Medicare Supplement Insurance Plans
Why You Need a Medicare Supplement Insurance Plan
Medicare is a federal program to help older Americans and some disabled Americans pay for the high cost of health care. However, Medicare was never intended to cover all your healthcare costs. So even if you’re covered by Medicare, you are still responsible for a large portion of your health care costs. That’s where a BCBS Medicare Supplement or senior Medicare Supplement Plan can help.
What Medicare Doesn’t Cover
Medicare does not cover all incurred healthcare costs. Medicare coverage consists of:
Part A (which covers hospital and skilled nursing facility care), and;
Part B (which covers doctor bills and other medical expenses).
Even with Medicare Part A and Part B coverage, you’re responsible for some out-of-pocket expenses including:
(Here are the 2023 deductibles):
Part A hospital deductible ($1,600)
Part B deductible ($226)
Copayments for hospital stays over 60 days
Care in a skilled nursing facility after 20 days
Twenty percent coinsurance for doctor bills and other medical expenses
Medicare supplement plans pay for additional expenses. By law, Medicare Supplement Insurance Plans are standardized into twelve plans. That means Medicare Supplement Insurance Plan F* from one company must include the same benefits as the same plan from another company. While the benefits must be the same, each company’s rates, reputation, membership features, and quality of service can vary. With Blue Cross and Blue Shield of Illinois, you don’t have to sacrifice comprehensive benefits or freedom of choice for affordability.
Benefits
Guaranteed acceptance with no health questions asked
Freedom to choose any doctors or specialists
Coverage with domestic travel
Guaranteed renewability regardless of changes in your health
Coverage guaranteed to match Medicare’s cost increases year after year
Blue Extras Member Discount Program includes discounts on wellness products and services including vision, fitness clubs, weight management, complementary alternative medicine, hearing, and more.
Medicare Supplement Insurance Plan Basic Benefits
Hospitalization
Part A coinsurance plus coverage for 365 additional days after Medicare benefits end.
Medical Expenses
Part B coinsurance (generally 20% of Medicare-approved expenses), or in the case of hospital outpatient department services under a prospective payment system, applicable copayments.
Blood
First three pints of blood each year.
Premier Plans
Of all available standardized plans, Medicare Supplement Insurance Plans F and Medicare Supplement Insurance Plan G* offer the most complete protection for uncovered Medicare Part B excess charges. These are the most popular plans because they also pay the Medicare Part A hospital deductible and copayments, skilled nursing facility copayment, and foreign travel emergency care.
Medicare Supplement Insurance Plan F also covers the Medicare Part B deductible.
Budget-Conscious Plans
Medicare Supplement Insurance High Deductible Plan F*
Features a $2,700 annual deductible (2023) before plan benefits begin
Medicare Supplement Insurance Plan N*
Features an office visit and emergency room copayment applicable to each visit
Medicare Supplement Insurance Plan K* and Medicare Supplement Insurance Plan L*
Feature cost-sharing for covered services under Medicare Part A and Part B. Once your annual out-of-pocket expenses reach the required limit, the plan pays 100% of covered expenses for the remainder of the calendar year.
Medicare Supplement Plan F and High Deductible Plan F are only available to those individuals who turned 65 before January 1, 2020.
Part B Medical Excess
Part B Medical Excess covers charges from your provider that exceed Medicare-approved amounts. Only Medicare Supplement Insurance Plan F, Medicare Supplement Insurance High Deductible Plan F, and Medicare Supplement Insurance Plan G cover these charges. For all other plans, you are responsible for paying excess charges. In no case can a provider charge more than 115% of the Medicare-approved amount.
Skilled nursing coinsurance
Medicare pays the first 20 days of treatment in a skilled nursing facility, and an annually adjusted per diem for the 21st through 100th day. Plans with this benefit pay an additional annually adjusted per diem for the 21st through the 100th day.
In order to receive any skilled nursing facility benefits, you must meet Medicare’s requirements:
You were admitted to a hospital for at least three days
You were admitted to a Medicare-approved skilled nursing facility within 30 days of leaving the hospital.
Foreign Travel Emergency
Medically necessary, foreign travel emergency care services begin during the first 60 days of each trip outside of the United States. All plans offering this benefit require you to pay a foreign travel emergency deductible and a percentage of costs after the deductible is met.
Preventive Care
Preventive Care covers some annual physical and preventive tests and services administered or ordered by your doctor when not covered by Medicare.
Reduced Premium Medicare Select Option
Medicare Supplement Insurance Plans F, G, K, L, and N Med-Select options offer the same solid benefits as the “standard” plans but cost less. You’ll save on premiums simply by agreeing to use any of the Med-Select participating hospitals for non-emergency elective admissions. If you do not use one of these hospitals for your non-emergency admissions, you pay the $1,600 Part A deductible. Med-Select is not an HMO. With Med-Select, you are fully covered for emergency care at any hospital, and you can choose your own doctors and specialists.
Med-Select is available in specific geographic areas only; you must live within a 30-mile radius of a Med-Select participating hospital.
Benefits Medicare does not pay in 2023 |
Expenses covered by our plans | ||||
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Plan A | Plan B | Plan F | High Deductible Plan F |
Plan N* | |
Part A (Hospital Services)** | |||||
$1,600 Medicare hospital deductible |
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$400 per day copayment for covered expenses for days 61-90 in hospital |
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$800 per day copayment for covered expenses while you use your Lifetime Reserve |
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100% of Medicare allowable expenses for additional 365 days after Medicare hospital benefits stop completely |
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Calendar year blood deductible (charges for first three pints of blood) |
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$200.00 per day for days 21-100 in a skilled nursing facility |
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Hospice care (Medicare Part A) |
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Part B (Physician’s Care and Medical Services) | |||||
$226 Part B deductible |
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Coinsurance for medical expenses (25% of Medicare approved amount for preventive services and 20% for most others)† |
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Generally 20% except up to $20 copayment for office visit and up to $50 ER |
100% of Medicare Part B excess charges (above Medicare approved amounts) |
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Coinsurance for durable medical equipment (20% of Medicare approved amounts)† |
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Additional Expenses Not Covered by Medicare |
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Benefits for medically necessary emergency care received in a foreign country†† |
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Medicare Supplement Plan F and High Deductible Plan F are only available to those individuals who turned 65 before January 1, 2020.
* Plan F also has an option called a high-deductible Plan F. This high-deductible plan pays the same or offers the same benefits as Plan F after one has paid a calendar year $2,700 deductible. Benefits from high-deductible Plan F will not begin until out-of-pocket expenses are $2,700.
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.
** Hospital benefits must be provided by facilities participating in Medicare. Payments are limited to the reasonable charge as determined by Medicare.
*** After 90 days of hospitalization, Medicare benefits are paid from a one-time lifetime reserve of 60 additional days (days 91-150) which are not renewable for each benefit period. See your Outline of Coverage for details and limitations of these benefits.
† After the $226 Part B deductible is met for Plans A, B, F, High Deductible Plan F, and Plan N.
†† Foreign Travel Emergency covered at 80% after the first $250 each is paid each calendar year; up to $ 50,000-lifetime maximum.
*Not connected with or endorsed by the U.S. Government or Federal Medicare Program