Medigap in 2011

How Medigap Plan Options Have Changed

Beginning June 1, 2010, several Medicare supplement changes were implemented. Some Medigap plans were eliminated while two new plans were created. Also, some Medigap plan designs have added benefits while still other benefits were eliminated.

As of June 1, 2010, your Medigap plan design choices include: Plans A, B, C, D, F, G, K, L, M and N.

New Plans for Medigap in 2011

If you're buying a Medigap plan for the first time, or thinking of changing your Medigap plan design in 2011, you now have two new plans - M and N - to choose from.

Plan M covers the core benefits as outlined below, as well as skilled nursing facility coinsurance, 50% of Medicare Part A deductible and foreign travel emergency care.

Plan N covers the core benefits, skilled nursing facility care coinsurance, 100% of Medicare Part A deductible, and foreign travel emergency care. This plan has a slight difference in core benefits; that is, it covers 100% of the Medicare Part B coinsurance except up to $20 of the copayment for office visits and up to $50 for emergency room visits.

Discontinued Medigap Plans and Benefits

June 1, 2010 saw the elimination of four Medigap plans E, H, I, or J. You may keep your discontinued plan if you purchased before June 1, 2010. Note that plans E and J were the only two plans that covered up to $120 for preventive care not covered by Medicare Part B. Since Medicare now includes preventive care coverage, these benefits are no longer needed under Medigap. However, the remaining plans do cover - now as a core benefit - any out-of-pocket costs (coinsurance) that you would owe for preventive care.

For all plans, Medigap changes in 2011 include no coverage for at-home recovery. This benefit is also no longer necessary.

Medigap Changes for Other Plan Designs

In addition to the elimination of plans E, H, I, and J, and the two new plans, M and N, there are other Medicare supplement changes. Plans A, B, C, D, F, and G now include the core benefit for hospice care and copayment insurance. Plan G now covers 100% of Medicare Part B excess charges, which is an increase from the 80% of the coverage that was offered before.

No changes have been made to Plans K and L.

Although it is not a new change to Medigap in 2011, you should take note that prescription drug coverage is no longer available through Medigap. If you have one of these older Medigap plans, you may continue to hang on to it.

Core Benefits for Medigap in 2011

Although core benefits may be covered differently depending on your plan design, they still remain the same for Medigap in 2011. These core benefits are included with all new Medigap plans:

• Hospital coinsurance for up to 365 days more than what is covered by Medicare Part A
• Copays and coinsurance for Medicare Part B
• Up to the first 3 pints of blood
• Medicare Part A hospice care coinsurance or copayments (this is a new benefit effective June 1, 2010)
• Preventive care coinsurance

Core benefits apply to plans that remain available for Medigap in 2011. If you purchased a Medigap plan before June 1, 2010 and that plan is still available today, your core benefits will change to the new plan design. If you purchased a plan that has been discontinued in 2010, your plan design remains without changing and these core benefits may not apply.

Other Benefits under Medigap in 2011

These other benefits are included in some Medigap plan designs, but they may not be included in all plan designs:

• Skilled nursing facility coinsurance (C, D, F, G, M, N and partially under K and L)
• Inpatient hospital deductible (B, C, D, F, G, N and partially under K, L, and M)
• Medical deductible (C and F)
• The amount that a health care provider may charge you over the Medicare allowed amount (also called Medicare Part B excess charges) (F and G)
• Foreign travel emergency (C, D, F and G)

Note that Plan F is the only Medigap plan that covers all of the benefits available under Medigap; however, it is a high-deductible plan. That means you pay a $2,000 Medigap deductible before Medigap begins to cover services.