Medicare Supplement (Medigap) Insurnace

Medicare Supplement  ( Medigap ) Insurance

If you’re turning 65 soon, you’re probably thinking about Medicare and Medicare Supplement (Medigap) Insurance.  You’re likely wondering how you can possibly afford both Medicare premiums plus premiums for a Medicare Supplement (Medigap) 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 (Medigap) 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 (Medigap) Insurance Pays For:

According to Medicare.gov, there are 11 standard Medicare Supplement (Medigap) 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

**Massachusetts, Minnesota, and Wisconsin: Your  Medicare Supplement (Medigap) Insurance policies are standardized in a different way