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MEDIGAP PLANS: Required and Optional Benefits in Arizona

Some equate ‘the golden years’ as a time of playing with the grandchildren, a time of enjoying walks with your better half, and slowing down a bit. However, aging may bring a lot of discomfort too. This is also the time when different diseases attack you which may require special medical care to fight against.

Living in Arizona, it is not easy for every person to afford the medical expenses when the person is above the age of 65. Our US government health department offers Medicare for people in the age group of 65 or above. This Medicare insurance doesn’t fully cover the medical expenses of hospitalization and other treatment. It only pays a part of the expenses which is not more than a certain percentage in most of the cases. If unfortunately a person suffers from any serious disease, it becomes almost impossible to bear the expenses. The US health department has authorized some private companies to sell supplemental standardized plans.

In Arizona, 12 different supplemental plans are available to enhance the scope of the Medicare insurance coverage. These companies sell these plans to the people who are already enrolled in the Medicare Part A and Part B. The supplemental plans are known as the Medigap plans. The name “Medigap” says is all, it fills the gap of Medicare insurance coverage. The plans are standardized however the premium cost of each company is different. AZMEDICARE offers the best premium packages at the most affordable rates in Arizona.medicare supplement insurance plans in arizona

 

Your Medicare insurance plan alone does not facilitate much. It doesn’t cover deductibles, co-insurance and other similar costs. Medigap is the solution to cover these deductibles. You can buy a Medigap policy to pay for your Original Medicare deductibles, co-payments, co-insurance, and other costs.

Benefits of buying Medigap insurance:

Medigap policies have four required benefits that must be included and five optional benefits that are only included with some plan options. Each of the Medigap policies present required benefits. These include:

1.   Required benefits:

Part A hospital care co-insurance:

Medicare Part A covers in-patient hospital stays. But if your stay lasts longer than 60 days, you have to make a co-insurance payment for each day you are still in the hospital. After a certain point, Medicare stops covering your inpatient hospital costs altogether. If you have a Medicare Supplement insurance policy, it will cover the co-insurance costs e.g., if the co-insurance is $300 per day for days 61 to 90 of your hospital stay. Beyond 90 days, there’s a $600 co-insurance per day. If you have a Medigap policy, it also will cover any in-patient hospital costs after Medicare stops covering them. It will do so for up to 365 days after you use up your Medicare benefits.

Part A hospice care co-insurance or co-payment:

Medicare Part A hospice care covers respite care and prescription drugs for pain relief. However, there is a 5% co-insurance for respite care and a $5 co-payment for each prescription drug. If you have Medicare Supplement insurance, it will pay for the co-insurance and co-payments. It is also noted that Plans K and L cover only a portion of the co-insurance and co-payments.

Part B co-insurance or co-payment:

Medicare Part B covers preventative services and necessary supplies to diagnose and treat medical conditions. Part B only pays 80% of the Medicare-approved amount for a particular service. So if the Medicare-approved cost for a service is $500, Medicare only pays for $400 of it. If you have a Medigap policy, it will cover the remaining 20% and both the Medicare and Medigap pay their own share.

First 3 pints of blood:

Medicare only covers the cost of blood for the 4th pint and beyond for a blood transfusion. It doesn’t cover pints 1 – 3. If you have a Medigap policy, it will cover the first 3 pints of blood and support the Medicare policy.

2.   Optional benefits:

These optional benefits are not included in all of the Medigap plans. Here’s the detailed benefits:

Part A deductibles:

Medicare Part A covers a range of hospital costs. But before coverage starts, you need to pay a deductible. In 2016, the deductible is $1,288 per benefit period. 9 out of the 10 Medicare Supplement insurance plan options cover the Part A deductible. The only plan option that doesn’t cover it is Plan A. While the Plans K and M cover 50% of it, and Plan L covers 75% of it.

Part B deductible:

Medicare Part B covers a range of preventative and diagnostic services. Before the initiation of the coverage, you need to pay a deductible. In 2016, the deductible is $166 per year. If you have Medicare Supplement Plan F or Plan C, your policy will cover the Part B deductible. No other plan options include this coverage except the mentioned above.

Part B excess charges:

In some cases, a health care facility will charge up to 15% more than the Medicare-approved amount for a service. If you have Medicare Supplement Plan F or Plan G, your policy will pay for the extra charges. No other plan options include this coverage.

AZMEDICARE and Medigap Insurance Plans:

All these aforementioned plans are offered by AZMEDICARE in Arizona. These plans not only cover senior citizens, it also covers people having certain disabilities. The company offers all these plans at a great premium cost. It doesn’t matter if you buy the Medigap policies in the open enrollment period or not, it will cost the same. You can also visit http://azmedicare.info/medicare-supplements/ or further information. Or call for an appointment.

 



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