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Medicare Supplemental Benefits

Medicare is a federally administered health care program that provides insurance coverage to the elderly and disabled. Many decide to get their benefits directly through the federal government through a program known as original Medicare. When they get their benefits through the federal government, they have the option to purchase a Medicare supplemental plan called a Medigap. These plans will pay for excess costs associated with original Medicare and may provide some additional coverage. These plans are labeled with the letters A, B, C, D, F, G, K, L, M and N.

  1. Hospice Care

    • Medicare beneficiaries in hospice care must pay a coinsurance for respite and Part A services. This Medigap benefit will cover this coinsurance. Every Medigap plan will cover this benefit in full, except plan K, which only covers 50 percent and plan L, which covers 75 percent.

    Hospital Coinsurance

    • Medicare charges a coinsurance for hospital care after 60 days of care. In 2010, the coinsurance was $275 daily and then $550 after 90 days. This is a basic benefit that every Medigap plan must cover in full. It also offers an additional year (365 days) of lifetime reserve hospital days.

    Hospital Deductible

    • For each benefit period, Medicare charges a $1,100 (as of 2010) deductible that beneficiaries must pay out of pocket.

    Overseas Emergency Care

    • Medicare does not cover emergency care overseas. With this benefit, beneficiaries will have 80 percent of any emergency care covered. There is a $250 deductible and a maximum lifetime benefit of $50,000. Plans C, D, F, G, M and N include this benefit.

    Part B Annual Deductible

    • Medicare charges a small deductible under Part B. It was $155 in 2010. Plans C and F will pay in full during the deductible.

    Part B Coinsurance

    • Medicare beneficiaries pay a 20 percent coinsurance on most covered services. This Medigap benefit will provide coverage for that 20 percent coinsurance. All Medigaps provide full coverage for this benefit, except plan K which covers 50 percent, plan L which covers 75 percent and plan M which will cover all except $50 for any emergency visits and $20 for inpatient doctor visits.

    Part B Preventive Care Coinsurance

    • Medicare pays 80 percent for all preventive care services that are covered under Medicare, leaving the beneficiary with a 20 percent coinsurance. This benefit will pay for this coinsurance once the Part B deductible is paid in full. All plans except M and N provide this benefit.

    Part B Excess Charges

    • Excess charges are when a doctor who does not take the Medicare-approved payment charges the beneficiary for any excess amount not provided by Medicare. Doctors can charge up to 15 percent more than what Medicare paid if they do not take Medicare-approved payment in most states. Plans F and G will pay the excess charges in full.

    Skilled Nursing Facility Coinsurance

    • After 20 days in a skilled nursing facilities, beneficiaries are responsible for a daily coinsurance. In 2010, this amounted to $137.50 a day. Plans C, D, F, G, M and N cover this benefit in full. K covers 50 percent, while L will cover 75 percent of the coinsurance.

    Three Pints of Blood

    • All plans will provide coverage for the first three pints of blood a beneficiary may need each year. All plans will pay for them in full, except K which will pay 50 percent and L which will pay 75 percent.

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