What You Need To Know About Medicare Supplement Plan Coverage

Posted on: 12 January 2017

Medicare supplement insurance policies help pay for out-of-pocket health care costs not covered by traditional Medicare. Although Medicare supplement insurance is regulated by federal and state laws, plan options and premiums vary. Therefore it's important to know what basic benefits supplement plans provide as well as how they work.

How a Medicare Supplement Plan Works

Eligibility. You must qualify for Medicare Part A and Part B before you can purchase Medicare supplemental insurance–also known as Medigap. If you are married and both you and your spouse qualify for Medicare coverage and want to buy supplemental medical insurance, you must each purchase your own supplement plan since Medigap policies provide coverage for only one individual.

Cost. When you buy a Medigap policy from a private insurance company, you pay a monthly premium for the supplemental coverage. The premium you pay is in addition to the monthly premium you pay to Medicare for your Medicare Part B coverage for outpatient health care costs. If you paid Medicare taxes during your working years, you don't have to pay a monthly premium for Medicare Part A, which is your hospital insurance.

Availability. You can buy a Medicare supplemental policy from any insurance company in your state that is licensed to sell Medigap insurance.

Advantages a Medicare Supplement Plan Offers

A Medicare supplemental insurance policy helps pay medical expenses, such as co-payments, deductibles, and coinsurance amounts for hospital stays, hospice care, and a stay in a skilled nursing facility, that Original Medicare doesn't cover. Supplement plans generally pay coinsurance only after you've paid your deductible for the year. However, some plans pay the deductible as well.

Some Medicare supplement insurance plans cover medical services you receive if you become ill or are injured when traveling outside of the U.S. Coverage works the same as if you received medical care in the U.S. Original Medicare pays its share of the Medicare-approved amount for covered medical services and then your supplement plan pays its share.

The insurance company from which you buy Medicare supplemental insurance can't cancel your policy or charge you if you become sick or suffer a chronic illness–providing you buy a policy during your open enrollment period. As long as you continue to pay the premium on time, the insurer must renew your policy.

Benefits Medicare Supplement Plans Usually Don't Offer

Although a Medicare supplement policy helps pay health care costs remaining after Original Medicare pays its share, most supplemental insurance plans don't cover costs associated with:

  • Eyeglasses or routine vision care
  • Hearing aids
  • Routine dental care
  • Long-term care in a nursing home or skilled nursing facility
  • Private-duty nursing

Medicare supplement plans also don't cover the costs for prescription drugs. To get prescription drug coverage, you must enroll in a Medicare prescription drug plan–known as Medicare Part D. Medicare drug coverage is offered by insurance companies approved by Medicare. Plans vary in cost and the specific drugs they cover.

For more information, contact a professional in your area or visit a website like http://scis.us.


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Hi there! My name is Sara Jerba. I'm no doctor, but I'm very familiar with them due to experience. You could say I was a sickly child. Between various allergies and a few other conditions, I got to be very good friends with my doctors and nurses. Although I hate staying overnight in the hospital, I do feel quite at home there. Now, don't feel sorry for me. Most of my conditions have eased or even abated entirely as I've grown up. And none of them were ever life-threatening--just inconvenient. It's actually been very positive in the long run; it's brought a lot of wonderful people and important knowledge into my life that I wouldn't have had otherwise.

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