Medicare Supplement Insurance Options:
2012 Medicare Supplement
Benefit Chart of Medicare Supplement Plans Sold for Effective Dates on or After January 1, 2012
| Basic Benefits: |
| Hospitalization: |
Part A coinsurance plus coverage for 365 additional days after Medicare benefits end. |
| Medical Expenses: |
Part B coinsurance (generally 20% of Medicare-approved expenses) or copayments for hospital outpatient services. Plans K, L, and N require insureds to pay a portion of Part B coinsurance
or copayments. |
| Blood: |
First 3 pints of blood each year. |
| Hospice: |
Part A coinsurance. |
| A |
B |
C |
D |
F/F* |
G |
Basic,
Including
100% Part B coinsurance |
Basic,
Including
100% Part B coinsurance |
Basic,
Including
100% Part B coinsurance |
Basic,
Including
100% Part B coinsurance |
Basic,
Including
100% Part B coinsurance |
Basic,
Including
100% Part B coinsurance |
| |
|
Skilled Nursing Facility Coinsurance |
Skilled Nursing Facility Coinsurance |
Skilled Nursing Facility Coinsurance |
Skilled Nursing Facility Coinsurance |
| |
Part A Deductible |
Part A Deductible |
Part A Deductible |
Part A Deductible |
Part A Deductible |
| |
|
Part B Deductible |
|
Part B Deductible |
|
| |
|
|
|
Part B Excess (100%) |
Part B Excess (100%) |
| |
|
Foreign Travel Emergency |
Foreign Travel Emergency |
Foreign Travel Emergency |
Foreign Travel Emergency |
*Plan F also has an option called a high deductible plan F. This high deductible plan pays the same benefits as Plan F after one has paid a calendar year [$2,070] deductible. Benefits from
high deductible plan F will not begin until out-of-pocket expenses exceed [$2,070]. Out-of-pocket expenses for this deductible are expenses that would ordinarily be paid by the policy. These
expenses include the Medicare deductibles for Part A and Part B, but do not include the plan's separate foreign travel emergency deductible.
| K |
L |
M |
N |
| Hospitalization and preventive care paid at 100%; other basic benefits paid at 50% |
Hospitalization and preventive care paid at 100%; other basic benefits paid at 75% |
Basic, Including 100% Part B coinsurance |
Basic, Including 100% Part B coinsurance, except up to $20 copayment for office visit, and up to $50 copayment for ER |
| 50% Skilled Nursing Facility Coinsurance |
75% Skilled Nursing Facility Coinsurance |
Skilled Nursing Facility Coinsurance |
Skilled Nursing Facility Coinsurance |
| 50% Part A Deductible |
75% Part A Deductible |
50% Part A Deductible |
Part A Deductible |
| |
|
Foreign Travel Emergency |
Foreign Travel Emergency |
| Out-of-pocket limit $[4,660]; paid at 100% after limit reached |
Out-of-pocket limit $[2,330]; paid at 100% after limit reached |
|
|
Medigap Frequently Asked Questions
Why were plans E, H, I and J eliminated?
Plan E was eliminated because the new Plan D would contain exactly the same benefits. Plans H, I and J were eliminated because with the other dropped benefits these plans would also duplicate other plans
available.
What will happen if the plan that you have is dropped?
Any plan that was purchased prior to June 2010 will remain inforce. Keep in mind these new plans are for new issues with effective dates of June 2010 and beyond. Your clients’ current Medigap plan
is guaranteed renewable for life. Even if their health changes, they cannot be terminated or forced to change to one of the new plans.
What is the new hospice benefit?
All plans will now include the Hospice Benefit as part of the “Core Benefits.” Medicare provides coverage for inpatient respite care up to 5 days less a co-payment amount of 5% of the daily
benefit. The new Hospice benefit will pick up this 5% co-pay.
Why was the At-Home Recovery benefit dropped?
It was determined that the benefit was confusing and difficult to understand and administer.
Why was Preventive Care dropped from all plans?
Because Medicare Part B has changed to cover many more preventive benefits, effectively rendering this benefit redundant.
Medicare Benefits For Part A
| Benefits For Medicare |
2012 Out-Of-Pocket Cost |
| Part A Benefits |
Part A Cost |
Inpatient Hospital
Day 1 Through Day 60 |
$1,156 Deductible For First Stay During a Year |
| Day 61 Through Day 90 |
$289 Per Day 61 Through 90 |
| 60 Day "Lifetime Reserve" |
$578 Per Day |
| Skilled Nursing Facility Day 1 through Day 20 |
$0 Day 1 Through Day 20 |
| Skilled Nursing Facility Day 21 through Day 100 |
$144.50 Day 21 Through Day 100 |
| Hospice Care For Terminally Ill |
Nominal Coinsurance For Drugs And Resite Care |
Medicare Benefits Part B
| Benefits For Medicare |
2012 Out-Of-Pocket Cost |
| Part B Benefits |
Part B Cost |
| Annual Deductible |
$140 |
| Physician And Other Medical Services |
20% Of Medicare Approved Amount |
| Outpatient Hospital Care |
20% Of Medicare Approved Amount |
| Ambulatory Surgical Services |
20% Of Medicare Approved Amount |
| Laboratory Services |
$0 |
| Outpatient Mental Health Services |
68.75% Of Medicare Approved Amount |
Also See: Regence
BlueShield | Premera
BlueCross | Asuris
NW Health
|
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