The Original Medicare Plan pays for many health care services and supplies, but it doesn’t pay all of your health care costs. There are costs that you must pay, like coinsurance, copayments, and deductibles. These costs are called “gaps” in Medicare coverage. You might want to consider buying a Medigap policy (Medicare Supplement) to cover these gaps in Medicare coverage.

Medicare supplement Plan F and Plan J are two of the most bought by seniors. The primary reason is these two plans fill in the most gaps that Medicare does not cover. Many supplemental insurance companies offer Plan F, but Plan J can be harder to find as only a select few companies currently offer Plan J. Plan J offers the most comprehensive coverage available to seniors enrolled in Medicare. Consumers choose Plan J because it covers all eight gaps Medicare coverage including:

    Basic Benefits
    Skilled Nursing Facility Coinsurance
    Part A Deductible
    Part B Deductible
    Part B Excess (100%)
    Foreign Travel Emergency
    At-home Recovery
    Preventive Care Not Covered by Medicare.

Medigap Plan J is the only plan designation that will pay benefits for preventive care visits. It differs from most other plans in that it also provides coverage for recovery time at home - such as a home visit from a physical therapist. Seniors who desire complete coverage usually select the Plan J. After June 1st, 2010, insurance companies will no longer be allowed to offer Plan J due to changes outlined in the Medicare Improvements for Patients and Provider Act of 2008. If you own a Plan J prior to June 1st, 2010, you may continue under your current policy. See below for more details.

The Medicare Improvements for Patients and Providers Act (MIPPA), signed into law on July 15, 2008, encompasses significant changes for Medicare beneficiaries. All Medicare Supplemental (Medigap) policies sold or renewed by or after July 1, 2010 must comply with the following rules. As of July 1, 2010, the standardized Medigap plans that can be sold will be different. Certain Medigap plans, E, H, I and J, will no longer be sold. Those who currently own one of these plans may be allowed to keep their policy.

Hospice coinsurance has been added as a basic core benefit in Medigap A and all other Medigap policies. Medigap policies M and N are new standardized policies that can and will be offered by most insurers. These plans have higher cost-sharing for the Medicare Part A deductible and limited or no coverage for the annual Part B deductible ($135 in 2009). These new policies substitute set co-payments for coverage of the usual Part B 20 percent cost-sharing.

Plan M covers half of the Part A hospital deductible, has no coverage for the Part B annual deductible and provides for copayments of $20.00 for office visits and $50 for hospital Emergency Room visits. Plan N covers the Part A hospital deductible, but has no coverage for the Part B annual deductible. Plan N also imposes Part B copayments of $20.00 for office visits and $50 for hospital Emergency Room visits.

The new Modern Medicare supplement plans are now available for a July 1st effective date. For more information about rates and plan availability, email us at info@iiss.us or give us a call at (712) 276-1745 or Toll-Free (877) 276-1745.

Medicare Advantage (Part C)

Neither Insurance & Investment Solutions of Siouxland TM ("IISS"), nor its agents,  are connected with or endorsed by Medicare, Social Security, or any other governmental agency.