What Does a Medicare Supplement Plan Cover?

If you have recently turned 65, it may be time to explore your options for Medicare plans. Your health and healthcare needs may change as you age, so take stock of what kind of coverage is most beneficial at this stage in life. Original Medicare was once considered great coverage, but as healthcare costs have risen, it would be like trying to make it through the winter with only a hat and gloves. A Medicare Supplement plan can help provide that extra layer of protection so that the out-of-pocket medical costs associated with aging don’t become a financial burden. Here is what a Medicare Supplement plan may cover:

Hospitalization Coverage

Hospitalization coverage can help cover your share of healthcare costs related to an inpatient hospital stay. Your Medicare Supplement plan can provide coverage for up to 365 days of hospitalization after using all your Medicare benefits. 

Coverage for Part A coinsurance and hospital costs may include a semi-private room and meals in a hospital setting. It may also include other related medical services and supplies that fall under Part A (aka Hospital Insurance).

Skilled Nursing Facility Care

This type of care is for those who may need 24-hour medical and nursing care provided in a facility. These costs are covered once you meet the Part A deductible and coinsurance amounts.

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This coverage can pay for up to one hundred days of skilled nursing care per benefit period. The plan may also include physical, speech, and occupational therapy as long as it is deemed medically necessary by your physician.

Hospice Care Coinsurance or Copayments

This coverage may include coinsurance or copayment expenses for inpatient respite care, home healthcare, and drugs related to hospice treatment.

Most Medicare Supplement plans can cover the coinsurance and copayment costs associated with Medicare Part A hospice care. Depending on your plan type, there may be a limit to how much coverage you receive.

Even though the Medicare Supplement plan can pay for part of the costs associated with hospice care, you may still be responsible for any charges above the amount covered by the plan. Check with your plan provider for specific details.

Outpatient Services and Medical Equipment Costs

Medicare Part B coinsurance and copayments can cover physician services and outpatient hospital services. It can also cover durable medical equipment (DME) and some preventive services. With a Medicare Supplement plan, you can get coverage for the 20% coinsurance or copayment that Medicare requires you to pay after you meet your Part B deductible. This coverage can reduce the out-of-pocket costs associated with receiving necessary healthcare services. 

Part B Deductible

Medicare Part B (aka Medical Insurance) can help cover medical services, like doctor’s visits and preventive and outpatient care. The Part B deductible is the amount you pay for covered services before Medicare begins to pay its share. Most Medicare Supplement plans can cover the Part B deductible, relieving the burden of many seniors on a budget. With these plans, you are not responsible for paying the entire Part B deductible. Plan G is still the most comprehensive Medigap plan available to those eligible for Medicare after 2020 even though it doesn’t cover the Part B deductible. That means your out-of-pocket expenses under Plan G are $226 in 2023. 

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Emergency Services

Medicare Supplement plans can help you with the coinsurance and copayments that Medicare Part A and Part B do not cover. This may include coverage for visits to the emergency room and ambulance services. Depending on your plan, you may also be covered for urgent care services, although this might vary from plan to plan.

Blood Services

The plan may cover up to three pints of blood for each calendar year. Any remaining balance can go toward a deductible for the following year. If you require more than three pints of blood in a year, you may be responsible for covering the additional costs. 

If you receive a transfusion from a hospital or other health care provider, your Medicare Supplement plan may not cover the cost of the actual transfusion. You may be reimbursed for these costs if your provider has a contractual agreement with Medicare.

Excess Charges

These are additional charges that some medical providers require for services covered by Medicare Part B. Providers may sometimes charge more than the approved Medicare rate for a service, resulting in an excess charge.

Medicare Part B coverage can pay 80% of the approved amount after you have paid your Part B deductible. If a provider charges an excess amount, then Medicare may only pay 80% of the agreed amount. You might have to pay the remaining 20% out-of-pocket as well as the extra amount.

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Excess Charges are outlawed in the following states: Connecticut, Massachusetts, Minnesota, New York, Ohio, Pennsylvania, Rhode Island, and Vermont. In most of these states, Plan N is comparable to Plan G in terms of coverage. Massachusetts and Minnesota have different rules for Medigap plans.

Foreign Travel Emergency Coverage

If you are traveling abroad and become ill or injured, your Medicare Supplement plan may help cover some of the expenses. This coverage only applies to medical treatments deemed medically necessary by the attending physician. Routine checkups and preventive services may not be covered under this plan. You must also pay for your services upfront and then submit a claim for reimbursement.

Choose Medicare Supplement Plans

Medicare Supplement plans can be an excellent option for people who are on Medicare and want to get the best coverage for their healthcare needs. It can allow you to give your body the care it deserves without breaking the bank. Do your research and understand what a Medicare Supplement plan covers. If you still feel overwhelmed with all the options, visit a Medicare broker. There you can get professional advice tailored just for you.

Author: samanvya

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