Medicare Supplemental Health Care Plans

Traditional Medicare is made up of Part A and Part B. These cover hospital stays, some preventive services, hospice and home health care. There are many services original Medicare does not cover, however. Many Medicare beneficiaries choose to purchase additional Medicare supplement plans, also called Medigap plans, in order to gain additional benefits. Medigap plans are standardized by the federal government but sold by private insurance companies. Not all Medigap policies are sold in all areas.

Not Covered

• There are several different standard Medigap policies, each with its own benefits. However, there are some benefits that are not covered by any Medigap policy as of 2010. These include private duty nursing, hearing aids, dental care, vision services or eyeglasses and long-term care in a nursing home. You may be able to gain some or all of these through a Medicare Advantage (MA) plan, but you cannot have both a Medigap and an MA plan at the same time.

Open Enrollment

• You are not required to buy a Medigap policy, but if you do, you must join during your open enrollment period. You cannot be turned down for coverage during open enrollment, which begins on the first day of the month in which you are both enrolled in Medicare Part B and in which you turn 65 years old. This period lasts for six months, and will not be offered again or changed. Many insurance companies will take applications for Medigap in the six months preceding your open enrollment time.

Plan A

• Medigap plans are usually referred to using the letters A through N. All companies must offer Plan A if it also sells any other kind of Medigap plan. Plan A is the most basic Medigap policy, with benefits for Medicare Part A co-insurance, the hospital costs of up to an additional 365 days after traditional Medicare benefits are gone, the first three pints of blood, Medcare Part B preventive care co-insurance and the co-insurance or co-payment for Part A hospice services.

Other Benefits

• Other Medigap benefits depend on which plan you purchase. These can include the co-insurance for skilled nursing facility care, coverage of excess charges for Part B, the deductibles for both Part A and Part B and foreign travel emergency care. Only Plan F includes all possible Medigap benefits.

Out-of-Pocket Expenses

• Plan F is offered as both a regular and as a high-deductible plan. With the high-deductible Plan F, you must pay $2,000 worth of medical care yourself before the Medigap policy kicks in. Plans K and L are cost-sharing plans that also have annual out-of-pocket expenses. Plan K pays for 50 percent of most services, and Plan L pays for 75 percent. The out-of-pocket expense for K as of 2010 is $4,620, while Plan L's is $2,310. The annual deductibles and out-of-pocket expenses result in lower monthly premiums.