Medicare Supplement Insurance: What You Need to Know

Medicare Supplement Insurance: What You Should Know

Medicare Supplement Insurance is sometimes also called Medigap. It essentially fills in the various gaps of coverage that would require you to pay out-of-pocket for doctor visits, nursing home expenses, and even prescriptions.

Who Can Get Medicare Supplement Insurance?
Medicare Supplement Insurance is made available to anyone who is at least 65 years of age and who has both Medicare Part A and B. It is also available to people who qualify for Medicare because of a disability and have both Part A and B.

Part A is provided by the federal government at no cost. Part B is also provided by the federal government but is a monthly expense. This will vary based upon income, though the average person (for 2017) will pay a monthly premium of $134.

What is Medicare Supplement Insurance?
Medicare Supplement Insurance is a way to cover all that Medicare doesn’t cover.

Medicare Part A will cover inpatient hospital care, hospice care, in-home physical therapy and part-time skilled nursing care, as well as blood transfusions after the first 3 pints of blood. It will also provide inpatient care at a religious, non-medical healthcare facility of a patient’s choosing.

Medicare Part B will cover more medical aspects, including durable medical equipment, diagnostic tests, screenings, chemotherapy, nursing care, doctor services, an initial physical exam as well as a yearly wellness exam. It will also cover ambulance services and some Pap smear and mammography screenings. It will also cover flu and pneumonia vaccinations.

There are still a lot of expenses that are not covered – and that’s what Medicare Supplement Insurance is used to cover.

There are a total of 9 coverage areas that Medigap will take care of. Four are covered by all of the plans while the remaining five are split among the various plans that are offered.

There are 10 plans that a person can choose from and will include a mixture of benefits that range from co-insurance and co-payments of hospice care and skilled nursing facility all the way to the deductibles for Medicare Part A and B. The plans might also encompass excess charges for Part B as well as foreign travel emergency expenses.

The 10 plans are available throughout all states, with the exception of Massachusetts, Minnesota, and Wisconsin. The plans are the same in terms of coverage regardless of the insurance provider. This means that it’s important to first decide on the plan and then shop different companies based on price as well as long-term pricing structures, which change as you get older.

The Different Medicare Supplement Insurance Plans
The various Medicare Supplement Insurance are all given a different letter. Regardless of the letter, they will all contain coverage in four areas. This includes:

  • First three pints of blood for a transfusion
  • Co-insurance expenses from Part A hospital care
  • Co-insurance/co-payment expenses from Part A hospice care
  • Co-insurance/co-payment expenses from Part B
  1. Medicare Part F is the most common of the Medigap plans and that’s because it provides coverage across all areas. In addition to the four things above, a person would have deductibles for Part A and Part B covered, the Part A skilled nursing care co-insurance, Part B excess charges, as well as foreign travel emergency (80%) expenses covered.
  2. Plan A: All four of the main areas
  3. Plan B: All four of the main areas + deductible for Part A
  4. Plan C: All four of the main areas + deductibles for Part A and B and co-insurance for skilled nursing care in Part A + foreign travel emergency (80%)
  5. Plan D: All four of the main areas + deductible for Part A and co-insurance for skilled nursing care + foreign travel emergency (80%)
    Plan F: Coverage in all areas
  6. Medicare Supplement Part G: All four of the main areas + deductible for Part A and co-insurance for skilled nursing care + Part B excess charges + foreign travel emergency (80%)
  7. Plan K: All four of the main areas at 50% with exception of co-insurance costs for hospital care for Part A. For 2017, individuals must spend $5120 out-of-pocket prior to receiving reimbursement for other medical expenses. 50% of the deductible for Part A + co-insurance for nursing care is also included.
  8. Plan L: Similar to K with the exception that it is all at 75% and the out-of-pocket yearly limit for 2017 is $2560.
  9. Plan M: All four main areas + 50% of deductible for Part A, Part A co-insurance for skilled nursing care + foreign travel emergency (80%)
  10. Plan N: All four main areas + deductible for Part A, co-insurance for skilled nursing care + foreign travel emergency (80%)

    In the end, it’s important to compare the various plans and determine where you need the coverage. Then, get quotes from multiple providers of Medical Supplement Insurance to get the best overall premiums.

Carlos Lopez is the director for Disabled Friends. He also handles the department of disability resources for MedicareFAQ, a learning resource center for all seniors and Medicare beneficiaries.

Home Care Services for Senior

Many elderly people want to stay in their own homes as they age. However, an unexpected illness or injury or gradually increasing frailty can make that more difficult. Luckily, there are many home care options available.

Assess the Situation

The first step in deciding whether home care services can meet an elder’s needs is to evaluate the situation. For example, is the home located in an urban setting where services are readily available or in a more remote rural setting? Can the living quarters be easily accessed or can the home be modified with ramps and similar changes? Is there any support from family and/or friends? What is the client’s financial situation? All of these factors will have an impact on what services are available.What is Home Care?

Home care services typically fall into certain categories. These may encompass basic home support, transportation, nursing care, specialty medical care and respite care for caregivers.
Household Care
A home takes considerable maintenance. For example, gardening and yard work, painting, general maintenance and repairs are required on a regular basis. The interior of the house also requires cleaning. Then there are activities such as laundry and dishes, and the usual “business” activities such as paying bills and scheduling appointments. All of these services are available in many locations.
Transportation services may be very important in allowing elderly people to remain in the home. In the city, buses and taxis are usually available, as are services like Uber. Seniors may have the option of reduced fares in some cases. Medical vans are available in many locations for seniors who have disabilities.
Personal Care
A home health aide can provide assistance with many of the activities involved in daily living. Sometimes called custodial care, this can include assistance with bathing and other hygiene activities, assistance with meals – including meal preparation – shopping or transportation. In some areas, home health aides may also be able to help supervise medications or take a patient’s blood pressure.
Health Care
Health care services typically fall into one of two categories – nursing care and specialty care. The first includes the full range of nursing services, such as medication administration, dressing changes and other skilled services. Specialty care is provided by health care professionals such as physical therapists, occupational therapists or respiratory therapists.

Care Providers

Although many family members are ready and willing to help a senior who lives alone, others may have time limitations or live too far away. Sometimes neighbors can help as well. A church group or similar community organization may be able to provide some services. Care providers may be independent contractors or work for organizations like a hospital or home health agency. In the first case, the senior or his/her family members pay the contractor directly and must take care of all employment issues such as interviews, background checks, hiring, taxes, Social Security and payroll. In the second, those services are provided by the agency. One of the advantages of an agency is that they will handle all legal issues and payroll, perform extensive background checks and have multiple caregivers on the payroll to cover all times of the day and night. Full-service agencies usually bond their employees. Full-service agencies are more expensive, however. A registry falls somewhere between the two options – it is less expensive but does not offer the full range of personnel management services.

How to Hire In-Home Caregivers

The initial hiring process is key to getting the kind of services and person you want and need. Hiring someone to come and do yard work once or twice a week is very different from hiring someone to perform hands-on personal care. Begin by looking for community resources – contact the local hospital and organizations dedicated to the needs of the older adult. Check the phone book and ask for reverences from friends, family or neighbors. Always interview more than one candidate if at all possible. Develop a specific list of tasks and expectations and if you’re hiring an independent provider, have a contract to spell out all the details. Confirm fees if working with an agency. Check references and do background checks on your top candidates. The internet, local police, legal aid and local attorneys may be able to help in this process. If things don’t seem to be working out, don’t hesitate to hire a new provider.

Good research and careful preparation can allow you or a loved one to find the necessary support. You can also access community resources other than those mentioned here. Home care can make a big difference in an older person’s ability to continue living at home in relative independence.


Carlos Lopez is the director for Disabled Friends. He also handles the department of disability resources for MedicareFAQ, a learning resource center for all seniors and Medicare beneficiaries.