Medicare Supplement [ Medigap ]
If you’re turning 65 soon, you’re probably thinking about Medicare and Medicare Supplement Insurance. You’re likely wondering how you can possibly afford both Medicare premiums plus premiums for a Medicare Supplement Insurance policy. This may be even more of a worry if you’re not going to have a part-time job after you retire at age 65.
To decide if you’re going to need help to fill the gap in coverage that’s left after Medicare pays 80% of your medical bills, your first step should be to learn some basic facts about what Medicare and Medicare Supplement Insurance policies cover.
What Medicare Pays For:
Original Medicare Part A is hospital coverage that pays for:
- Inpatient hospital services
- Skilled nursing facility care (after a hospital stay)
- Home health care
- Hospice Care
- All but the first 3 pints of blood you receive per calendar year
Original Medicare Part B is medical coverage and pays for:
- Medical expenses
- Home health care
- Clinical laboratory services
- Outpatient treatment
- Durable medical equipment and supplies
- Preventive health care including exams, screenings and shots
Original Medicare Part D is prescription drug coverage and pays for generic and brand-name prescription drugs.
What Medicare Supplement Insurance Pays For:
According to Medicare.gov, there are 11 standard Medicare supplement insurance plans – A, B, C, D, F, High-Deductible F, G, K, L, M and N, and each offers different benefits that are set by the U.S. government, though all 11 plans offer these basic benefits:
- Part A co-insurance and hospital costs up to an additional 365 days after Medicare benefits are gone
- Part B co-insurance or co-payment
- Part A hospice care co-insurance or co-payment
- The first 3 pints of blood
*If you choose plans High-Deductible F, K, L or M, you’ll share a greater portion of the costs through higher co-insurance and co-payment rates.
What Medicare Doesn’t Pay For:
- Custodial care
- More than 100 days of skilled nursing home care following a hospital stay
- Homemakers services
- Private-duty nursing care
- Dental cleanings, fillings, extractions and dentures
- Medical care while traveling outside the U.S.
- Cosmetic surgery
- Preventive care of the feet
- Eye exams and glasses
- Hearing exams and hearing aids