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Medicare 101
Medicare Supplements 101
MEDICARE SUPPLEMENT CHANGES 2010
Here are the highlights of the concerning the coming changes to Medicare Supplement (Medigap) insurance & Medicare.
New 2010 Medigap Benefits and Plans
New Hospice Benefit
All plans will now include the Hospice Benefit as part of the “Core Benefits.” Medicare pays for all but very limited co-payments for outpatient drugs ($5). Included in all Medigap plans a benefit to pay this co-payment will be included.
Medicare provides coverage for inpatient respite care up to 5 days less a co-payment amount of 5% of the daily benefit. The new Hospice benefit will pick up this 5% co-pay.
New Plans
The new regulation also makes the following two new plan options available to beneficiaries, which have higher cost–sharing responsibilities and lower estimated premiums:
- New Plan M includes 50 percent coverage of the Medicare Part A deductible and does not cover the Medicare Part B Deductible. Plan M has all the core benefits plus the foreign Travel Emergency Benefit.
- New Plan N does not cover the Medicare Part B deductible and adds a new co–payment structure of $10 for each physician visit and $50 for each emergency room visit (waived upon admission to the hospital). Plan N has all the core benefits plus the foreign Travel Emergency Benefit.
Benefit Chart of Medicare Supplement Plans Sold for Effective Dates on or After June 1, 2010
| A | B | C | D | F/F* | 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 | ||
| 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 |
*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 [$1900] deductible. Benefits from high deductible plan F will not begin until out-of-pocket expenses exceed [$1900]. 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.
| K | L | M | 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 $[4440]; paid at 100% after limit reached | Out-of-pocket limit $[2220]; paid at 100% after limit reached |
