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.
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.
The chart below shows basic information about the different benefits that
Medicare Supplement Plans cover for 2019.
If a percentage appears, the Medicare Supplement Plans
covers that percentage of the benefit, and you’re responsible for the rest.
There are 10 different Medicare Supplement Plans
Plans A, B, C, D, F*, G, K, L, M, N
* Plan F also offers a “high-deductible” plan in some states. If you choose this option, this means you must pay for Medicare-covered costs (coinsurance, copayments, and deductibles) up to the deductible amount of $2,300 in 2019 before your police pays anything.
** Plans K and L have an annual out of pocket limit. For 2019, those amounts are $5560 (K) and $2780 (L). Once you meet that amount, in addition to meeting your Medicare Part B deductible ($185/year for 2019), the plan pays 100% of covered services for the rest of the calendar year.
*** Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don’t result in an inpatient admission.
If you live in one of these 3 states, Medigap policies are standardized in a different way
Massachusetts, Minnesota, or Wisconsin
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
- We have plans to cover these though!