Medicare can be confusing. There are so many different parts and plans that it can be challenging to understand what’s best for you. We often hear, “What does Medicare Supplement Plan B cover?” And “Is it the same as Part B?”
This post will give you a thorough understanding of Plan B coverage and how it works. We’ll explore what Plan B supplements cover and highlight what they don’t, allowing you to decide about your health coverage.
Medicare Supplement Plans Explained
You’re probably familiar with Original Medicare (Parts A and B). But did you know you can buy additional coverage from private insurance companies to fill coverage gaps? These plans are Medicare Supplements – or Medigap plans.
There are standardized plans, each labeled with a letter (A, B, D, G, and more). This ensures similar benefits regardless of the insurance provider. Each plan helps with different out-of-pocket costs, such as deductibles, copayments, and coinsurance.
Are Medicare Part B and Supplemental Plan B the Same?
Medicare Plan B and Medicare Supplement Plan B might sound similar but they are very different. It’s important to understand what each one does.
Medicare Part B (medical insurance) is part of Original Medicare and Part A (hospital insurance). Part B helps pay for doctor’s visits, outpatient care, and preventive services.
A Medigap plan (like Plan B) supplements Original Medicare. Think of it as an extra layer of coverage. It helps pay some of the costs that Original Medicare doesn’t fully cover, like copayments, coinsurance, and deductibles.
Understanding Medicare Supplement Plan B
Let’s focus on Plan B, what it covers, and whether it fits you well. Medigap Plan B provides decent coverage, helping you manage unexpected healthcare costs.
What Does Medicare Supplement Plan B Cover?
Plan B provides supplemental coverage for several aspects of Original Medicare. This chart breaks down the specific coverage details:
| Medigap Benefit | Plan B Coverage |
|---|---|
| Part A Coinsurance & Hospital Costs up to 365 Additional Days (After Medicare Benefits Used) | 100% |
| Part B Coinsurance or Copayment | 100% |
| Blood (First 3 Pints) | 50% |
| Part A Hospice Care Coinsurance or Copayment | 100% |
| Skilled Nursing Facility Care Coinsurance | 100% |
| Part A Deductible | 100% |
| Part B Deductible | 100% |
| Part B Excess Charges | Not Covered |
| Foreign Travel Emergency (up to Plan Limits) | 80% |
| Out-of-Pocket Limit | Not applicable |
As you can see, Medigap Plan B covers significant expenses, giving you peace of mind. You must pay some out-of-pocket costs, but Plan B can mean considerable savings.
It can provide a vital safety net, particularly if you experience significant healthcare needs. However, Medicare Supplement insurance has some disadvantages, including costs, and doesn’t cover all medical expenses. If you’re trying to save money on your Medicare premiums, Medicare Supplement Plan A is cheaper than Plan B but offers fewer benefits.
If cost is a significant concern, explore whether Plan A or Medigap Plan N might be a good option. Or take us up on our free analysis report.
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What Does Medicare Plan B Not Cover?
This is critical: while Plan B provides excellent coverage, there are certain things it won’t cover. The best Medicare Supplement plans, even those with stellar reputations, will have some exclusions. Plan B will not pay for:
- Part B excess charges: Some doctors and healthcare providers may charge more than Medicare’s approved amount for services. This additional fee is called an “excess charge,” and Plan B does not cover it.
- Long-term care: Plan B won’t cover long-term care, such as assistance with daily living tasks.
- Vision and dental care: Medigap Plan B usually does not cover regular eye exams, dental care, or vision hardware.
- Hearing aids: Although Medicare covers hearing exams if your doctor determines it’s medically necessary, it generally does not cover hearing aids.
- Prescription medications: Unlike most Medicare Advantage plans, supplements, like Plan B, do not include drug plans.
Medicare Part B covers some limited outpatient prescription drugs. Still, it excludes drugs like those you would typically pick up at your local pharmacy, such as drugs for weight loss or erectile dysfunction, over-the-counter medications, and fertility drugs, among others. You’ll want to explore your options for a Part D prescription drug plan for most prescription drug coverage.
It is good to know the limitations so you aren’t caught off-guard. Now you know the answer to “What does Medicare Supplement Plan B cover?” You’ve also learned what it doesn’t, so there won’t be any surprises later.
Is Original Medicare and Plan B Better than Medicare Advantage?
Making the best decision between choosing Original Medicare with a Medigap policy or a Medicare Advantage plan is essential. Original Medicare allows you to see almost any doctor nationwide who accepts Medicare. You’re not limited to a network.
This can be a big deal if you travel a lot or want to keep seeing your current doctor. Plus, with Medigap policies, like Plan B, you get help paying for many out-of-pocket costs Original Medicare doesn’t fully cover. Think of it as a safety net for those unexpected medical bills.
However, original Medicare supplemental Medicare insurance often costs more upfront. You’ll have a monthly premium for Medicare Part B and Medigap plans. Although you’ll pay less when you use healthcare services because of the supplement plan, this trade-off can be confusing.
Is Medigap Plan B Right for You?
This boils down to individual circumstances and priorities. Weighing your budget and coverage needs is vital. Plans F and C used to be popular due to their broad coverage but became unavailable to those newly eligible for Medicare beginning January 1, 2020.
Those with Medicare before that date could continue these plans if they desired. This led to Plan G’s emergence as one of the 3 Most Popular Medicare Supplement Plans.
This trend is unsurprising because Plan G provides robust coverage, making it a smart choice for many seniors, although it comes at a cost. A high-deductible version of Plan G is also available, offering an appealing lower-premium alternative.
Instead, pick and choose what coverage you want to pay extra for. Some beneficiaries favor the flexibility of a plan like Medigap Plan K or N, where they pay out-of-pocket for services in trade for potentially lower premiums than those of Plan B.
If you’re considering changing plans, timing is essential. There are specific times when you’re allowed to make these changes. For detailed information on plan change options and timing, consult this guide from MedicareWire.com. They offer clear insights and advice on making the right decision for your healthcare coverage needs.
FAQs About What Does Medicare Supplement Plan B Cover?
FAQ 1: What services are covered by Medicare Supplement Plan B?
Plan B helps pay for several out-of-pocket costs associated with Original Medicare (Parts A and B). It covers Part A and Part B coinsurance, Part A and Part B deductible, the first 3 pints of blood annually, and 80% of covered foreign travel emergency care costs.
FAQ 2: What does a Plan B supplement cover?
Plan B pays for all of your Part A Hospital Insurance and Part B Medical Insurance coinsurance, except for the Part B Skilled Nursing Facility Coinsurance, which is covered at 100% after the first 20 days.
FAQ 3: What is not covered by Medicare Plan B?
Plan B won’t cover expenses like long-term care or custodial care, most dental, vision, and hearing care, including hearing aids, private-duty nursing, or medical care you receive outside of the United States. However, there are a few situations when health insurance plans may pay some of these costs, so it’s always good to confirm coverage for specific needs.
FAQ 4: Do you have to pay for Medicare Part B if you have a supplemental plan?
Yes, you still have to pay your monthly Medicare Part B premium. But instead of paying 20% of your Part B costs (after the deductible), Medigap Plan B picks that 20% up. You can contact Medicare.gov, 1-800-MEDICARE (1-800-633-4227), or your local State Health Insurance Program (SHIP) to confirm accurate plan costs. You’ll want to weigh costs against any potential coverage gaps you’ll be left to fill yourself before you make a final decision.
Conclusion
Knowing what Medicare Supplement Plan B covers can significantly impact your healthcare budget. Consider carefully whether it aligns with your needs. For a broader view, compare all Medicare Supplement Insurance plans. Explore, analyze, and find the plan that empowers you to face the future confidently.