Medicare Supplement (Med Supp or Medigap)

A Medicare Supplement policy (also known as "Medicare Supplement", "Med Supp", and "Medigap") is health insurance sold by private insurance companies to fill the "gaps" in Original Medicare Plan coverage. Medicare Supplement plans help pay some of the health care costs that Original Medicare doesn't cover. If you are in the Original Medicare Plan and have a Medicare Supplement policy, then Medicare and your Medicare Supplement policy will pay both their shares of covered health care costs.

Generally, when you buy a Medicare Supplement policy you must have Medicare Part A and Part B.

You and your spouse must each buy separate Medicare Supplement policies. Your Medicare Supplement policy won't cover any health care costs for your spouse.

Medicare Supplement Plan Types

Insurance companies can only sell you a "standardized" Medicare Supplement policy. These Medicare Supplement policies must all have specific benefits so you can compare them easily.

Depending on when you enroll, you may be able to choose 10 to 12 different standardized Medicare Supplement policies (Medicare Supplement Plans A through N). Medicare Supplement policies must follow Federal and State laws. These laws protect you. A Medicare Supplement policy must be clearly identified on the cover as "Medicare Supplement Insurance." Each plan, A through N, has a different set of basic and extra benefits.

The benefits in any Medicare Supplement Plan A through N are the same for any insurance company. Each insurance company decides which Medicare Supplement policies it wants to sell. Not all types of Med Supp policies may be available in your state (e.g., Massachusetts, Minnesota and Wisconsin). If you need more information about Med Supp policies in your state, call your State Insurance Department or State Health Insurance Assistance Program.

Med Supp Benefits 2009

What Med Supp Plans A through L Cover Before June 1, 2010
Source: Oregon SHIBA 8/24/09 Volunteer Training Manual: Medigaps and Other Insurance to Supplement Insurance.
Med Supp Benefits	A	B	C	D	E	F1	G	H	I	J1	K	L
Part A Hospital Coinsurance
Part B Coinsurance											50%	75%
Blood											50%	75%
Hospice Care											50%	75%
Skilled Nursing											50%	75%
Part A Deductible											50%	75%
Part B Deductible
Part B Excess Charges							80%
Foreign Travel Emergency
At-Home Recovery
Preventive Care
Preventive Care not Covered by Medicare
2009 out-of-pocket limit											$4,6202	$2,3102
1 Plans F and J also offer a high-deductible option. You $2,000 before your coverage begins. 2 After the out-of-pocket limit is reached and the Part B deductible is met, plan pays 100%.

Med Supp Benefits 2010

NEW: Starting June 1, 2010, the types of Medicare Supplement Plans that you can buy will change:

• There will be two new Medicare Supplement Plans offered: Plans M and N.
• Plans E, H, I, J will no longer be available to buy. If you already have or you buy Plan E, H, I, or J before June 1, 2010, you can keep that plan. Contact your plan for more information.

What Med Supp Plans Will Cover On and After June 1, 2010.
Source: Oregon SHIBA 8/24/09 Volunteer Training Manual: Medigaps and Other Insurance to Supplement Insurance
Med Supp Benefits	A	B	C	D	E3	F1	G	H3	I3	J1,3	K	L	M	N
Part A Hospital Coinsurance
Part B Coinsurance											50%	75%		2
Blood											50%	75%
Hospice Benefit											50%	75%
Skilled Nursing											50%	75%
Part A Deductible											50%	75%	50%
Part B Deductible
Part B Excess Charges
Foreign Travel Emergency
2010 out-of-pocket limit											$4,620*	$2,310*
* Once the out of pocket limit is reached plan pays 100% (Note: these are 2009 $ amounts) 1 Plans F and J also offer a high-deductible option. You pay $2,000 (2009 amount) before your coverage begins. 2 Plan N's Part B coinsurance: Beneficiary pays $20 per physician visit & $50 per Emergency Room visit, unless the patient is admitted, before coverage begins. 3 Plans E, H, I and J will no longer be sold after June 1, 2010. Because Med Supp Plans are guaranteed renewable, those who already have them may keep them.

The Cost of Medicare Supplement Plans

Though policies with the same name cover the same benefits, the price may differ from company to company. Insurance companies offering Medicare Supplement plans set their own premiums that can be priced, or "rated," according to your community, the age at which you purchased the policy or the age you are during each year you hold the policy.

Because you need to have Medicare Part A and Part B to get a Medicare Supplement policy, you have to pay the monthly Medicare Part B premium as well as a premium to the Medicare Supplement insurance company.

Each insurance company decides how it will set the price, or premium, for its Medicare Supplement policies. It is important to ask how an insurance company prices its policies. The way they set the price affects how much you pay now and in the future. Medicare Supplement policies can be priced or "rated" in three ways:

1. Community-rated (also called "no-age-rated")
2. Issue-age-rated
3. Attained-age-rated

Each of these ways of pricing Medicare Supplement policies is described in the following chart. The examples show how your age affects your premiums, and why it is important to look at how much the Medicare Supplement policy will cost you now and in the future. The amounts in the examples aren't actual costs.

When you may enroll in and switch Medicare Supplement plans

You may enroll in a Medicare Supplement plan during the six month period starting on the first day of the month in which you are 65 years or older and enrolled in Medicare Part B (the "open enrollment" period).

If your open enrollment period has passed, insurance companies are able to decline your Medicare Supplement application. This is one reason why it is important to apply for a Medicare Supplement plan within six months of when you first become eligible. Once you are accepted for a policy, it will automatically renew as long as you pay your premiums.

If you apply for a Medicare Supplement plan, you have a "free look" period of 30 days to decide if you like your new policy. The 30-day period begins on the first day the policy is active. If you decide to cancel your policy during the "free look" period, and if you are inside your open enrollment period, you can apply and be approved for a new Medicare Supplement plan. If you are outside your open enrollment period, your application can be declined. This is why people who are applying for a new Medicare Supplement plan should not cancel any current plan until they are approved for the new plan.