Most beneficiaries have likely heard of Medicare Supplement Insurance (Medigap), which bridges the “gap” between what Medicare pays for and the costs of medical care that are the responsibility of the Medicare recipient. Medigap policies help to pay some of the costs that Original Medicare does not cover when you need medical care or certain durable medical equipment.
What is Medicare Part B? (Don’t confuse it with Medicare Plan B)
The first thing to know is that Medicare Plan B is not the same as Medicare Part B.
- Medicare Part B is a part of the coverage offered to individuals who have Original Medicare.
- Medicare Part A provides coverage for inpatient care, and is the coverage often referred to as “hospital insurance.”
- Part B coverage includes most outpatient care, and provides coverage for doctor visits, outpatient clinic charges, and preventive services.
- Medicare describes the services that Part B covers as medically necessary services, such as the supplies and services that are “needed to diagnose or treat your medical condition and that meet accepted standards of medical practice.”
- Medicare also explains that Part B covers the preventive services, such as those necessary to prevent or detect illnesses such as the flu, “when treatment is likely to work best.”
Part B provides coverage for certain preventive, diagnostic and treatment services, but it is not the same as Plan B.
What is Medicare Supplement Plan B?
The Centers for Medicare and Medicaid Services (CMS) indicates that in order to purchase a Medigap policy, you need to have both Medicare Part A and Medicare Part B coverage. Medicare recipients who want a Medigap policy purchase the policies from private insurance companies, including if a Medicare recipient who has Original Medicare wants to purchase a Medigap Plan B policy.
A Medigap Plan B policy covers only one person, the same as other Medigap policies. If you and your spouse both want to purchase a Medigap policy, you each purchase your own Medigap Plan B policy.
Medigap plans no longer cover the Part B deductible. Medigap Plan B provides coverage for other Medicare costs, which include:
- Part A coinsurance and the hospital costs up to an additional 365 days after Medicare benefits are used up
- Part A deductible
- Part B coinsurance or copayment
- The first three pints of blood needed for a blood transfusion
- Part A hospice care coinsurance or copayment
Medicare offers a comparison chart so that Medicare recipients have the opportunity to compare each Medicare Supplement Policy side-by-side, including Plan B, to determine if there is a Medigap plan that suits their needs.
Is There Anything that Plan B Does Not Cover?
You need to know what a Medigap Plan B plan does not cover before making the decision to purchase this type of Medigap Plan. The Plan B Supplement insurance does not provide coverage for the following:
- Skilled nursing care coinsurance.
- Part B deductible.
- Part B excess charges.
- Beneficiaries who need emergency care during their travel outside of the United States.
- Services that Original Medicare does not pay for, such as dental, vision, eyeglasses, long-term care or private duty nursing.
Insurance Plans That Are Not Medigap Plans
Each type of Medicare plan differs somewhat from other plans. Some insurance plans that are not Medicare Supplement, or Medigap Plans include:
- Medicare Part D Prescription Drug Plans.
- Medicare Advantage Plans that people commonly call Medicare Part C plans.
- Long-Term care policies.
- Veteran’s Benefits.
Medicare also reveals that the Medicaid program, and Medicaid Plans for low-income Medicare beneficiaries who receive “Extra Help “benefits from Medicare differ from Medigap Plan B plans. Some other insurance plans that are not Medigap Plans include Tricare and employer plans or union plans.
Make sure that you understand Medigap Plan B and any other Medigap Plan before you purchase the plan, to make sure that you understand the benefits.
- What Part B Covers, Medicare.
- Medigap (Medicare Supplement Health Insurance), CMS.
- How to Compare Medigap Policies, Medicare.
- What’s Medicare Supplement Insurance (Medigap)?, Medicare.