- Inpatient Hospital Care: Covers the Medicare Part A coinsurance plus coverage for 365 additional days after Medicare coverage ends
- Medical Costs: Covers the Medicare Part B coinsurance (generally 20% of the Medicare-approved amount)
- Blood: Covers the first 3 pints of blood each year
- Part A Hospice coinsurance or co-payment
Comparison of Plans |
Core Plan |
Supplemental 1 Plan |
Basic Benefits |
x |
x |
Medicare Part A: Inpatient Hospital Deductible |
|
x |
Medicare Part A: Skilled Nursing Facility Coinsurance |
|
x |
Medicare Part B: Deductible |
|
x |
Foreign Travel Emergency |
|
x |
Inpatient Days in Mental Health Hospitals |
60 days per calendar years |
120 days per benefit year |
State-Mandated Benefits (Annual Pap tests and mammogram. Check your plan for other state-mandated benefits.) |
x |
x |
Minnesota Medicare Supplement Insurance Plans:
All Medigap policies offered by traditional insurance companies provide the following benefits:
Basic Benefits
- Inpatient Hospital Care: Covers the Medicare Part A coinsurance
- Medical Costs: Covers the Medicare Part B coinsurance (generally 20% of the Medicare-approved amount)
- Blood: Covers the first 3 pints of blood each year
- Part A Hospice and respite cost sharing
- Parts A and B home health services and supplies cost sharing
Medigap Benefits |
Basic Plan |
Extended Basic Plan |
Basic Benefits |
x |
x |
Medicare Part A: Inpatient Hospital Deductible |
|
x |
Medicare Part A: Skilled Nursing Facility Coinsurance |
(Provides 100 days of SNF care) |
(Provides 120 days of SNF care) |
Medicare Part B: Deductible |
|
x |
Foreign Travel Emergency |
80% |
80%* |
Outpatient Mental Health |
50% |
50% |
Usual and Customary Fees |
|
80%* |
Medicare-covered Preventive Care |
x |
x |
Physical Therapy |
20% |
20% |
Coverage while in a Foreign Country |
|
80%* |
State-mandated Benefits (Diabetic equipment and supplies, routine cancer screening, reconstructive surgery, and immunizations) |
x |
x |
* Pays 100% after you spend $1,000 in out-of-pocket costs for a calendar year.
Mandatory Riders - Insurance Companies can offer four additional riders that can be added to a Basic Plan. You may choose any one or all of the riders to design a Medigap policy that meets your needs.
- Medicare Part A: Inpatient Hospital Deductible
- Medicare Part B: Deductible
- Usual and Customary Fees
- Non-Medicare Preventive Care
Wisconsin Medicare Supplement Insurance Plans:
All Medigap policies offered by traditional insurance companies provide the following benefits:
Basic Benefits
- Co-payment for 61st to 90th day of hospitalization ($283 a day)
- Co-payment for 91st to 150th day of hospitalization ($566 a day) - full coverage after Medicare days are exhausted
- Co-payment for 21st to 100th day of skilled nursing care in a skilled nursing facility ($144.50 a day)
- 175 days per lifetime of inpatient psychiatric care in addition to Medicare’s 190 days per lifetime
- First 3 pints of blood
- 40 home health care visits in addition to Medicare
- 20% of Medicare’s Part B services with no lifetime maximum or, in case of hospital outpatient department services under a prospective payment system, applicable co-payments
- Coverage for full usual and customary cost of non-Medicare covered chiropractic care, non-Medicare hospital and ambulatory surgery center charges and anesthetics for dental care and non-Medicare breast reconstruction
- Coverage for 30 days non-Medicare skilled nursing facility care - no prior hospitalization required, but must meet medical necessity requirements
Note: Policies may also include preventive health care services, such as routine physical examinations, immunizations, health screenings, and private duty nursing services.
Optional Benefits
Insurance companies may offer the following optional benefits as a separate benefit for an additional premium.
- Part A deductible ($1,156)
- Additional home health care (up to 365 visits per year)
- Part B deductible ($140)
- Part B excess charges up to the actual charge or the limiting charge, whichever is less
- Foreign Travel Emergency: May have a deductible of up to $250. Must pay at least 80% of billed charges for Medicare-eligible expenses for medically necessary emergency care received outside the U.S. Emergency care must begin during the first 60 days of a trip outside the U.S. Benefit limit must be at least $50,000 per lifetime.
- Effective June 1, 2010, Medicare 50% Part A deductible
- Effective June 1, 2010, Part B co-payment or coinsurance rider
Cost-Sharing 50% AND 25% Plans
All Medigap Cost-Sharing policies offered by traditional insurance companies provide the following benefits:
Basic Benefits
- Co-payment for 61st to 90th day of hospitalization ($289 a day)
- Co-payment for 91st to 150th day of hospitalization ($578 a day) - full coverage after Medicare days are exhausted
- Co-payment for 21st to 100th day of skilled nursing care in a skilled nursing facility ($144.50 a day) (50% or 75%)
- 175 days per lifetime of inpatient psychiatric care in addition to Medicare’s 190 days per lifetime
- First 3 pints of blood (50% or 75%)
- 40 home health care visits in addition to Medicare
- 20% of Medicare’s Part B services with no lifetime maximum or, in case of hospital outpatient department services under a prospective payment system, applicable co-payments
- Coverage for full usual and customary cost of non-Medicare covered chiropractic care, non-Medicare hospital and ambulatory surgery center charges and anesthetics for dental care, and non-Medicare breast reconstruction
- Coverage for 30 days non-Medicare skilled nursing facility care - no prior hospitalization required, but must meet medical necessity requirements
Note: Policies may also include preventive health care services, such as routine physical examinations, immunizations, health screenings, and private duty nursing services
Optional Benefits
Insurance companies may offer the following optional benefits as a separate benefit for an additional premium.
- Part A deductible ($1,156) (50% or 75%)
- Additional home health care (up to 365 visits per year)
- Part B deductible ($140) (50% or 75%)
- Part B excess charges up to the actual charge or the limiting charge, whichever is less
- Foreign Travel Emergency: May have a deductible of up to $250. Must pay at least
80% of billed charges for Medicare-eligible expenses for medically necessary
emergency care received outside the U.S. Emergency care must begin during the first
60 days of a trip outside the U.S. Benefit limit must be at least $50,000 per lifetime.
Medicare Select
All Medicare Select policies provide the following benefits:
- Part A deductible ($1,156)
- Co-payment for 61st to 90th day of hospitalization ($289 a day)
- Co-payment for 91st to 150th day of hospitalization ($578 a day) - full coverage after Medicare days are exhausted
- Co-payment for 21st to 100th day of skilled nursing care in a skilled nursing facility ($144.50 a day)
- 175 days per lifetime of inpatient psychiatric care in addition to Medicare’s 190 days per lifetime
- First 3 pints of blood
- Part B deductible ($140)
- 20% of Medicare’s Part B services with no lifetime maximum and actual charges for authorized referral services
- 365 home health care visits including those paid by Medicare
- Foreign Travel Emergency: May have a deductible of up to $250. Must pay at least 80% of billed charges for Medicare-eligible expenses for medically necessary emergency care received outside the U.S. Emergency care must begin during the first 60 days of a trip outside the U.S. Benefit limit must be at least $50,000 per lifetime.
- Coverage for full usual and customary cost of non-Medicare covered chiropractic care, non-Medicare hospital and ambulatory surgery center charges and anesthetics for dental care, and non-Medicare breast reconstruction
- Coverage for 30 days non-Medicare skilled nursing facility care - no prior hospitalization required, but must meet medical necessity requirements
- Effective June 1, 2010, Medicare 50% Part A deductible
Medicare Select Cost-Sharing 50% and 25%
All Medicare Select Cost-Sharing policies provide the following benefits:
- Part A deductible ($1,156) (50% or 75%)
- Co-payment for 61st to 90th day of hospitalization ($289 a day)
- Co-payment for 91st to 150th day of hospitalization ($578 a day) - full coverage after Medicare days are exhausted
- Co-payment for 21st to 100th day of skilled nursing care in a skilled nursing facility ($144.50 a day) (50% or 75%)
- 175 days per lifetime of inpatient psychiatric care in addition to Medicare’s 190 days per lifetime
- First 3 pints of blood (50% or 75%)
- Part B deductible ($140) (50% or 75%)
- 20% of Medicare’s Part B services with no lifetime maximum and actual charges for authorized referral services
- 365 home health care visits including those paid by Medicare
- Foreign Travel Emergency: May have a deductible of up to $250. Must pay at least 80% of billed charges for Medicare-eligible expenses for medically necessary emergency care received outside the U.S. Emergency care must begin during the first 60 days of a trip outside the U.S. Benefit limit must be at least $50,000 per lifetime.
- Coverage for full usual and customary cost of non-Medicare covered chiropractic care, non-Medicare hospital and ambulatory surgery center charges and anesthetics for dental care, and non-Medicare breast reconstruction
- Coverage for 30 days non-Medicare skilled nursing facility care - no prior hospitalization required, but must meet medical necessity requirements
Cost Insurance - Basic and Enhanced
Basic Plan
- Co-payment for 61st to 90th day of hospitalization ($289 a day)
- Co-payment for 91st to 150th day of hospitalization ($578 a day) - full coverage after Medicare days are exhausted
- Co-payment for 21st to 100th day of skilled nursing care in a skilled nursing facility ($144.50 a day)
- First 3 pints of blood
- 40 home health care visits in addition to Medicare
- 20% of Medicare’s Part B services with no lifetime maximum or, in case of hospital outpatient department services under a prospective payment system, applicable co-payments
Note: Policies may also include preventive health care services, such as routine physical examinations, immunizations, health screenings, and private duty nursing services.
Enhanced Plan
Insurance companies may offer additional benefits for an additional premium:
- Part A deductible ($1,156)
- Additional home health care (up to 365 visits per year)
- Part B deductible ($140)
- Part B excess charges up to the actual charge or the limiting charge, whichever is less
- 175 days per lifetime of inpatient psychiatric care in addition to Medicare’s 190 days per lifetime
- Foreign Travel Emergency: May have a deductible of up to $250. Must pay at least 80% of billed charges for Medicare-eligible expenses for medically necessary emergency care received outside the U.S. Emergency care must begin during the first 60 days of a trip outside the U.S. Benefit limit must be at least $50,000 per lifetime.
- Coverage for full usual and customary cost of non-Medicare covered chiropractic care, non-Medicare hospital and ambulatory surgery center charges and anesthetics for dental care, and non-Medicare breast reconstruction
- Coverage for 30 days non-Medicare skilled nursing facility care - no prior hospitalization required, but must meet medical necessity requirements
High-Deductible Plan
Effective June 1, 2010, a high-deductible Medicare supplement plan will be available. This high-deductible plan offers benefits after you have paid a calendar year deductible of $2,070. This deductible consists of expenses that would ordinarily be paid by the policy. This includes the Medicare deductibles for Part A and Part B but does not include the separate foreign
travel emergency deductible of $250.
Benefits
- Part A deductible included
- Co-payment for 61st to 90th day of hospitalization ($289 a day)
- Co-payment for 91st to 150th day of hospitalization ($578 a day) - full coverage after Medicare days are exhausted
- Co-payment for 21st to 100th day of skilled nursing care in a skilled nursing facility ($144.50 a day)
- 175 days per lifetime of inpatient psychiatric care in addition to Medicare’s 190 days per lifetime
- First 3 pints of blood
- Part B deductible included
- Part B excess charges up to the actual charge or the limiting charge, whichever is less, included
- 20% of Medicare’s Part B services with no lifetime maximum and actual charges for authorized referral services
- 365 home health care visits including those paid by Medicare
- Foreign Travel Emergency: May have a deductible of up to $250. Must pay at least 80% of billed charges for Medicare-eligible expenses for medically necessary emergency care received outside the U.S. Emergency care must begin during the first 60 days of a trip outside the U.S. Benefit limit must be at least $50,000 per lifetime.
- Coverage for full usual and customary cost of non-Medicare covered chiropractic care, non-Medicare hospital and ambulatory surgery center charges and anesthetics for dental care, and non-Medicare breast reconstruction
- Coverage for 30 days non-Medicare skilled nursing facility care - no prior hospitalization required, but must meet medical necessity requirements
