Friday, May 4, 2012

What Is Medicare Supplemental Insurance Plan E?

Medicare Part A and Medicare Part B, also known as original Medicare Part A and Part B, make up the federal government program designed to provide health-care coverage for people over age 65 and for people under 65 who are disabled or who are experiencing end-stage renal disease (ESRD) and require dialysis or a kidney transplant. Medicare supplemental insurance (Medigap insurance) Plan E is one of 12 plans designed to fill the gaps in original Medicare coverage. These plans are sold by private Medicare supplemental insurance companies.

While original Medicare Part A covers most hospital bills as well as hospice care, original Medicare Part B handles doctor's fees, medical equipment, diagnostics, outpatient care and certain kinds of rehabilitation. But there are important limitations. For example, inpatient hospital care coverage won't last forever, and once the original Medicare coverage runs out, you're on your own.

Supplemental Medicare insurance Plan E delivers all the coverage available through Medigap plans A and B. Thus, Medigap Plan E covers original Medicare Part A coinsurance the percentage of the cost of services after deductibles have been paid for which you are responsible. It also provides coverage for an additional 365 days of hospitalization after original Medicare coverage ends. Should you need blood, Medigap Plan E covers the first three pints each year. Original Medicare does not cover the first three pints.

For outpatient services, Medigap Plan E pays the Medicare Part B coinsurance, which is usually 20 percent of the cost of services after deductibles are paid. The amount is based on the Medicare-approved amount for the services. The Medicare-approved limit is the amount a service provider who has accepted assignment with Medicare can be paid. Included in the amount are any deductibles, coinsurance or copayments. Plan E also covers the Medicare Part A deductible, as does Medicare supplemental insurance Plan B. Plan A does not cover this deductible.

Medicare supplemental insurance Plan E goes beyond Plan A and Plan B by paying the coinsurance costs for a skilled nursing facility. It also provides coverage for preventive care and foreign travel emergencies. Unlike Plan C, in does not cover the Medicare Part B deductible, nor does it cover at-home recovery, as does Medigap Plan D.

All Medicare supplemental insurance companies must offer Medigap Plan A. They are not necessarily obligated to carry Plan E or other Medigap plans, and the requirements vary from state to state. However, Medicare supplemental insurance plans offered by different companies can carry significantly different price tags. Although a company carries Plan E, in other words, it could charge more or less than another company for the same coverage. It pays to shop around.

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