Medicare does not cover 100 percent of healthcare procedures or expenses. The U.S. Department of Health and Human Services has established 10 plans for private insurance policies that supplement Medicare coverage. The supplemental plans, called Medigap policies, cover some or most of the additional costs and services. Each plan is named by a single letter.
In Nebraska, 47 percent of Medicare beneficiaries buy Medigap policies. Most of those who don’t purchase Medigap policies buy Medicare Advantage policies – a private alternative to Medicare – or have other complementary coverage, such as a retiree plan from their former employer. Medigap Plan F provides the most comprehensive benefits and is chosen by 69% of all Nebraska residents with Medigap policies. The average annual premiums paid for Plan F in 2010 in Nebraska was $2,244. Plan C is also popular in the state.
Every specific Medigap insurance policy is identical, regardless of which company sells it to you. Yet, prices have considerable variation. Companies use one of three methods to determine pricing. The majority (70 percent) of policies sold in Nebraska are based on your attained age. That means premiums will rise annually as you age.
Bankers Fidelity Life Insurance Company and Evererence Association price policies based on your age at the time you buy the policy. Prices will not increase due to your age, although inflation in healthcare costs and changes in federal laws are likely to result in modest annual increases.
AARP HealthCare Options (United Healthcare Insurance Company) sells the only community-rated plans in Nebraska. Its policies are not based on age at all. All policyholders in the community (which varies within Nebraska) pay the same base premiums. Smokers pay extra.
Check marks in the chart denote a coverage of 100% of the described Medigap benefit. If there is no check mark and instead a percentage marker, Medigap policies on each plan cover up to that percentage for the according benefit provision. If a box is blank, the Medigap policy is not sufficient for that benefit. You should also note that Medigap plans from MedicareSupplementalInsurance.com providers only cover your coninsurance premiums if you have already paid the deductible.
Check marks in the chart denote a coverage of 100% of the described Medigap benefit. If there is no check mark and instead a percentage marker, Medigap policies on each plan cover up to that percentage for the according benefit provision. If a box is blank, the Medigap policy is not sufficient for that benefit. You should also note that Medigap plans from MedicareSupplementalInsurance.com providers only cover your coninsurance premiums if you have already paid the deductible.
Medigap Plans Effective June 1, 2012 |
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Medigap Benefits Chart |
Plan A |
Plan B |
Plan C |
Plan D |
Plan F * |
Plan G |
Plan K |
Plan L |
Plan M |
Plan N | |
| Medicare Part A Coinsurance and Hospital Costs up to an Additional 365 Days After Medicare Benefits are Used Up. |  |
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| Medicare Part B Coinsurance or Copayment | |
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50% | 75% | |
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| Blood (First 3 Pints) | |
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50% | 75% | |
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| Part A Hospice Care Coinsurance or Copayment | |
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50% | 75% | |
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| Skilled Nursing Facility Care Coinsurance | |
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50% | 75% | |
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| Medicare Part A Deductible | |
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50% | 75% | 50% | |
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| Medicare Part B Deductible | |
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| Medicare Part B Excess Charges | |
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| Foreign Travel Emergency (Up to Plan Limits) | |
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| Out-of-Pocket Limit ** | |||||||||||
| $4,620 | $2,310 | ||||||||||
* Medigap Plan F also has a high deductible option available for your policy. Under the high deductible choice, it is your responsibility to cover the $2,070 for the 2012 period before your Medigap plan covers any additional cost.
** Medigap Plans K and G have additional out of pocket limits that will only require you pay $4,620 and $2,310, accordingly. Once that is covered by you (and you have also paid your yearly Part B deductible), the MedicareSupplementalinsurance.com provider Medigap plans will pay 100% of your covered services the rest of that calendar year.
*** Medigap Plan N will pay for 100% of your Part B consinsurance payment, up to a maximum of $20 for office visitations, as well as a $50 copayment for unexpected emergency room hospital visits that don't conclude in an longer duration stay at the hospital.
** Medigap Plans K and G have additional out of pocket limits that will only require you pay $4,620 and $2,310, accordingly. Once that is covered by you (and you have also paid your yearly Part B deductible), the MedicareSupplementalinsurance.com provider Medigap plans will pay 100% of your covered services the rest of that calendar year.* Medigap Plan F also has a high deductible option available for your policy. Under the high deductible choice, it is your responsibility to cover the $2,070 for the 2012 period before your Medigap plan covers any additional cost.
*** Medigap Plan N will pay for 100% of your Part B consinsurance payment, up to a maximum of $20 for office visitations, as well as a $50 copayment for unexpected emergency room hospital visits that don’t conclude in an longer duration stay at the hospital.
You’ll see that the charts show a broad premium range for each plan from each company. Where you fit in the range from lowest to highest can be determined by your gender, whether or not you smoke, and local healthcare costs in your area of Nebraska. You can receive specific personal quotes by filling out the zip code form and comparing rates instantly.
Before you decide which of the 10 plans to choose, fill out the zip code form to review plans and rates side by side. Making sure that you receive the proper amount of coverage at the best price is the best way to ensure that your health and wallet are protected.
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