Medicare Supplement Overview
Understanding Medicare Supplement Plan B
Navigating your Medicare options can feel complicated, but we’re here to help you understand your choices. Medicare Supplement Plan B, also known as Medigap Plan B, is designed to help cover some of the healthcare costs that Original Medicare (Part A and Part B) doesn’t pay. This can include deductibles, copayments, and coinsurance. Understanding what Plan B offers is an important step in ensuring you have the right coverage for your healthcare needs and budget.
Keep reading or jump to our Highlights and Frequently Asked Questions.
What is Medicare Supplement (Medigap) Plan B?
Medicare Supplement Insurance plans, often called Medigap, are sold by private insurance companies to help fill the “gaps” in Original Medicare. These plans are standardized, meaning that a Plan B from one company will offer the same basic benefits as a Plan B from another. However, the monthly premium can vary between companies.
Plan B is one of the ten standardized Medigap plans available in most states. It offers a moderate level of coverage, making it a potential option for those who want more protection than Original Medicare alone but may not need the extensive coverage of more comprehensive plans like Plan G or Plan F.
What Does Medigap Plan B Cover?
Understanding the specifics of what Plan B covers can help you decide if it’s the right choice for your healthcare needs. This plan is designed to help pay for some of your out-of-pocket costs associated with Original Medicare.
Here is a breakdown of the benefits included with Medigap Plan B:
- Medicare Part A Coinsurance and Hospital Costs: Plan B covers the Part A coinsurance for inpatient hospital stays, up to an additional 365 days after your Medicare benefits are used up.
- Medicare Part B Coinsurance or Copayment: It covers the Part B coinsurance or copayment, which is typically 20% of the Medicare-approved amount for most doctor services, outpatient therapy, and durable medical equipment.
- First Three Pints of Blood: Plan B covers the cost of the first three pints of blood needed for a medical procedure each year.
- Medicare Part A Hospice Care Coinsurance or Copayment: It helps cover the out-of-pocket costs for hospice care.
- Medicare Part A Deductible: One of the most significant benefits of Plan B is that it covers the Medicare Part A deductible. This is the amount you must pay for hospital and skilled nursing facility care before Original Medicare begins to pay.
What Is Not Covered by Medigap Plan B?
While Plan B provides important coverage, it doesn’t cover everything. It’s essential to be aware of what costs you will still be responsible for.
- Medicare Part B Deductible: You will still need to pay the annual Part B deductible before your Medigap plan begins to cover the 20% coinsurance.
- Medicare Part B Excess Charges: If your doctor does not accept Medicare assignment (meaning they don’t accept Medicare’s approved amount as full payment), they can charge up to 15% more. Plan B does not cover these excess charges.
- Skilled Nursing Facility Care Coinsurance: The daily coinsurance for care in a skilled nursing facility is not covered by Plan B.
- Foreign Travel Emergency Care: Plan B does not offer coverage for healthcare services you receive while traveling outside the United States.
- Prescription Drugs: Medigap plans sold after 2006 do not include prescription drug coverage. You will need to enroll in a separate Medicare Part D plan for your medications.
For a detailed comparison of what different Medigap plans cover, you can visit the official U.S. government website for Medicare at Medicare.gov.
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Medicare Supplement Plan B
Frequently Asked Questions
Who is eligible for Medicare Supplement Plan B?
To be eligible to purchase a Medigap Plan B, you must be enrolled in both Medicare Part A and Part B. The best time to buy a Medigap policy is during your 6-month Medigap Open Enrollment Period. This period automatically starts the first month you have Medicare Part B and you are age 65 or older. During this time, you have a guaranteed right to buy any Medigap policy sold in your state, regardless of your health status.
How does Plan B compare to other popular Medigap plans, like Plan G?
Medigap Plan G offers more comprehensive coverage than Plan B. The main difference is that Plan G covers Medicare Part B excess charges and skilled nursing facility care coinsurance, which Plan B does not. Both plans require you to pay the annual Part B deductible. Because of its broader coverage, Plan G typically has a higher monthly premium than Plan B.
Can I switch from a Medicare Advantage plan to a Medigap plan?
Yes, it is possible to switch from a Medicare Advantage (Part C) plan to Original Medicare with a Medigap plan, but there are specific rules and times when you can do this. If you switch, you may have to go through medical underwriting, which means an insurance company can deny you coverage or charge you more based on your health history unless you have a “guaranteed issue right.” These rights are available in specific situations, such as if you move out of your Advantage plan’s service area.
Insurance Connection USA is a division of Garrison Enterprises a licensed Insurance agency and not connected with or endorsed by the United States government or the federal Medicare program. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. Medicare has neither reviewed nor endorsed this information. Not connected with or endorsed by the United States government or the federal Medicare program.
Important Highlights
Medicare Supplement Plan B helps cover out-of-pocket costs like the Medicare Part A deductible and Part B coinsurance.
You will need to purchase a separate Medicare Part D plan for prescription drug coverage, as Medigap plans do not include it.
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