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Medigap Plans for Effective Dates Beginning June 1, 2010
:: June 1, 2010 Medigap Benefits Chart
:: Changes to Medicare Supplement Plans
:: Changes to Original Medicare
:: Insured Consumers
Basic Medicare Supplement Benefits After 6/1/2010
- Hospitalization: Part A, coinsurance plus coverage for 365 days after medicare Benefits end.
- Medical Expenses: Part B coinsurance (generally 20 percent of Medicare-approved expenses) or copayments for hospital outpatient services. Plans K, L and N require insured beneficiaries to pay a portion of Part B coinsurance or copayments.
- Blood: First three pints of blood each year.
- Hospice: Part A coinsurance and respite care expenses (including applicable prescription copayments)
The chart shows the standardized Medigap Plans effective June 1, 2010 and later.
June 1, 2010 Medigap Benefits Chart
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Medigap Plans A through N |
| Medigap Benefits |
A |
B |
C |
D |
F1 |
G |
K |
L |
M |
N |
| Medicare Part A Coinsurance and Hospital Benefits |  | | | | | | | | | |
| Medicare Part A Deductible | | | | | | | 50% | 75% | 50% | |
| Medicare Part B Coinsurance or Co-payment | | | | | | | 50% | 75% | | 2 |
| Medicare Part B Deductible | | | | | | | | | | |
| Medicare Part B Excess Charges | | | | | | | | | | |
| Blood (First Three Pints) | | | | | | | 50% | 75% | | |
| Hospice Care Coinsurance or Co-payment | | | | | | | 50% | 75% | | |
| Skilled Nursing Coinsurance | | | | | | | 50% | 75% | | |
| Foreign Travel Emergency (Up to Plan Limits)3 | | | | | | | | | | |
| Medicare Preventive Care Part B Coinsurance | | | | | | | | | | |
| | 2010
out-of-pocket imit4 » | $4,620 | $2,310 | |
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1Medigap Plan F offers a high deductible option. You must pay for Medicare-covered costs up to the high-deductible amount ($2,000 in 2010) before your Medigap policy pays anything
2100% part B coinsurance except up to $20 copayment for office visits and up to $50 copayment for ER.
3You must also pay a separate deductible for foreign travel emergency ($250 per year).
4After you meet your out-of-pocket yearly limit and your yearly Part B deductible ($155 in 2010) the plan pays 100% of covered services for the rest of the calendar year
All plans may not be available in all states.
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Changes to Medicare Supplement Plans
- Eliminating At-Home recovery benefit (offered in Plans D, G, I, and J). The home care benefit is under-utilized and as part of the "Modernization" it was decided to remove it.
- Eliminating Preventive Care benefit (offered in Plans E and J). The Preventive Care benefit is no longer being offered because the Medicare program has changed over the years to include significantly more preventive care benefits, making this separate benefit unnecessary.
- Replacing the 80% Part B Excess benefit in Plan G with a 100% Part B excess benefit.
- Hospice benefit to be added as a core benefit to every plan.
- Eliminating Plans E, H, I, and J, because with the benefit changes they duplicate other plans.
- Adding new benefit Plan options including:
- Plan M - 50% coverage of the Part A deductible
- Plan N - new copay structure (up to $20 copay for physician visits; up to $50 copay for emergency room). Plan N will use copays, specific to the Plan, to keep monthly premiums lower. Consumers will be responsible for copays associated with Plan N.
- Medicare Supplement insurers will be required to make Plans C or F available to consumers, if they offer plans in addition to Plan A.
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Changes to Original Medicare
The coinsurance percentage paid by consumers for mental health services will be lowered each year until it matches the coinsurance percentage for other Medicare services. Coinsurance will change from 50/50 to 80 (Medicare) / 20 (consumer) by 2014 (68.75% of approved amount in 2010).
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Insured Consumers
Insured consumers with existing Medicare Supplement Plans can retain their current medicare Supplement Plan. There is no need for them to change to one of the new plans. Insured consumers enrolling for June, 2010 effective dates and beyond will choose from the new Medicare Supplement Plans.
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