The Insurance Buying Guide: What's Included?
Basic Benefits (Plan A) supplement Medicare benefits by providing coverage for your hospitalization co-insurance payment from day 61-90 and 91-150. This means that the $190 and $380 per day you would be required to pay under Medicare, will be paid for by the supplement. If your benefits end during a period of hospitalization, the supplement pays for an additional 365 days at 100 percent. In addition, the 20 and 50 percent co-insurance payment under Medicare Part B is covered after you pay the required $100 deductible. The first three pints of blood or packed red blood cells are covered as well under both Part A and B.
Plan B includes the Basic Benefits and adds on coverage for the Medicare Part A deductible of $760 per benefit period. Therefore, if you had Plan B, you would have your deductible met and all co-insurance payments.
Plan C includes everything in Plan A and B and adds the co-insurance amount of $95 a day for skilled nursing care you would be required to pay under Medicare Part A for days 21-100. It pays the $100 deductible under Medicare Part B and 80 percent of emergency care while in a foreign country after a $250 deductible. If you travel out of the country, you may want to consider this!
Plan D includes everything preceding it except the Medicare Part B deductible and adds on coverage for custodial care (dressing, laundry, shopping, etc.). Medicare Part A Home Health Care coverage does not pay for custodial care and many seniors need assistance with daily life functions, especially after recovering from a serious illness or injury. This pays up to $1600 a year for short-term assistance.
Plan E does not cover the Medicare Part B deductible or At-Home Recovery services but does include Preventive Care. The benefit amount is $120 per year for routine physical exams, screening procedures such as blood pressure and cholesterol as well as patient education.
Plan F does not included Preventive Care or At-Home recovery but does add on Excess Charges for Medicare Part B expenses. What this means is if you go to a doctor that does not accept Medicare assignments (meaning they will not honor the Medicare approved charges), you would be obligated to pay the entire bill. This benefit pays the amount you'll be billed for at either 100 percent of 80 percent. If 80 percent, you would be obligated to pay the remaining 20 percent.
Plan G excludes the Medicare Part B deductible and Preventive Care and pays the Excess Charges at a level of 80 percent, rather than 100 percent as in Plan F.
Plan H includes coverage for prescription medications at 50 percent with an annual limit of $1250 per year, after a $250 deductible is met. This is called the Basic Benefit. An Extended Benefit is available only in Plan J that increases the annual amount to $3000.
Plan I excludes Medicare Part B deductible and Preventive Care but includes Prescription Drugs at the basic level of $1250 annually.
Plan J is the most comprehensive and includes coverage for all benefits previously listed at the maximum levels. It is also the most costly, however.
The key is to shop carefully if you're in the market for Medigap coverage. While the benefits will be the same, no matter what company you purchase your policy through, the prices will vary from state to state and company to company. That's because not all states have the same medical costs and, insurance companies have different claims experience. And, prices are increasing, which has forced many people and companies alike, to opt for a managed care approach to covering seniors' health care issues.
Since Plan C is Plan C, no matter which company is offering it, when you shop around for coverage, you'll be looking at price, service and reliability. It's also vital to find an insurance company you feel comfortable with and one that is reputable and in good shape financially. Your state insurance department can alert you to any problem companies.
