Understanding Medicare Supplement Plan B

Understanding Medicare Supplement Plan B

Like most states, there are ten standardized Medicare Supplement Plans each identified with a letter from A-N. One of those plans available for beneficiaries to choose from is Medicare Supplemental Plan B, also called Medigap Plan B. This is not to be confused as Medicare Part B as Part B is the medical insurance of Original Medicare which covers preventative services and medically necessary services.

What is Medicare Supplement Plan B?

Medicare Supplement Plan B provides basic benefits for Medicare Part A and B with a little bit more coverage on hospitalization (Part A). Medigap Plan B is accepted by physicians who accept Original Medicare coverage.

  • Part A Hospital Coinsurance
    • Pays for days 61-90 of a hospital stay in each Medicare benefit period
    • Pays for days 91-150 of a hospital stay. Medicare will only pay for these 60 days once during your lifetime
  • Additional Part A Hospital Benefits
    • An extra 365 days of inpatient hospital care after your use your Original Medicare hospital benefits
  • Part A Hospice Coinsurance and Copayment: Pays for outpatient prescription drug and inpatient respite care coinsurance
  • Part A Deductible (Hospital Insurance)
  • Part B Coinsurance or Copayment: Pays for the Part B coinsurance after you meet your annual deductible
  • Part A and B Blood Coverage: Pays for the first three pints of blood per calendar year

What Medicare Supplement Plan B does not cover are Medicare Part B excess charges, Part B deductible, skilled nursing coinsurance, and foreign travel emergencies.

Is Medicare Supplement Plan B right for you?

When choosing a Medicare Supplement, it is important to purchase one that fits your needs medically and financially. Consider calculating your budget and determine what monthly Medigap plan will be more economical in your situation. Medigap plans are to help you but not to hurt your bank.

Another factor when choosing a Medicare Supplement is to look at your medical and family history. If you have health issues or any pre-existing conditions you might want to consider looking at a plan that provides more coverage for any possible large medical expenses. If you do have good health and family history, you could take a chance in getting a plan with less coverage which could possibly save you money on premiums.

When can I enroll in Medicare Supplement Plan B?

Medicare Supplement Plans, such as Medigap Plan B, works in conjunction with Original Medicare. The best time to enroll in a Medicare Supplemental Plan B is during the six-month Medigap Open Enrollment Period (OEP). This period begins on the first day of the month you turn 65 or older and enrolled in Medicare Part B. If you enroll during the Medigap Open Enrollment Period, private insurance companies cannot deny you coverage, charge you a higher premium, or delay your coverage if you have health issues or disabilities.

If you wait to purchase a Medigap policy after your OEP, insurance companies can use medical underwriting to determine your qualification for a policy, which then they do not have to sell you a policy if you do not meet medical underwriting requirements.

Guaranteed-Issue Rights

If you do miss your Open Enrollment window and have guaranteed-issue rights, you are able to enroll in a Medigap plan without being charged a higher premium or denied coverage.

By having guaranteed-issue rights, Medigap insurance companies must sell you a Medigap policy at the best available rate regardless of your health and cannot deny you coverage.

If you are the age of 65 or older, you have a guaranteed-issue right within 63 days of when you lose or end certain health coverage. It also prevents companies from enforcing a waiting period for coverage on pre-existing conditions. Guaranteed-issue right include:

  • Losing a group health plan that covered Medicare cost-sharing (at no personal fault)
  • When first eligible for Medicare, you joined Medicare Advantage and disenrolled
  • within 12 months
  • Your previous Medigap plan, Medicare Advantage or PACE programs ends its coverage

It is important to keep any necessary documents (letters, emails, notices, etc.), for proof of guaranteed-issue rights.

Costs of Medicare Supplement Plan B

The cost of a Medigap Plan B policy can vary. Policies are sold by private insurance companies and each set their own premiums. Plan rates can be priced in three ways:

  • Community-Rated (Non-Age Related): Individuals in a given area are charged the same rate, regardless of age
  • Issue-Age Rated: Charged based on the age of the applicant, but price does not increase as policyholder ages
  • Attained-Age Rated: Rates are cheaper at 65, but prices scale as policyholder ages

Contact our representatives to learn about the benefits of Medicare Supplemental Plan B.