Medigap Plan E
| Medigap Plan E Policy Coverage | |
|---|---|
| Basic Benefits |  |
| Part A Deductible | |
| Part B Deductible |  |
| Part B Excess | |
| Skilled Nursing Coinsurance | |
| Foreign Travel Emergency | |
| At Home Recovery | |
| Additional Preventative Care | |
Quick Introduction to Medigap Plans
Medigap is a private health insurance policy that is designed to cover medical costs not covered by Medicare programs. It covers many of the costs that people would otherwise have to pay individually such as copayments, coinsurance, and deductibles. There are twelve different Medigap plans ranging from A to L. Any insurance company offering Medigap plans is required to offer Plan A, other plan availability will vary by insurance company and by state. Medigap policies do not cover long-term care such as nursing homes, vision or dental care, hearing aids, eyeglasses or private-duty nursing. This article will deal exclusively with Medigap Plan E covering some of the benefits and other considerations.
More on Medigap Plan E Policies
What's covered in Medigap Plan E?
Medigap Plan E policies provide Basic coverage in addition to other benefits. Basic coverage of all Medigap plans includes:
- Medicare Part A Coinsurance, and all costs after hospital benefits are exhausted
- Medicare Part B Coinsurance or Copayment for other than preventative services
- Blood (first 3 pints). Medicare typically covers all costs associated with blood after the first 3 pints.
- Medicare Preventative Care Part B Coinsurance
In addition, Medigap Plan E provides the following additional benefits:
Skilled Nursing Facility Care Coinsurance
Under Medicare alone for each benefit period you pay nothing for the first 20 days, and up to $133.50 per day for days 21--100. Medigap Plan E policies cover these additional payments.
Medicare Part A Deductible
For each benefit period, under Medicare alone, you pay -- $1,068 for days 1--60 of a hospital stay. Medigap Plan E policies cover these additional payments.
Foreign Travel Emergency (Medicare coverage outside the U.S.)
Generally, Medicare covers none of these costs. Medigap Plan E policies provide coverage of many of these costs, up to plan limits.
Medicare Preventive Care Part B Coinsurance
Generally, you pay the $135 yearly Part B deductible and Part B coinsurance, but there are exceptions. Medigap Plan E policies cover these additional payments.
Preventive Care not Covered by Medicare
Without the Medigap policy, you would pay all costs.
Some Items Not Covered By Medigap Plan E Policies
Hospice Care Coinsurance or Copayment
You may be required to pay up to $5 for each drug a hospice provides when you are getting hospice services in your home and 5% of the Medicare-approved amount for each day of inpatient respite care (up to certain limits).
Medicare Part B Deductible
You pay the $135 yearly deductible.
Medicare Part B Excess Charges
For doctors and other providers who don't accept assignment, you still must pay the difference between the Medicare-approved amount and either the provider's fee, or the "limiting charge" (no more than 15% above the Medicare-approved amount) that applies for doctor's fees and many other Part B services.
At-home Recovery (Medicare-approved home health care to provide treatment ordered by your doctor for an illness or injury.)
You pay $0 for Medicare-approved home health services, and 100% for services not covered by Medicare.
Source: Centers for Medicare & Medicaid Services, Choosing a Medigap Policy: A Guide to Health Insurance for People With Medicare (2009).
Conclusion
If a Medigap Plan E policy is available in your state and you already have Medicare, it may be right for you. If a Medigap Plan E policy doesn't meet your needs, consider Medigap Plan F policies.