Medicare Supplement Plans

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Medicare Supplement Plans

Understanding Medicare Supplement Plans

Medicare supplement plans, sometimes called Medigap plans are offered by private health insurance companies, and come in 10 standard plan designs. These plans work in conjunction you’re your Medicare parts A and B, as opposed to Medicare Advantage plans that replace your Medicare.

Basically, you are covered by two health insurance plans: Medicare and your Medicare supplement plan. When you go to the doctor, Medicare will pay their portion, then your Medicare supplement will step-on and pay their portion. Your Medigap coverage will vary, depending on the plan you elect. Before we can compare Medicare Supplement plans or to fully understand the benefit of a Medigap plan, you should have a basic understanding of what how Medicare parts A and B function.

Traditional Medicare has two basic components, part A and part B. Part A is your hospitalization coverage, while Part B covers doctors and Durable Medical Equipment (DME). There are also Parts C and D. Part C is Medicare Advantage, where a private insurance company replaces your Medicare coverage, and Part D is prescription drug coverage. We will cover Medicare Part D on this page as will but let’s not think too much about Part D just yet. To learn more about Medicare Advantage Part C, click here for more information. Now, let’s look at what your traditional Medicare covers in a little more detail.

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Traditional Medicare Basics

Part A

Covers facility-related expenses, like hospitals and skilled nursing facilities. When you enter a hospital facility, you are responsible for a deductible of $1632.00 (in 2024) for each benefit period. Each benefit period is 60 days plus 60 days following your release. Days 61 through will cost you $408.00 for each day until you reach day 91. At day 91, your daily coinsurance increases to $816.00 a day!

Inpatient care in a hospital

$1,600 deductible for each benefit period. A benefit period is generally 60 days, plus 60 days following release from the facility.

Days 1–60: $0 coinsurance for each benefit period.

For days 61–90: $408 coinsurance per day of each benefit period.

While days 91 and beyond: $816 coinsurance per each “lifetime reserve day” after day 90 for each benefit period (60 days over lifetime).

Beyond lifetime reserve days: No coverage.

Skilled nursing facility care

Days 1–20: $0 for each benefit period.

While days 21–100: $204.00 coinsurance per day of each benefit period.

And days 101 and beyond: No coverage.

Hospice care

No charge for hospice (palliative care)

Home health care

Generally, no charge

Part B

Physician services, outpatient hospital services, certain home health services, durable medical equipment, and certain other medical and health services covered by Medicare Part B. For Part B-covered services, you usually pay 20% of the Medicare-approved amount after you meet your deductible ($240.00 for 2024).

How the Medicare Supplement fits-in

These plans work in conjunction with Medicare, as opposed to Medicare Advantage plans that replace your Medicare. Basically, you are covered by two health insurance plans: Medicare and you Medigap plan. When you go to the doctor, Medicare will pay their portion, then your Medicare supplement will step-on and pay the difference (depending on your plan).