|  | Healthcare Industry | Health Insurance

States That Offer Medigap Insurance for People

Medicare supplements work with original Medicare Parts A and B. These supplements, often called Medigap, help seniors afford Medicare costs by offering coverage for Medicare deductibles, co-pays and coinsurance. Some Medigap plans also offer their own, additional benefits. Medigap plans are standardized; the same plan features the same coverage, no matter where you live or from whom you buy it. However, there are three exceptions to this. Medigap in Minnesota, Wisconsin and Massachusetts are organized into different plans, although the benefits are similar and exceed standard Medigap in some ways.

  1. Standardized Medicare Plans

    • The standard Medigap plans may change year to year. As of 2011, Medigap policies ran from A through D, F, G, K, L, M and N. Plan A is the most basic and offers only the core benefits that all Medigap must include, such as Part A hospital coinsurance costs, Part B co-pays and coinsurance, Part A hospice co-pays and the reasonable costs of the first 3 pints of blood per year. Every other plan has its own set of benefits, such as foreign travel emergency coverage, coverage of the Part A and B annual deductible and skilled nursing facility coinsurance. Only Plan F has all possible Medigap benefits. All states except Massachusetts, Minnesota and Wisconsin sell these standardized Medicare supplement plans.

    Minnesota

    • Minnesota offers the same Medigap benefits, but organized into different plans. Like the standardized plans, the Minnesota Basic Plan has benefits for Part A and B coinsurance, the first 3 pints of blood and Part A hospice co-pays. It also offers additional benefits, such as 50 percent of coverage for outpatient mental health care, 20 percent of the coverage for physical therapy and full benefits for preventive services. Minnesota also sells Extended Basic, which covers the Part A and B deductibles and 120 days of skilled nursing facility care. Extended Basic also features a foreign travel emergency benefit.

    Wisconsin

    • Wisconsin also sells its Medigap policies in a different form. Wisconsin essentially has only one Medigap plan; with additional riders, purchasers can choose to add if they want extra benefits. The basic Wisconsin Medicare supplement has benefits for the first 3 pints of blood, co-pay coverage for hospitalizations and skilled nursing facility care, 175 days of inpatient psychiatric care benefits and 40 extra home health visits. Optional benefits include ones for foreign travel emergencies, the Part B excess charges, the annual Part A deductible and more home health care visits. Wisconsin also allows Medigap to be sold as Medicare Select, HMO-style managed care plans, which have lower monthly premiums but require patients to get their care from inside a network of approved providers.

    Massachusetts

    • Massachusetts sells two Medicare supplements, called the Core and the Supplement 1. The Core is the most basic and has coverage only for Part A additional hospitalization days, the first 3 pints of blood and Part B coinsurance. The Supplement 1 has all the same benefits as the Core, as well as skilled nursing facility coinsurance, foreign travel emergency coverage and benefits for the Part B annual deductible. Both plans offer inpatient mental health facility stay benefits, which the Core covers for 60 days per calendar year after Original Medicare runs out, while the Supplement 1 covers an extra 120 days per benefit period.

Health Insurance - Related Articles