurance supplements, it is also important to recognize crucial dates related to your coverage. It is advisable to purchase your policy within six months of enrolling in your original plan, a period called Open Enrollment. During this period, you are not required to submit to medical underwriting, and your Medigap provider may not charge you a higher premium because of preexisting conditions or your medical history. You should also be aware of your guaranteed issue dates. Ask about these dates before you sign up fro your policy. A provider with good customer service will ensure that you understand your rights and options for switching policies.


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