Texas Medicare Suplements

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Eleven Standardized Medicare Supplement Insurance Plans

Benefit Chart of Medicare Supplement Plans Sold for Effective Dates on or After June 1, 2010.

These charts show the benefits included in each of the standard Medicare supplement plans. Every company must make available Plan "A". Some plans may not be available in your state. Plans E, H, I, and J are no longer available for sale.

A
B
C
D
F
F*
G

Basic, including 100% Part B co-insurance

Basic, including 100% Part B co-insurance

Basic, including 100% Part B co-insurance

Basic, including 100% Part B co-insurance

Basic, including 100% Part B co-insurance*

Basic, including 100% Part B co-insurance

Skilled Nursing Facility Co-insurance

Skilled Nursing Facility Co-insurance

Skilled Nursing Facility Co-insurance

Skilled Nursing Facility Co-insurance

Part A Deductible

Part A Deductible

Part A Deductible

Part A Deductible

Part A Deductible

Part B Deductible

Part B Deductible

Part B Excess (100%)

Part B Excess (100%)

Foreign Travel Emergency

Foreign Travel Emergency

Foreign Travel Emergency

Foreign Travel Emergency

 
K
L
M
N

Hospita-
lization and preventive care paid at 100%; other basic benefits paid at 50%

Hospita-
lization and preventive care paid at 100%; other basic benefits paid at 75%

Basic, including 100% Part B coinsurance

Basic, including 100% Part B co-insurance, except up to $20 copayment for office visit, and up to $50 copayment for ER

50% Skilled Nursing Facility Co-insurance

75% Skilled Nursing Facility Co-insurance

Skilled Nursing Facility Co-insurance

Skilled Nursing Facility Co-insurance

50% Part A Deductible

75% Part A Deductible

50% Part A Deductible

Part A Deductible

Foreign Travel Emergency

Foreign Travel Emergency

Out-of-pocket limit $4,660; paid at 100% after limit is reached

Out-of-pocket limit $2,330; paid at 100% after limit is reached

*Plans F also has an option called a high deductible Plan F. This high deductible plans pays the same benefits as Plan F after on has paid a calendar year $2,070 deductible. Benefits from a high deductible Plan F will not begin until out-of-pocket expenses exceed $2,070. Out-of-pocket expenses for this deductible are expenses that would ordinarily be paid be the policy/certificate. These expenses include the Medicare deductibles for Part A and Part B, but do not include the plans' separate foreign travel emergency deductible.

Basic Benefits

Hospitalization

• Part A coinsurance plus coverage for 365 additional days after Medicare benefits end.


Medical Expense

• Part B coinsurance (generally 20% of Medicare-approved expenses) or copayments for hospital outpatient services. Plans K, L, and N require insureds to pay a portion of Part B coinsurance or copayments.

Blood

• First 3 pints of blood each year.


Hospice

• Part A coinsurance

Medicare Part A Hospital Deductible

• The 2012 deductible is $1,156


Skilled Nursing Facility (SNF) Coinsurance

• $144.50 a day for days 21-100 in a Skilled Nursing Facility in 2012


Medicare Part B Yearly Deductible

• The 2012 deductible is $140



Medicare Part B Excess Charges

• Difference between doctor's charge and Medicare's approved amount

• Up to 15% above the Medicare approved charge which is the doctor’s maximum charge


Foreign Travel Emergency

• Pays 80% of the cost of emergency care during the first two months of each trip after you pay a $250 deductible

• Lifetime maximum of $50,000