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New 2010 Medigap Benefits and Plans

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Medicare Changes

New Hospice Benefit
All plans will now include the Hospice Benefit as part of the “Core Benefits.” Medicare pays for all but very limited co-payments for outpatient drugs ($5). Included in all Medigap plans a benefit to pay this co-payment will be included.

Medicare provides coverage for inpatient respite care up to 5 days less a co-payment amount of 5% of the daily benefit. The new Hospice benefit will pick up this 5% co-pay.

New Plans
The new regulation also makes the following two new plan options available to beneficiaries, which have higher cost–sharing responsibilities and lower estimated premiums:

  • New Plan M includes 50 percent coverage of the Medicare Part A deductible and does not cover the Medicare Part B Deductible. Plan M has all the core benefits plus the foreign Travel Emergency Benefit.
  • New Plan N does not cover the Medicare Part B deductible and adds a new co–payment structure of $10 for each physician visit and $50 for each emergency room visit (waived upon admission to the hospital). Plan N has all the core benefits plus the foreign Travel Emergency Benefit.

Benefit Chart of Medicare Supplement Plans Sold for Effective Dates on or After June 1, 2010

A B C D F/F* G
Basic,
Including
100% Part B coinsurance
Basic,
Including
100% Part B coinsurance
Basic,
Including
100% Part B coinsurance
Basic,
Including
100% Part B coinsurance
Basic,
Including
100% Part B coinsurance
Basic,
Including
100% Part B coinsurance
Skilled Nursing Facility Coinsurance Skilled Nursing Facility Coinsurance Skilled Nursing Facility Coinsurance Skilled Nursing Facility Coinsurance
Part A Deductible Part A Deductible Part A Deductible Part A Deductible Part A Deductible
Part B Deductible Part B Deductible
Part B Excess (100%) Part B Excess (100%)
Foreign Travel Emergency Foreign Travel Emergency Foreign Travel Emergency Foreign Travel Emergency

*Plan F also has an option called a high deductible plan F. This high deductible plan pays the same benefits as Plan F after one has paid a calendar year [$1900] deductible. Benefits from high deductible plan F will not begin until out-of-pocket expenses exceed [$1900]. Out-of-pocket expenses for this deductible are expenses that would ordinarily be paid by the policy. These expenses include the Medicare deductibles for Part A and Part B, but do not include the plan’s separate foreign travel emergency deductible.

K L M N
Hospitalization and preventive care paid at 100%; other basic benefits paid at 50% Hospitalization and preventive care paid at 100%; other basic benefits paid at 75% Basic, Including 100% Part B coinsurance Basic, Including 100% Part B coinsurance, except up to $20 copayment for office visit, and up to $50 copayment for ER
50% Skilled Nursing Facility Coinsurance 75% Skilled Nursing Facility Coinsurance Skilled Nursing Facility Coinsurance Skilled Nursing Facility Coinsurance
50% Part A Deductible 75% Part A Deductible 50% Part A Deductible Part A Deductible
Foreign Travel Emergency Foreign Travel Emergency
Out-of-pocket limit $[4440]; paid at 100% after limit reached Out-of-pocket limit $[2220]; paid at 100% after limit reached

For help understanding how this may impact your Medicare Plans or Health Care costs, please contact a representative at CATALIST HEALTH by calling – 1 – 866 – 460 – 4321 or by e-mailing info@catalistfinancial.com

The post New 2010 Medigap Benefits and Plans appeared first on Catalist Health Insurance.


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