Do you have a Medicare Supplement Plan E, H, I or J?

When discussing Medicare Supplement plans they are almost always referred to Medicare Supplement Plans “A” through “N”.  However, when you review an Outline of Coverage, which defines what each plan covers, there are certain Medicare Supplement plans that appear to be missing between “A” and “N”.  Specifically, Medicare Supplement Plans E, H, I and J are not listed on the Outline of Coverage.  Why?  Because as a result of the Medicare Modernization Act, Medicare Supplement Plans E, H, I and J are no longer available to purchase.  If you already had a Medicare Supplement Plan E, H, I and J prior to June 1, 2010, you were allowed to keep the plan.  However, at this point in time and considering all the changes in original Medicare coverage it might be a good time to shop and compare the different plans that have been added and find a more affordable and more appropriate Medicare Supplement plan.  A Medicare Pathways Benefit Advisor will assist you in reviewing your options for a more modernized Medicare Supplement plan.  If you still have a Medicare Supplement Plan E, H, I and J there are other plans available that will cover the gaps left by original Medicare Part A and Part B, but one that will not duplicate benefits already provided as standard coverage by original Medicare.

Who determined Medicare Supplement Plans E, H, I and J should no longer be available for purchase?

The Centers for Medicare and Medicaid Services (also known as “CMS”) constantly monitors Medicare Supplement plans, current economic situations, and maintains the needs of senior citizens.  Recently, original Medicare has upgraded some of the benefits that people receive by just having original Medicare Part A and/or Part B. With this upgrade in original Medicare coverage, some of the “older” Medicare Supplement Plans (Plans E, H, I and J) were eliminated due to the fact that the benefits offered in these plans became duplication of benefits. For example, original Medicare now covers more preventive care benefits than they did previously. As a Medicare beneficiary you are entitled to an annual wellness exam, as well as a comprehensive health check when first enrolling in original Medicare Part A and Part B.  Medicare also helps pay for many other preventive screenings and services.  In fact, beginning on January 1, 2013, even more preventive screenings and services became available at little to no cost to the Medicare beneficiary.  With the increase in standard original Medicare Part A and Part B coverage, it does not make sense to offer Medicare Supplement plans that duplicate coverage that you are entitled to through original Medicare.

If I have a Medicare Supplement Plan E, H, I or J, why would I want to switch to a different Medicare Supplement plan?

If you have a Medicare Supplement Plan E, H, I or J you may want to review your options for other Medicare Supplement plans because it is highly probably that you will find a plan that offers very similar coverage at a much more affordable premium.  A Medicare Pathways Benefit Advisor will be able to assist you in finding a more affordable and a more appropriate Medicare Supplement plan from the list of Medicare Supplement plans now available.

What do Medicare Supplement Plans E, H, I and J cover?

While Medicare Supplement Plans E, H, I and J are no longer available to purchase, if a Medicare beneficiary purchased one of these plans prior to June 1, 2010, they were allowed to keep the plan.  Some individuals still have these plans and, in most cases, are paying higher premiums than the modernized Medicare Supplement plans for less coverage.

The following describes what Medicare Supplement Plan E, H, I and J covers:

Medicare Supplement Plan E:

Medicare Supplement Plan E was the true middle-point plan that filled several significant original Medicare coverage gaps.  Originally, Plan E was one of the supplemental plans that included not only basic care benefits, but preventive care coverage as well. However, as original Medicare sought to modernize and improve its benefit structure, it did away with preventive care due to infrequent use.  Plan E benefits included the basic standard coverage, as in any Medicare Supplement plan, including Part B co-insurance, Part A deductible, blood work (3 pints annually), skilled nursing facility co-insurance, emergency care for traveling abroad and, as mentioned earlier, preventive care. Plan E did not include original Medicare Part B deductible, home recovery care, Part B excess costs, and charges not approved by Medicare. As in other similar plans, holders of Plan E are obliged to pay these excess charges when incurred.  When original Medicare eliminated preventive care from its line of supplemental benefits, Plan E became identical to Plan D.

Medicare Supplement Plan H:

Medicare Supplement Plan H covered all of the standard benefits including hospital co-insurance, hospitalization benefits of 365 additional days after original Medicare coverage had elapsed, original Medicare Part B co-insurance which is usually 20% of hospital outpatient care costs and additional blood coverage of 3 pints yearly. Aside from the basic coverage, Plan H also covered skilled nursing co-insurance and Part A deductible, as well as emergency coverage for foreign travel. Plan H also covered a maximum of 80% of emergencies that might be incurred overseas, hospice care and original Medicare Part B. This plan, however, did not cover Medicare Part B deductible, preventive care or at home recovery.  Plan H is only limited to medical charges that are Medicare-approved. If the charges are in excess of what original Medicare Part A and Part B covers (i.e., Part B excess) then the Medicare beneficiary will have to pay any additional costs.

Medicare Supplement Plan I:

Medicare Supplement Plan I used to be very popular because it covered many of the main high risk gaps left by original Medicare Part A and Part B, while covering most of the main Medicare-approved health care expenses. Relative to the array of benefits, Plan I was also very affordable.  Plan I covered 100% of original Medicare’s Part B excess without covering original Medicare’s Part B deductible. This made the plan most convenient for those who expect to pay for medical charges in the future that are higher than what original Medicare will cover.  Plan I did cover original Medicare Part B co-insurance or co-insurance, original Medicare Part A co-insurance, skilled nursing care, and hospice care. It also covered 80% of emergency charges incurred by treatment during travel abroad. One distinct feature of Plan I was its coverage of 50% of prescription drug charges, provided that the minimum deductible of $250.00 was met, up to maximum amount of $1,250.00 yearly.  Plan I also offered coverage for at home recovery (up to $40 per visit or $1,600 yearly). However, Plan I did not cover preventive care.  If you purchased a Plan I before June 1, 2010, you can keep the plan.

Medicare Supplement Plan J:

Medicare Supplement Plan J has been one of the most popular plans because of the comprehensive coverage it offers and its affordability. The plan was actually designed to cover most of the high risk gaps in original Medicare Part A and Part B.  Without the benefits of preventative care and at home recovery, Plan J became so similar to Plan F that it was obsolete.  Among other benefits provided by Plan J are coverage for original Medicare Part A deductible, coverage for original Medicare Part B deductible, coverage for 100% excess for original Medicare Part B, up to 80% coverage for emergencies when travelling abroad (after a set deductible) and skilled nursing facility co-insurance.

Contact a Medicare Pathways Benefit Advisor to discuss your Medicare Supplement plan options.  A Benefit Advisor will review the plan you current have an compare to the more modernized Medicare Supplement plans that were established in June, 2010.  A Benefit Advisor will do a rate comparison, as well, to determine if there is a more affordable plan available that will cover the gaps in original Medicare similarly to your current plan.  You can call 1-866-466-9118 to speak with a Benefit Advisor, or simply Request a Quote and a Benefit Advisor will contact you.

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