Medicare Supplement Insurance Plans: What are the Benefits?

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Medicare Part A Coinsurance:  Medicare Part A covers the first 60 days as an inpatient in a hospital at 100% after a deductible. Beginning day 61, they begin to charge a daily copay until the 90th day. Once in your lifetime, they will continue coverage for days 91-150, but at an increased co-pay. The first row on a Medicare Supplement Insurance Plans Insurance Plans grid shows how much of these daily co-pays the supplement will pay. Additionally, Medicare Part A cuts off at day 150. The supplement will continue to assume 100% of the cost for one year after Medicare Part A ends, giving you a total of 18 months of coverage as an inpatient in a hospital.

Medicare Part B co-insurance: Typically, Medicare Part B pays 80% of your approved charges. The supplement will pay the percentage left over listed on the page, with plans A-G assuming 100% of the cost, and N leaving the co-pays listed.

The first three pints of blood: a deductible by Medicare. The supplement will pay the percentage listed on the screen.

Hospice: Medicare Part A will pay all but a portion of hospice care, provided hospice is given by a Medicare-licensed facility. The supplement will pay the portion listed on this screen thereafter.

Skilled Nursing Care: It is important to be aware this is not a long-term care benefit. Medicare has specific coverage limits of up to 100 days, and only under certain conditions. If you meet Medicare’s criteria, they’ll cover the first 20 days at 100%. Days 21 – 100 they’ll leave you with a co-pay. The supplement will pay the co-pay at the percentage amount listed every day Medicare continues to approve the stay. It is very important to be aware that when Medicare cuts off the stay and no longer approves it, the supplement cuts off as well.

The Part A deductible: Medicare Part A has a deductible before they pay for your inpatient stay. The Medicare deductible is not an annual deductible. Once your stay ends and 60 days elapse, if you return to the hospital, they will charge you a new deductible. You could have a maximum of 6 deductibles in one year. The supplement will pay the percentage listed on the screen.

The Medicare Part B deductible: This deductible is once a year, resetting every January 1. Notice only two supplements cover this benefit.

Excess: Not all states allow this to be charged. If you live in Connecticut, Massachusetts, Minnesota, New York, Ohio, Pennsylvania, Rhode Island and Vermont, you will not have to worry about being billed excess. This supplement benefit will have no impact on you. Excess means that some, but not all doctors, are allowed to charge up to 15% above Medicare’s approved amount. Only two plans cover this benefit.

Foreign Travel Emergency: Medicare usually does not work outside of the U.S. and its territories. If you are traveling outside of the U.S. and have an emergency, the supplement will act as temporary emergency medical insurance, giving you a $250 deductible, then paying 80% of the charges up to $50,000, leaving you with 20%, and everything over $50,000. We typically recommend our clients get emergency international medical coverage to fill these gaps, even if they have a Medicare Supplement Insurance Plan.

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