Main Category: Medicare / Medicaid / SCHIP
Also Included In: Health Insurance / Medical Insurance
Article Date: 27 May 2010 - 7:00 PDT
Starting June 1, two new Medicare supplemental plan options-M and N-will be available, and four plans-E, H, I and J-will no longer be sold, although Medicare consumers who have these four plans will be able to keep them.
Further, all Medicare supplemental plans sold on or after June 1 will also include a hospice benefit. Two benefits -at-home recovery and preventive medical care- will no longer be included in plans sold after June 1. Consumers who currently have plans that include these benefits, however, will retain them.
"Medicare consumers who are happy with their Medicare supplemental plans are not required to purchase a new plan," said Joe Baker, president of the Medicare Rights Center "and they should rest assured that they will not lose any benefits."
Medicare supplemental insurance plans, also known as "Medigap" plans, are designed to fill gaps in Original Medicare. They do not work with Medicare private health ("Medicare Advantage") plans.
Medigap plans have standardized benefit packages and the plans are labeled by letters-Plan A, Plan B, etc. Each Medigap plan pays for a particular set of benefits. Plan A offers the fewest benefits and is usually the least expensive. Plans that offer more benefits, like Plan F, are generally more expensive.
All Medigap plans must cover the following benefits:
- Hospital co-insurance coverage
- 365 additional days of full hospital coverage
- Full or partial coverage for the 20 percent co-insurance for doctor charges and other Part B services
- Full or partial coverage for the first 3 pints of blood you need each year
All plans that are sold after June 1 must offer these basic benefits and also pay all or part of the hospice co-insurance for drugs and respite care.
Not all plans are available in all areas of the country, and the rules governing the sale of Medigaps differ from state to state. (Massachusetts, Minnesota and Wisconsin have different standardized Medigap plans for their residents.)
People who are buying Medigaps for the first time or who are considering switching Medigaps are advised to first call their State Health Insurance Assistance Program (SHIP) or Department of Insurance to (1) confirm that plans are required to sell them a new Medigap policy at that time, (2) get a current list of plans available in their area, (3) get information about the plans' premiums and (4) know the rules and protections in their state.
For more information about Medigaps , including details about plans M and N and a chart that summarizes the benefits under different plans, visit MedicareInteractive.org.
For a directory of State Health Insurance Assistance Programs (SHIP), go here.
For contact information for state Departments of Insurance, go here.
"Knowing when you have the right to buy a Medigap policy in your state is very important," said Baker. "The rules and consumer protections differ from state to state, and if you miss your window of opportunity, the consequences can range from your costs going up to your options being limited to not being able to buy a Medigap at all."
Information for People with Medicare in New York State
Medicare consumers in New York State are allowed to purchase Medigap policies at any time. Plans are also strictly forbidden from adjusting premiums based on customers' health condition and age.
Medicare Rights Center