Newsletters 2010 Newsletters Ask Mary Beth: What changes can I expect with Medigap this year?
Monday, 12 April 2010 22:43
The alphabet soup of Medigap (Medicare Supplemental Insurance) policies, designed to ease out-of-pocket spending under Medicare, are set to change due to federal legislation that was passed in July 2008. Currently, there are 12 standard Medigap policies available through private insurance companies that supplement Medicare’s basic coverage and close the “gap” between covered and uncovered costs. These plans, labeled alphabetically from A – L have varying characteristics such as different deductibles and co-insurance options, and range widely in coverage provided, including options for hospital stays, hospice care, outpatient services and more.
Beginning June 1, 2010 the following eliminations, modifications and additions will take place to Medigap Coverage:
- Plans E, H, I and J will no longer be sold due to the removal of the “Preventive Care Benefit” which had paid up to $120 per year for health screening exams. This benefit became outdated as Medicare added screening procedures for various types of cancers and the “at home recovery” benefit which pays up to $1,600 per year for short-term, at-home assistance for daily living activities (bathing, dressing, personal hygiene, etc.) for those recovering from an illness, injury, or surgery. Note: These plans will essentially become identical to other lettered plans with the elimination of these benefits.
- Individuals who currently hold the above plans will be allowed to keep them with their existing coverage (permitted premiums are paid), however no new policies will be issued under plans E, H, I or J.
- The 80% Part B Excess Charges Benefit under plan G will be replaced with a 100% benefit.
- A new Hospice Benefit will be created and included as a part of basic benefits under all plans to cover the out-of-pocket costs imposed by Medicare’s hospice benefit.
- Two new plan options will be created:
- Plan M will be created with increased cost sharing, paying 50% of the Part A deductible. Some costs of foreign travel emergencies, however, will not cover the Part B deductible.
- Plan N will be created with a new co-pay structure of $20 for physician visits and $50 for Emergency Room Visits. Plan N will also cover some costs of foreign travel emergencies and like Plan M, will provide no coverage for Part B deductible.
Though the above changes are being made effective June 1st for new policies issued, many benefits will remain the same, including a standard core benefit inclusive of Part A full coverage for daily inpatient hospital coinsurance charges, all costs of hospital care after the Medicare benefit is used up, and Part B coinsurance charges. In addition, all Medigap plans will cover 100 percent of any Part B coinsurance charge for preventive care.
When considering the various types of Medigap plans for your personal situation, keep the following in mind:
- It isn’t guaranteed that all Medigap providers will offer the new plans M and N.
- No matter which private insurance company you purchase your plan from, you will always receive the same policy coverage and benefits. However, premiums rates will vary across the board as the companies issuing the policies are free to fix their own charges to these plans.
We advise you to evaluate all plan options, providers and costs prior to selecting a policy. Review the offer documents of each policy to ensure that you are choosing the best fit for your circumstances. Due to the plethora of information made available when making decisions about Medicare Supplemental Insurance, it may be best to utilize the expertise of a qualified professional. We invite you to use us as a resource in reviewing your current situation and are happy to make a referral to a trusted professional should you like additional help.
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