|
Medigap Benefits |
A |
B |
C |
D |
F* |
G |
K** |
L** |
M |
N |
| Medicare Part A Coinsurance |
X |
X |
X |
X |
X |
X |
X |
X |
X |
X |
| Medicare Part B Coinsurance |
X |
X |
X |
X |
X |
X |
50% |
75% |
X |
X*** |
|
Blood (1st 3 Pints) |
X |
X |
X |
X |
X |
X |
50% |
75% |
X |
X |
|
Part A Hospice Care Coinsurance or Copayment |
X |
X |
X |
X |
X |
X |
50% |
75% |
X |
X |
| Skilled Nursing Facility Coinsurance |
|
|
X |
X |
X |
X |
50% |
75% |
X |
X |
| Medicare Part A Deductible |
|
X |
X |
X |
X |
X |
50% |
75% |
50% |
X |
| Medicare Part B Deductible |
|
|
X |
|
X |
|
|
|
|
|
| Medicare Part B Excess Charges |
|
|
|
|
****100% |
****100% |
|
|
|
|
| Foreign Travel Emergency |
|
|
X |
X |
X |
X |
|
|
X |
X |
|
|
|
|
|
|
|
Out of Pocket Limit $4640 |
Out of Pocket Limit $2320 |
|
|
*Plan F also offers a high-deductible plan. If you choose this high-deductible version, this means you must pay for Medicare-covered costs up to the deductible amount of $2070 (in 2012) before your Medigap plan pays anything.
**After you meet your yearly Part B deductible ($140 in 2012), the Medigap plan pays 100% of covered services for the rest of the calendar year.
***Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don't result in an inpatient admission.
****Pays 100 percent of the excess fees, which are limited to 15 percent above the Medicare-approved amount
Texas Medicare Supplement Glossary of Terms:
Part A Coinsurance - Pays the daily hospital coinsurance for days 61 - 150, plus an additional 365 days at 100% of Medicare eligible expenses
Part B Coinsurance - this covers the 20% that Medicare doesn't cover for Part B (outpatient) expenses
Blood - pays for the first 3 pints of blood that Medicare doesn't cover
Skilled Nursing Coinsurance - Covers the coinsurance for Skilled Nursing facility on days 21 - 100 up to $144.50 per day in 2012.
Part A Deductible - pays this deductible ($1156 in 2012)
Part B Deductible - pays the annual deductible for Part B (outpatient) services, which is $140 in 2012.
Excess Charges - Part B excess charge benefit pays some or all of the difference between what your doctor charges and Medicare's approved amount, depending on which plan you choose
Foreign Travel Emergency - pays 80% of the cost of your foreign emergency care after a $250 deductible. Maximum lifetime benefit is $50K.
Part A Hospice Care Coinsurance or Copay - pays for Medicare-approved hospice benefits except for small copay for prescription medicines for patient comfort
Part B Preventive Care Coinsurance - pays your coinsurance for Medicare Part B covered preventive care, such as annual routine physical, immunizations, mammograms, pap smear, colorectal screenings, prostate screenings, and bone density tests.
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