Medicare is a health insurance program administered by the federal government in the United States. The program is mostly meant to help people aged 65 years or older, although citizens under 65 with certain health conditions may also qualify. Original Medicare comes in two parts, A and B, which cover hospital services, hospice and home health care. Medicare does not cover a significant number of health services, however, and many seniors purchase Medicare supplement plans to help close the gaps. As of 2010, Illinois offers all standardized Medigap supplemental policies.
Premiums
Medicare supplements in Illinois are available according to geographic region. Not all supplements may be available in all areas. Medigap policy benefits are standardized by the federal government, but the plans are sold by private insurance companies, which can also choose whether or not to offer a particular policy. These companies can set their own premiums and charge different rates depending on gender or age. In Illinois, Medigap policies are guaranteed to be renewable but premium costs are not, and may go up as often as once per year.
Basic Benefits
Medigap policies in Illinois are referred to by letter, from A through N. The basic benefits for all Medigap plans A through J and N include the co-insurance for Part A Medicare, full coverage of an additional 365 days of hospitalization after Medicare benefits stop and the first three pints of blood per calendar year. Each plan comes with its own menu of further services, such as the Medicare Part A and Part B deductible, excess charges and skilled nursing facility co-payment. Plan N is similar to plans A through J but has co-payments for emergency room and office visits.
Plans K and L
Plans K and L differ from the other policies in that they are cost-sharing plans. Plan K covers 50 of most benefits, while Plan L covers 75 percent. Their benefits include the deductible for Medicare Part A, the Medicare Part B copayment or co-insurance, the blood deductible, skilled nursing facility co-insurance and hospice care co-insurance or copayment. Plans K and L have lower monthly premiums than most other plans but higher out-of-pocket costs, with a yearly limit of $4,620 for Plan K and one of $2,310 for Plan L.
Plan F
Plan F is a popular plan which offers benefits for the Medicare Part A and B deductibles, Part B doctor charges, the co-payment for skilled nursing facilities and foreign travel emergency care. Plan F is also available as a high-deductible plan. It features the same benefits as the regular Plan F but comes with a $2,000 annual deductible, which must pay before benefits kick in. However, this also results in much lower premiums per month.
Tags: Medicare Part, Plan Plan, skilled nursing, comes with, federal government, Medigap policies, nursing facility
