A Medicare Supplement is an insurance policy that comes in and fills in the gaps, or expenses, Medicare does not pay on a Medicare approved medical expense. The amount of the medical expenses that a Medicare Supplement plan covers is based on which Medicare Supplement Plan you purchase. The Medical Supplement plans are identified by letters “A” through “N” of the alphabet. The most comprehensive Medicare Supplement plan is Plan F because it comes in and pays 100% of the expenses that Medicare does not pay.

What is the Medicare Supplement Plan F?

A Medicare Supplement Plan F covers the following expenses that original Medicare leaves for the Medicare beneficiary to pay out-of-pocket:

  • Medicare Part A deductible – $1,156.00 per hospital admission
  • Medicare Part A other hospital costs (up to 365 days after Medicare benefits are used)
  • Medicare Part B deductible – $140.00 each benefit year
  • Medicare Part B co-insurance – 20% for offices visits, diagnostic tests, outpatient surgery, etc.
  • Blood – first three pints (original Medicare does not cover the first three pints)
  • Medicare Part A Hospice Care coinsurance or co-payment
  • Medicare Part B Excess Charges
  • Skilled Nursing Facility Care co-insurance
  • Foreign Travel Emergency (up to plan limits)

What is the Medicare Supplement Plan N?

A Medicare Supplement Plan N pays all of the above-identified Medicare approved expenses except the following:

  • Medicare Part B deductible – $140.00 each benefit year
  • Medicare Part B excess

A Medicare Supplement Plan N also allows for a copayment up to $20.00 for office visits rather than the Medicare Part B 20% coinsurance. The amount of copay is determined by the type of services provided and the type of physician (i.e., a specialist) providing the service. Additionally, a Medicare Supplement Plan N allows for a $50.00 copayment for emergency room visits that do not result in hospital admission rather than the Medicare Part B 20% coinsurance.

Do I choose Medicare Supplement Plan F or Plan N?

A Medicare Pathways’ Benefit Specialist can help you review your personal situation and make a recommendation. Call 1-866-466-9118 or click here to request a quote. Below is a breakdown on a why Medicare Beneficiary might choose each plan.

A Medicare Supplement Plan F carries a higher premium because of the extensive coverage it offers. A Medicare Supplement Plan F provides 100% coverage of most Medicare cost sharing. With a Medicare Supplement Plan F you will have little to no out-of-pocket medical expenses for Medicare approved medical services. Medicare Supplement Plan F is a great option for Medicare beneficiaries that want full coverage and don’t mind paying a little more for it.

A Medicare Supplement Plan N has a much lower monthly premium because of the cost sharing involved. In other words, the Supplement Plan N requires you, the Medicare beneficiary, to share some of the expenses not covered by Medicare Part A and Part B. The savings you receive on your premium may be more than enough to cover these extra costs throughout the year! Medicare Supplement Plan N is a great plan for Medicare beneficiaries that want the premium savings and don’t mind using some of that to pay for Plan N cost sharing.

In sum, a regular Medicare Supplement Plan F offers 100% coverage for the expenses that original Medicare does not pay. A Medicare Supplement Plan N pays 100% of the expenses original Medicare does not pay with the exception of the Medicare Part B deductible, and instead of the Part B coinsurance, you pay up to $20.00 copay for office visits, etc. The Medicare Supplement Plan F has a higher premium than a Medicare Supplement Plan N due to the fact the Plan N involves some cost-sharing of the medical expenses with the Medicare beneficiary. Typically, the more cost-sharing involved, the lower the premium.

 

We can help you with a Medicare Health Plan review and determine what Medicare Supplement best meets your financial and medical needs. Give us a call today for a no-cost and no-obligation review and quote. Contacting Medicare Pathways, Inc  at 1-866-466-9118 will connect you with a licensed insurance agent.