Standardized Medicare Supplement Plans for Most States (excluding MA, MN and WI )
Every company offering Medicare Supplement insurance must offer Plan A. In addition, companies may have some, all, or none of the other plans.
Basic Benefits (Included in Plans A - G):
Inpatient Hospital Care: Covers the cost of Part A coinsurance and the cost of 365 extra days of hospital care during your lifetime after Medicare coverage ends.
For medicare supplement plans, Medical Costs: Covers the Part B coinsurance (generally 20% of Medicare-approved payment amount) or copayment amount which may vary according to the service. For hospital outpatient services, the copayment amount will be paid under a prospective payment system. If this system is not used, then 20% of eligible expenses will be paid.
Blood: Covers the first 3 pints of blood each year.
|Options ||A ||B ||C ||D ||F* ||G |
|Basic Benefits || || || || || || |
|Part A: Inpatient Hospital Deductible || || || || || || |
|Part A: Skilled-Nursing Facility Coinsurance || || || || || || |
|Part B: Deductible || || || || || || |
|Foreign Travel Emergency || || || || || || |
|Part B: Excess Charges || || || || ||100% ||100% |
* Plan F also has a high deductible option. If you choose this option, in 2019 you must pay $2,300 out-of-pocket per year before the plans pay anything. Insurance policies with a high deductible option generally cost less than those with lower deductibles. Your out-of-pocket costs for services may be higher if you need to see your doctor or go to the hospital.
Basic Benefits (Plans K- N):
Basic Benefits for Plans K, L and N include similar services as Plans A through G and M, but cost sharing for the basic benefits is at different levels.
|Options ||K** ||L** ||M ||N |
|Basic Benefits ||100% of Part A Hospitalization Coinsurance plus coverage for 365 days after Medicare Benefits end 50% Hospice cost-sharing 50% of Medicare eligible expenses for the first three pints of Blood 50% Part B Coinsurance, except 100% Coinsurance for Part B Preventive Services ||100% of Part A Hospitalization Coinsurance plus coverage for 365 days after Medicare Benefits end 75% Hospice cost-sharing 75% of Medicare eligible expenses for the first three pints of Blood 75% Part B Coinsurance, except 100% Coinsurance for Part B Preventive Services || ||Basic, Including 100% co-insurance, except up to $20 copayment for office visit, and up to $50 copayment for ER |
|Skilled Nursing Coinsurance ||50% Skilled Nursing Facility Coinsurance ||75% Skilled Nursing Facility Coinsurance || || |
|Part A: Deductible ||50% Part A Deductible ||75% Part A Deductible ||50% Part A Deductible || |
|Part B: Deductible || || || || |
|Part B: Excess (100%) || || || || |
|Foreign Travel Emergency || || || || |
|At-Home Recovery || || || || |
|Preventive Care NOT Covered by Medicare || || || || |
| ||$5,560 Out of Pocket Annual Limit (2019) *** ||$2,780 Out of Pocket Annual Limit (2019) *** || || |
**Plans K and L provide for different cost-sharing for items and services than Plans A through G and M. Once you reach the annual limit, the plan pays 100% of the Medicare copayments, coinsurance, and deductibles for the rest of the calendar year. The out-of-pocket annual limit does NOT include charges from your provider that exceed Medicare-approved amounts, called "Excess Charges". You will be responsible for paying excess charges.
***The out-of-pocket annual limit will increase each year for inflation.