Medicare supplement insurance policies (Medigap): Understanding their functionality

Medicare Supplement Policies (Medigap): Understanding Their Function

In 2020, Medicare Supplement (Medigap) plans continue to provide coverage for various out-of-pocket costs that Original Medicare Parts A and B do not fully pay. These costs generally include deductibles, coinsurance, and copayments associated with covered Medicare services.

### Out-of-pocket costs covered by Medicare Supplement plans in 2020: - **Medicare Part A deductible** and coinsurance (hospital costs) - **Part B coinsurance** (typically 20% of approved services) - Some plans cover **Part B excess charges** (charges above Medicare-approved amounts, up to 15%) - Certain plans cover **skilled nursing facility coinsurance** - Some plans cover **foreign travel emergency care**

### Part B deductible coverage specifics: - Most Medicare Supplement plans **do not cover the Medicare Part B annual deductible** if you were first eligible for Medicare on or after January 1, 2020. - Plans that **do NOT cover the Part B deductible** and are available for those first eligible on or after January 1, 2020, include: - **Extended Basic Plan 2020** - The standard Medicare Supplement plans (like Plan G) for new enrollees starting 2020 onwards also do **not cover the Part B deductible** but cover nearly all other Part B costs fully after that deductible is met.

- Plans available to those first eligible **before January 1, 2020** may cover the Part B deductible.

### Other key notes for 2020: - The **High-Deductible Plan** requires you to pay out-of-pocket expenses up to the deductible amount ($2,700 in 2020) before coverage begins. - After meeting deductible or out-of-pocket maximums (which vary by plan), Medicare Supplement plans cover 100% of covered services. - Examples of out-of-pocket maximums: Plan G's maximum out-of-pocket is the Part B deductible itself, which was $198 in 2020; Plan K and L have lower limits with partial coverage.

### Summary Table for Part B Deductible Coverage in 2020:

| Medigap Plan Type | Covers Part B Deductible? | Eligible if first enrolled before January 1, 2020? | |---------------------------|-------------------------------------------------------|----------------------------------------------------| | Extended Basic Plan 2020 | No | Available to all applicants first eligible on or after 1/1/2020 | | Plan G | No | Yes | | High-Deductible Plan | N/A (Has separate deductible before coverage starts) | Yes | | Plans for those before 2020| May cover Part B deductible depending on plan | Yes |

If you first became eligible for Medicare on or after January 1, 2020, most Medicare Supplement plans, including Plan G, do not cover the Part B deductible, and you are responsible for paying this amount out-of-pocket before coverage kicks in for Part B services.

For a fuller understanding, costs beyond the Part B deductible such as coinsurance, copayments, and excess charges can all be covered depending on the specific Medigap plan chosen. Copayment is a fixed dollar amount a person with insurance pays when receiving certain treatments, for Medicare, this usually applies to prescription drugs.

After the Initial Enrollment Period, insurance companies may turn a person down from coverage or charge higher premiums. Each person must have their own Medicare supplement policy; married individuals must have separate policies. The cost of a Medicare supplement plan varies widely, and factors such as the insurance provider, the enrollee's age, the chosen plan, and location can affect the price.

Medicare supplement plans are not the same as Medicare Advantage plans. Medicare Advantage plans are sold and administered by private companies as an alternative to Medicare parts A and B, and they may cover more than separate Medicare plans, such as dental or vision care. A person cannot have parts A and B and an Advantage plan at the same time.

Currently, 10 Medicare supplement plans are available, with coverage varying between each of the 10 plans. Due to a recent ruling, Medicare supplement plans C and F are no longer available for new enrollees, but people who joined these plans before January 1, 2020 will be able to continue using them. More expensive plans generally provide more benefits, but plans with a higher deductible may have a lower monthly cost but require the person to spend more on eligible medical treatments before the insurer starts to fund treatment.

Some health organizations offer Medicare Supplement plans to cover out-of-pocket costs beyond the Medicare Part B deductible, such as coinsurance, copayments, and excess charges, in line with science-backed health-and-wellness practices. If you first became eligible for Medicare on or after January 1, 2020, certain Medicare Supplement plans like Plan G may not cover the Part B deductible, making it necessary for you to manage the expense out-of-pocket before coverage kicks in for Part B services.