What types of coverage are not Medicare Supplement plans?

As a Medicare beneficiary, you may also be enrolled in other types of coverage, either through the Medicare program or other sources, such as an employer. When you first sign up for Original Medicare, you’ll fill out a form called the Initial Enrollment Questionnaire and be asked whether you have other types of insurance. It’s important to include all other types of coverage you have in this questionnaire. Medicare uses this information when deciding who pays first when you receive health-care services.

Below is a list of other types of insurance you may have. Please note that these types of coverage are different from Medicare Supplement plans:

What benefits do Medicare Supplement plans cover?

Currently, there are 10 standardized Medigap plans, each represented by a letter (A, B, C, D, F, G, K, L, M, N; there’s also a high-deductible version of Plan F). These plans are available in most states; Massachusetts, Minnesota, and Wisconsin each have their own different set of standardized Medicare Supplement plans.

Coverage levels and premiums vary, but the benefits of each plan within a lettered category remain the same despite the insurance company or location. For example, Plan A benefits are the same in New Jersey as they are in Oregon. If a Medicare Supplement plan includes a certain benefit, this benefit is covered 100% unless otherwise specified.

In general, all Medicare Supplement plans cover the following benefits:

  • Medicare Part A coinsurance and hospital costs (up to an additional 365 days after Medicare benefits are used)
  • Medicare Part B coinsurance or copayment*
  • Blood (first 3 pints)*
  • Part A hospice care coinsurance or copayment*

*Coverage may be partial for some plans. Medigap Plan N covers the Part B coinsurance except for up to $20 copayment for some office visits and up to $50 copayment for emergency room visits that don’t result in an inpatient admission.

Some types of Medicare Supplement plans also cover:

  • Skilled nursing facility care coinsurance
  • Medicare Part A deductible
  • Medicare Part B deductible
  • Medicare Part B excess charges (the amount that a non-participating provider may charge above the Medicare-approved cost for a service)
  • Foreign travel emergency (up to plan limits)

Two Medicare Supplement plans (Plan K and Plan L) include an out-of-pocket limit. Once your spending for Medicare-covered services reaches a certain amount, the Medigap plan will cover 100% of Medicare-covered costs for the rest of the year.

As mentioned, benefits vary by plan type. For a quick look at the benefits provided by standardized Medicare Supplement plans, please view this Medigap Plan Benefits Chart.

What benefits are not covered by Medicare Supplement plans?

Medigap policies generally do not cover the following health services and supplies:

  • Long-term care (care in a nursing home)
  • Routine vision or dental care
  • Hearing aids
  • Eyeglasses
  • Private-duty nursing
  • Prescription drugs

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