Supplemental Medical Insurance for SeniorsMedicare supplement plans help patients cover extra expenses—but which ones are the best choices? New enrollees to Medicare are often surprised to find that the comprehensive medical insurance, wide-ranging as it is, doesn’t address every single cost incurred in a medical visit or hospital stay. Thanks to private insurers, there’s a reasonable source for defraying some of those incidental charges. Medicare supplement plans—slangily known as “Medigap” plans—are sold by private insurers to help Medicare patients cover secondary costs original Medicare doesn’t cover. Medigap policies help defray extra expenses that would otherwise fall in the laps—and pocketbooks—of the insured. So when a healthcare expense is incurred, the primary insurer (i.e., Medicare) pays everything up to the coverage limits. This coverage may not address expenses for copayments or total deductibles or leave the policyholder on the hook for additional expenses. That’s where Medigap plans come in. This supplemental insurance pays for certain parts of medical treatment—most often, the above-mentioned copayments and deductibles—as sort of “backup” funding for the patient. Since Medigap plans are sold by private insurers outside Medicare, they offer a level of fluidity older patients often require for emergencies and unexpected circumstances. “Medigap gives you flexibility without having to worry about a physician network,” insurance broker Garrett Ball explained in 2017. “Medigap’s more predictable (with) out-of-pocket costs. With Medigap, you don’t have copays in most cases. You pay a higher monthly premium, but you know you’re only going to have a certain amount of OOP costs.” Supplemental insurance plans are only available for those who already have Medicare coverage, and can be tricky to get because of some quirks in certain states. (Those with Medicare Advantage plans can’t get Medigap plans, either.) But they’ve helped a huge number of older citizens stave off a mountain of excessive costs for late-life medical care.
What Medicare Supplemental Insurance Plans CoverEach of the 10 Medigap plans offers one aspect of full coverage across the board, with no exceptions. That’s the Medicare Part A coinsurance and hospital costs. Part A basically addresses any inpatient hospital stay the policyholder may experience, including skilled nursing care, hospice care, and some aspects of home healthcare. All Medigap plans pay 100% of the coinsurance and copayment charges incurred. From there, each plan offers different coverage levels for different things:
- Medical Part B Coinsurance and Copayments — Simply stated, this refers to medical insurance that doesn’t involve a stay in the hospital. It includes doctor office visits, preventative care, vaccines or shots, outpatient mental health and rehab, chemotherapy or physical therapy, wheelchairs, and other equipment and services.
- First Three Pints of Blood — Some patients have to pay for the initial stages of their blood transfusions. Some Medigap plans cover all or part of the first three pints.
- Medicare Part A Hospice Care Coinsurance or Copayments — For those facing life expectancies of six months or less or are receiving palliative care rather than efforts to cure an illness.
- Skilled Nursing Care Facility Coinsurance — This is coverage for in-patient rehab centers with on-site, trained medical staffers handling some specific therapy needs for patients.
- Deductibles for Parts A & B — Medigap plans offer different percentages of recouping for patient-paid upfront costs; some cover all, some cover half and others cover none.
- Part B Excess Charges — These address some of the overage fees in case you visit a doctor not in the Medicare network.
- Foreign Travel Emergencies — Since Medicare doesn’t cover the treatment you receive if you’re visiting a foreign country, some Medigap plans offer to cover a large amount of your incurred expenses away from America. Some do not.