Benefits For Medicare - Medigap Supplement Plan Comparisons
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Benefits For Medicare And Medigap Coverage
The Benefits For Medicare Supplement Plans have been standardized by the Federal government. However, the coverages and premiums may differ significantly between insurance carriers. The tables below are for three different supplement plans - Plan A, Plan F and Plan G. The benefits for Medicare are shown for both Part "A" and Part "B" in these tables. The tables also indicate the benefits that each of the various plans cover and your out of pocket expense.
Please note that Plan A does not cover the $1068 in hospital deductible, the day 21 through day 100 Skilled Nursing Facility Care deductible of $133.50 per day, or the $135 Part "B" annual deductible for Medical Expenses, Blood or Durable Medical Equipment. Supplement Plan F provides 100% coverage for all of these expenses. Supplement Plan G includes all of these coverages except for the Part "B" annual deductible. Also, supplement Plan F adds a Home Health Care and Foreign Travel benefit. Supplement Plan G adds at home recovery benefits.
Benefits For Medicare Video
Plan "A"
Services (Part "A")
| Medicare Pays
| Plan "A" Pays
| You Pay
|
|---|---|---|---|
HOSPITALIZATION Semiprivate Room And Board, General Nursing And Miscellaneous Services And Supplies: First 60 Days
| All But $1068
| $0
| $1068 (Part A Deductible)
|
61st through 90th Day
| All But $267 a Day
| $267 a Day
| $0**
|
91st Day and after: While Using 60 Day Lifetime Reserve Days
| All But $534 a Day
| $534 a Day
| $0**
|
Once Lifetime Reserve Days Are Used: Additional 365 Days
| $0
| $0
| $0**
|
Beyond The Additional 365 Days
| $0
| $0
| All Costs
|
SKILLED NURSING FACILITY CARE You Must Meet Medicare's Requirecluding Having Been In A Hospital For At Least Days And Entered A Medicare Approved Facility Within 30 Days After Leaving The Hospital First 20 Days
| All Approved Amounts
| $0
| $0**
|
21st through 100th Day
| All But $133.50 a Day
| $0
| Up To $133.50 a Day
|
101st Day And After
| $0
| $0
| All Cost
|
BLOOD First 3 Pints
| $0
| 3 Pints
| $0**
|
Additional Pints
| 100%
| $0
| $0**
|
HOSPICE CARE Available As Long As Your Doctor Certifies You Are Terminally Ill And You Elect To Receive These Services
| All But Very Limited Coinsurance For Outpatient Drugs And Inpatient Respite Care
| $0
| Balance
|
Services (Part "A")
| Medicare Pays
| Plan "B" Pays
| You Pay
|
MEDICAL EXPENSES - IN OR OUT OF THE HOSPITAL AND OUTPATIENT HOSPITAL TREATMENT, such as Physician's services, inpatient and outpatient medical and surgical services and supplies, physical and speech therapy, diagnostic tests, durable medical equipment. First $135 of Medicare Approved Amounts
| $0
| $0
| $135 (Part B Deductible)
|
Remainder of Medicare Approved Amounts
| Generally 80%
| Generally 20%
| $0**
|
Part B Excess Charges (above Medicare Approved Amounts)
| $0
| $0
| All costs
|
BLOOD First 3 Pints
| $0
| All costs
| $0**
|
Next $135 of Medicare Approved Amounts
| $0
| $0
| $135 (Part B Deductible)
|
Remainder of Medicare Approved Amounts
| 80%
| 20%
| $0**
|
CLINICAL LABORATORY SERVICES TESTS FOR DIAGNOSTIC SERVICES
| 100%
| $0
| $0**
|
PARTS "A" AND "B
| |||
HOME HEALTH CARE - MEDICARE APPROVED SERVICES Medically necessary skilled care services and medical supplies
| 100%
| $0**
| |
Durable medical equipment First $135 of Medicare Approved Amounts
| $0
| $0
| $135 (Part B Deductible)
|
Remainder of Medicare Approved Amounts
| 80%
| 20%
| $0**
|
** $0 is for Covered Charges. You are responsible for all non-covered charges.
| |||
Medicare Replacement vs Supplement
Plan "F"
Services (Part "A")
| Medicare Pays
| Plan "F" Pays
| You Pay
|
|---|---|---|---|
HOSPITALIZATION Semiprivate Room And Board, General Nursing And Miscellaneous Services And Supplies: First 60 Days
| All But $1068
| $1068 (Part A Deductible)
| $0**
|
61st through 90th Day
| All But $267 a Day
| $267 a Day
| $0**
|
91st Day and after: While Using 60 Day Lifetime Reserve Days
| All But $534 a Day
| $534 a Day
| $0**
|
Once Lifetime Reserve Days Are Used: Additional 365 Days
| $0
| 100% of Medicare Eligible Expenses
| $0**
|
Beyond The Additional 365 Days
| $0
| $0
| All Costs
|
SKILLED NURSING FACILITY CARE You Must Meet Medicare's Requirecluding Having Been In A Hospital For At Least Days And Entered A Medicare Approved Facility Within 30 Days After Leaving The Hospital First 20 Days
| All Approved Amounts
| $0
| $0**
|
21st through 100th Day
| All But $133.50 a Day
| Up To $133.50 a Day
| $0**
|
101st Day And After
| $0
| $0
| All Cost
|
BLOOD First 3 Pints
| $0
| 3 Pints
| $0**
|
Additional Pints
| 100%
| $0
| $0**
|
HOSPICE CARE Available As Long As Your Doctor Certifies You Are Terminally Ill And You Elect To Receive These Services
| All But Very Limited Coinsurance For Outpatient Drugs And Inpatient Respite Care
| $0
| Balance
|
Services (Part "A")
| Medicare Pays
| Plan "F" Pays
| You Pay
|
MEDICAL EXPENSES - IN OR OUT OF THE HOSPITAL AND OUTPATIENT HOSPITAL TREATMENT, such as Physician's services, inpatient and outpatient medical and surgical services and supplies, physical and speech therapy, diagnostic tests, durable medical equipment. First $135 of Medicare Approved Amounts
| $0
| $135 (Part B Deductible)
| $0**
|
Remainder of Medicare Approved Amounts
| Generally 80%
| Generally 20%
| $0**
|
Part B Excess Charges (above Medicare Approved Amounts)
| $0
| 100%
| $0**
|
BLOOD First 3 Pints
| $0
| All costs
| $0**
|
Next $135 of Medicare Approved Amounts
| $0
| $135 (Part B Deductible)
| $0**
|
Remainder of Medicare Approved Amounts
| 80%
| 20%
| $0**
|
CLINICAL LABORATORY SERVICES TESTS FOR DIAGNOSTIC SERVICES
| 100%
| $0
| $0**
|
PARTS "A" AND "B
| |||
HOME HEALTH CARE - MEDICARE APPROVED SERVICES Medically necessary skilled care services and medical supplies
| 100%
| $0
| $0**
|
Durable medical equipment First $135 of Medicare Approved Amounts
| $0
| $135 (Part B Deductible)
| $0**
|
Remainder of Medicare Approved Amounts
| 80%
| 20%
| $0**
|
** $0 is for Covered Charges. You are responsible for all non-covered charges.
| |||
OTHER BENEFITS - NOT COVERED BY MEDICARE
| |||
FOREIGN TRAVEL - NOT COVERED BY MEDICARE - Medically necessary emergency care services beginning during the first 60 days of each trip outside the USA First $250 each calendar year
| $0
| $0
| $250
|
Remainder of charges
| $0
| 80% to a lifetime Maximum Benefit of $50000
| 20% and amounts over the $50000 lifetime Maximum Benefit
|
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Plan "G"
Services (Part "A")
| Medicare Pays
| Plan "G" Pays
| You Pay
|
|---|---|---|---|
HOSPITALIZATION Semiprivate Room And Board, General Nursing And Miscellaneous Services And Supplies: First 60 Days
| All But $1068
| $1068 (Part A Deductible)
| $0**
|
61st through 90th Day
| All But $267 a Day
| $267 a Day
| $0**
|
91st Day and after: While Using 60 Day Lifetime Reserve Days
| All But $534 a Day
| $534 a Day
| $0**
|
Once Lifetime Reserve Days Are Used: Additional 365 Days
| $0
| 100% of Medicare Eligible Expenses
| $0**
|
Beyond The Additional 365 Days
| $0
| $0
| All Costs
|
SKILLED NURSING FACILITY CARE You Must Meet Medicare's Requirecluding Having Been In A Hospital For At Least Days And Entered A Medicare Approved Facility Within 30 Days After Leaving The Hospital First 20 Days
| All Approved Amounts
| $0
| $0**
|
21st through 100th Day
| All But $133.50 a Day
| Up To $133.50 a Day
| $0**
|
101st Day And After
| $0
| $0
| All Cost
|
BLOOD First 3 Pints
| $0
| 3 Pints
| $0**
|
Additional Pints
| 100%
| $0
| $0**
|
HOSPICE CARE Available As Long As Your Doctor Certifies You Are Terminally Ill And You Elect To Receive These Services
| All But Very Limited Coinsurance For Outpatient Drugs And Inpatient Respite Care
| $0
| Balance
|
Services (Part "A")
| Medicare Pays
| Plan "G" Pays
| You Pay
|
MEDICAL EXPENSES - IN OR OUT OF THE HOSPITAL AND OUTPATIENT HOSPITAL TREATMENT, such as Physician's services, inpatient and outpatient medical and surgical services and supplies, physical and speech therapy, diagnostic tests, durable medical equipment. First $135 of Medicare Approved Amounts
| $0
| $0
| $135 (Part B Deductible)
|
Remainder of Medicare Approved Amounts
| Generally 80%
| Generally 20%
| $0**
|
Part B Excess Charges (above Medicare Approved Amounts)
| $0
| 80%
| 20%
|
BLOOD First 3 Pints
| $0
| All costs
| $0**
|
Next $135 of Medicare Approved Amounts
| $0
| $0
| $135 (Part B Deductible)
|
Remainder of Medicare Approved Amounts
| 80%
| 20%
| $0**
|
CLINICAL LABORATORY SERVICES TESTS FOR DIAGNOSTIC SERVICES
| 100%
| $0
| $0**
|
PARTS "A" AND "B
| |||
HOME HEALTH CARE - MEDICARE APPROVED SERVICES Medically necessary skilled care services and medical supplies
| 100%
| $0
| $0**
|
Durable medical equipment First $135 of Medicare Approved Amounts
| $0
| $0
| $135 (Part B Deductible)
|
Remainder of Medicare Approved Amounts
| 80%
| 20%
| $0**
|
HOME HEALTH CARE - AT HOME RECOVERY SERVICES NOT COVERED BY MEDICARE Home care certified by your doctor for personal care during recovery from an injury or sickness for which Medicare approved a Home Care Treatment Plan
| |||
Benefit for each visit
| $0
| Actual charges to $40 a visit
| Balance
|
Number of visits covered (must be received within 8 weeks of last Medicare approved visit)
| $0
| Up to the number of Medicare approved visits, not to exceed 7 each week
| Balance
|
Calendar year maximum
| $0
| $1,600
| Balance
|
** $0 is for Covered Charges. You are responsible for all non-covered charges.
| |||
The Cost Of A Medicare Supplement
Generally, the premiums for a Medicare supplement plan will increase in relation to the afforded coverages. In other words, a Plan F provides more coverage than a Plan A and thus will be more expensive. Keep in mind that premiums for a supplement policy are established with respect to the ratio of claims experienced by the insurance carrier. Due to increased medical cost and claims, most companies will increased premiums usually on an annual basis. Be a informed consumer and don't be afraid to ask your prospective agent hard questions.
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