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Benefit Chart of Medicare Supplement Plans Sold on or After June 1, 2010
Benefit Plans A, B, C, D, F, F+, G, K, L and N

 

Medicare Update 2011

 

First, The Different Parts of Medicare (Compliments of www.medicare.gov)

Medicare is health insurance for people age 65 or older, under 65 with certain disabilities, and any age with End-Stage Renal Disease (ESRD). ESRD is permanent kidney failure requiring dialysis or a kidney transplant. The different parts of Medicare help cover specific services if you meet certain conditions.

Medicare Patients receive an EOB (Explanation of Benefits) or MSN (Medicare Summary Notice) from Medicare after going to the doctor or hospital.  That is what our company uses to pay claims. 

Here are Sample EOB/MSN's and How to Read Them:

Medicare has the following parts:

Medicare Part A
(Hospital Insurance)

  • Helps cover inpatient care in hospitals (includes critical access hospitals, inpatient rehabilitation facilities, and long-term care hospitals).
  • Helps cover skilled nursing facility (not custodial or long-term care), hospice, and home health care services.

Medicare Part B
(Medical Insurance)

  • Helps cover doctor services and outpatient care.
  • Helps cover some preventive services to help maintain a person’s health and to keep certain illnesses from getting worse.
  • Generally pays 80% of the Medicare-approved amount for covered services

Medicare Part C
(Medicare Advantage Plans)

  • A way to get Medicare benefits through private companies approved by and under contract with Medicare.
  • Includes Part A, Part B, and usually other benefits Medicare doesn’t cover. Most plans also provide prescription drug coverage.

Medicare Part D
(Prescription Drug Coverage)

  • Run by private companies approved by Medicare, which can either be Medicare Advantage Plans or separate Medicare Prescription Drug Plans.
  • Helps cover the cost of prescription drugs.
  • Each plan can vary in cost and drugs covered.

* Denotes plans available by our carrier

BASIC MEDICARE SUPPLEMENT BENEFITS:

  • Hospitalization: Part A coinsurance plus coverage for 365 additional days after Medicare benefits end.
  • Medical Expenses: Part B coinsurance (generally 20% of Medicare-approved expenses) or copayments for hospital outpatient services. Plans K, L and N require insureds to pay a portion of the Part B coinsurance or copayments.
  • Blood: First three pints of blood each year.
  • Hospice: Part A coinsurance.

2010 Medicare Supplement Plans Benefit Chart (Plans A-G)

Plan-A* Plan-B* Plan-C* Plan-D* Plan-F/F+* ** Plan-G*
 
Basic,
including 100% Part B coinsurance		 Basic,
including 100% Part B coinsurance		 Basic,
including 100% Part B coinsurance		 Basic,
including 100% Part B coinsurance		 Basic,
including 100% Part B coinsurance		 Basic,
including 100% Part B coinsurance
  Skilled Nursing Facility Coinsurance Skilled Nursing Facility Coinsurance Skilled Nursing Facility Coinsurance Skilled Nursing Facility Coinsurance Skilled Nursing Facility Coinsurance
  Part A Deductible Part A Deductible Part A Deductible Part A Deductible Part A Deductible
    Part B Deductible   Part B Deductible  
        Part B Excess (100%) Part B Excess (100%)
    Foreign Travel Emergency Foreign Travel Emergency Foreign Travel Emergency Foreign Travel Emergency

 

2010 Medicare Supplement Plans Benefit Chart (Plans K-M)

 
Plan-K* Plan-L* Plan-M Plan-N*
Hospitalization and preventive care paid at 100%; other basic benefits paid at 50% Hospitalization and preventive care paid at 100%; other basic benefits paid at 75% Basic,
including 100% Part B coinsurance		 Basic, including 100% Part B coinsurance, except up to $20 copayment for office visit, and up to $50 copayment for ER
50% Skilled Nursing Facility
Coinsurance		 75% Skilled Nursing Facility
Coinsurance		 Skilled Nursing Facility Coinsurance Skilled Nursing Facility Coinsurance
50% Part A
Deductible		 75% Part A
Deductible		 50% Part A Deductible Part A Deductible
    Foreign Travel Emergency Foreign Travel Emergency
Out-of-pocket limit $4620; paid at 100% after limit reached Out-of-pocket limit $2310; paid at 100% after limit reached    

 

* Denotes plans available by our carrier.


** Plan F also has an option called a high deductible Plan F. This high deductible plan pays the same benefits as Plan F after one has paid a calendar year $2000 deductible. Benefits from high deductible Plan F will not begin until out-of-pocket expenses exceed $2000. Out-of-pocket expenses for this deductible are expenses that would ordinarily be paid by the policy. These expenses include the Medicare deductibles for Part A and Part B, but do not include the plan’s separate foreign travel emergency deductible. (The calendar year high deductible for high deductible Plan “F” shall be adjusted annually by the Secretary of the United States of Health and Human Services. The cover page must specify the applicable deductible amount.)