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Glossary of Terms

Perhaps the most difficult thing about Medicare Supplements is the terminology. Let’s look at the benefits as described by Medicare.

 

Medicare Part A coinsurance – all Medigap plans offer this benefit. It covers the very expensive daily hospital copays that you begin accruing after your 60th day in the hospital.

Medicare Part B coinsurance or copayment – every Supplement also covers this benefit, which is one of the most important. Since Medicare only covers 80% of your Part B outpatient expenses, this benefit is what pays the other 20% for you. This can be crucial for high-ticket items like cancer treatments or dialysis.

Blood (First 3 pints) – this benefit is on all plans and pays for the first 3 pints of blood in a blood transfusion. Medicare only pays for the 4th pint and above. Blood is very expensive, so this is a good benefit.

Part A Hospice care coinsurance or copayment – Supplements pay for the parts of hospice that Medicare doesn’t under this benefit, so costs incurred by you are usually nothing.

Skilled Nursing Facility coinsurance – Medicare allows for 100 days of skilled nursing facility  (SNF) care after you have been in a hospital and need nursing care while you recover. However, Medicare only pays for the first 20 days. A policy with SNF coverage will pay for the other 80 days.

Medicare Part A deductible – the 2024 Part A deductible is $1,632. You can pay this more than once a year if, for example, you have two inpatient hospital stays more than 60 days apart.

Medicare Part B deductible – in 2024, the Part B deductible is $240/year. You will pay the Part B deductible once per year for services such as doctor’s visits, lab work, or physical therapy unless your Medicare Supplement provides this benefit.

Medicare Part B excess charges –  Medicare providers can either accept Medicare’s assigned rates for each service or, if they choose, they can charge you an excess charge. This charge can be up to 15% above the assigned rate. It can be pricey for items like diagnostic imaging or surgery. You may wish to choose a Medicare Supplement that covers this expense.

Foreign travel emergency – Since Medicare is a U.S. health insurance program, it does not offer you coverage outside our country.

Some Medicare Supplements include a foreign travel benefit. It will pay 80% of your expenses up to $50,000 after a small deductible.

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