Medicare Supplement Plan Benefits – Which Medicare Supplement Plans Offer What Services?

Medicare Supplement plans are supplemental insurance policies that are designed to fill in the gaps left by Medicare coverage. A Medicare Supplement Plan, sometimes also called Medigap, is a privately purchased insurance plan that will help cover some of the medical costs that Medicare does not cover. This can include deductibles, coinsurance and out-of -pocket costs like copays. With out-of -pocket medical expenses and Medicare coverage rising steadily, a Medicare Supplement Plan can really help put your mind at ease when it comes to the cost of health care.

There are two types of Medicare Supplement plans: closed and open enrollment. With closed enrollment plans, you are locked into a plan with which you have to stay until you reach the open enrollment date. There is no flexibility to change your Medicare Supplement plans once you have reached the open enrollment date. And, because you are required to stay with the plan until you want to switch, many seniors find that their out of pocket expenses can become quite large once they get to this point. A lot of them eventually decide to switch to Medicare Part D, the prescription drug plan offered by the government.

With an open enrollment period, Medicare Supplement plans are allowed to vary from plan to plan. In order to make sure that there are sufficient numbers of providers to adequately cover the needs of seniors, the Medicare Supplement Plans must be standardized. This allows for the plan to be offered across the board by all insurers. There are no restrictions on which medications or providers a Medicare Supplement Plan can use. You can even select plans that allow you to choose between companies and sets of doctors and hospitals.

Medicare Supplement Plans must also pay at least some of the costs for both of these basic benefits: the coverage for hospital stays and physician visits. The two basic benefits, as they are referred to, cover medically necessary services in most instances. They do not pay for inpatient and outpatient care, sight-and-earning care or dental care. Medicare Supplement Plans must also pay a percentage of the cost of durable medical equipment and certain hospital stays.

All Medicare supplement plans, with some exceptions, provide some coverage for durable medical equipment. Your Medicare Supplement Plan contract should specify what items of equipment you will cover for. Items covered include: wheelchairs, electric assistive mobility scooters, mobility aids such as walkers, and mobility scooters; mobility devices used by disabled persons to enter and exit vehicles; and scooter lifts. Some medications that are covered by Medicare are also provided through the Medicare Supplement Plans such as eyeglasses, hearing aids, and cholesterol medicine.

Medicare Supplement Plan contracts are not “open-ended” programs. In other words, you cannot turn around and join another company if your current provider does not offer Medicare Supplement Plan coverage that suits your needs. Most private insurance companies also do not offer Medicare Advantage Plan benefits. Your Medicare Supplement Plan provider can change your benefits at any time; you cannot simply “opt out” of changes made by your private insurance company. Therefore, before enrolling in a Medicare Supplement Plan, make sure that your current health insurance provider offers Medicare Advantage Plan benefits.