Medicare Supplements

We want to make sure you choose the plan that best fits your goals and lifestyle. What is important to you?

• Cost
• Choice of Doctors
• Options in different geographic locations
• Prescription Drug Coverage
  
• Co-Pays - Additional cost after monthly premiums

Information directly from the U.S. Government website - www.medicare.gov

Medicare Deductible and Coinsurance Amounts for 2010:
Part A: (pays for inpatient hospital, skilled nursing facility, and some home health care) For each benefit period Medicare pays all covered costs except the Medicare Part A deductible (2010 = $1,100) during the first 60 days and coinsurance amounts for hospital stays that last beyond 60 days and no more than 150 days.

For each benefit period you will pay:

• A total of $1,100 for a hospital stay of 1-60 days.
• $275 per day for days 61-90 of a hospital stay.
• $550 per day for days 91-150 of a hospital stay (Lifetime Reserve Days).
• All costs for each day beyond 150 days

Skilled Nursing Facility Coinsurance

• $137.50 per day for days 21 through 100 each benefit period.

Part B: (covers Medicare eligible physician services, outpatient hospital services, certain home health services, durable medical equipment)

• $155.00 per year. (Note: You pay 20% of the Medicare-approved amount for services after you meet the $155.00 deductible.)

Additional information about the Medicare premiums, deductibles, and coinsurance rates for 2009 is available in the September 19, 2008 Fact Sheet titled, "CMS Announces Medicare Premiums, Deductibles for 2010 " on the www.cms.gov web site.

*Note: If your income is above $85,000 (single) or $170,000 (married couple), then your Medicare Part B premium may be higher than $96.40 per month.  For additional details, see our FAQ titled: " Medicare Part B Monthly Premiums in 2010"

A Medigap policy is health insurance sold by private insurance companies to fill gaps in Original Medicare coverage. Medigap policies don’t work with any other type of health insurance, including Medicare Advantage Plans, employer/union group coverage, Veterans Administration (VA) benefits, or TRICARE. Medigap policies help pay your share (coinsurance, copayments, or deductibles) of the costs of Medicare-covered services. Some Medigap policies cover certain costs not covered by Original Medicare.

What is a Medigap policy?
A Medigap (also called “Medicare Supplement Insurance”) policy is private health insurance that is designed to supplement Original Medicare. This means it helps pay some of the health care costs (“gaps”) that Original Medicare doesn’t cover (like copayments, coinsurance, and deductibles).

Medigap policies may also cover certain things that Medicare doesn’t cover. If you are in Original Medicare and you have a Medigap policy, Medicare will pay its share of the Medicare-approved amounts for covered health care costs. Then your Medigap policy pays its share. (Note: Medicare doesn’t pay any of the costs for you to be insured under a Medigap policy.)

Also, a Medigap policy is different than a Medicare Advantage Plan. Every Medigap policy must follow Federal and state laws designed to protect the consumer and it must be clearly identified as “Medicare Supplement Insurance.” Medigap insurance companies can only sell you a “standardized” Medigap policy identified by letters A through L.

Each standardized Medigap policy must offer the same basic benefits, no matter which insurance company sells it. Cost is usually the only difference between Medigap policies sold by different insurance companies.

Medicare Advantage Plans
Medicare Advantage Plans include the following:

• Preferred Provider Organization (PPO) Plans
  
• Health Maintenance Organization (HMO) Plans
  
• Private Fee-for-Service (PFFS) Plans
  
• Medical Savings Account (MSA) Plans
  
• Special Needs Plans (SNP)

Medicare Advantage Plans and Medigap Policies
Important: If you have a Medigap policy and you are switching from Original Medicare to a Medicare Advantage Plan, you don’t need and can’t use the Medigap policy to cover deductibles, copayments, or coinsurance under the Medicare Advantage Plan. You may choose to drop your Medigap policy, but you should talk to our Medicare Specialist Bob Fitzgerald and your current Medigap insurance company before you do because you may not be able to get it back. If you already have a Medicare Advantage Plan, it is illegal for anyone to sell you a Medigap policy unless you are switching back to Original Medicare.

Medicare Prescription Drug Coverage (Part D)
Medicare offers prescription drug coverage (Part D) for everyone with Medicare. To get Medicare drug coverage, you must join a plan run by an insurance company or other private company approved by Medicare. Each plan can vary in cost and drugs covered. If you want Medicare drug coverage, you need to choose a plan that works with your health coverage.

There are two ways to get Medicare prescription drug coverage:

1. Medicare Prescription Drug Plans. These plans add drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private Fee-for-Service Plans.
   
   
2. Medicare Advantage Plans (like an HMO or PPO) or other Medicare health plans that have prescription drug coverage. You get all of your Part A and Part B coverage, including prescription drug coverage (Part D), through these plans.

Some Pharmaceutical Companies offer assistance programs for the drugs they manufacture. To see if any programs are available for the drugs you are taking, please select the letter in the list below to see if your drug is on the list. If your drug is on the list, click on the link labeled "details" for detailed information about the program.  www.medicare.gov/pap/index.asp

What Medigap policies do not cover:
Medigap policies do not cover long-term care (such as a nursing home or home health care), vision or dental care, hearing aids, eyeglasses, and private-duty nursing.

For more information
Remember, this guide is about Medigap policies. Visit the Medicare web site to view the handbook “Medicare & You.” You can also call 1-800-MEDICARE (1-800-633-4227 ). TTY users should call 1-877-486-2048 .