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CT Medicare Supplemental Insurance

How to Compare CT Medicare Supplemental Insurance Plans

Please read how to compare CT Medicare Supplemental insurance plans (the first post in this series) if you haven’t already. The previous posts covers Medicare plans A through G. This post starts with Plan K. (Plan H, Plan I and Plan J are no longer available for purchase).

How to Compare CT Medicare Supplemental Insurance Plans (continued)

CT Medigap vs Medicare Advantage Plans

Positives for Medigap Plans

These plans are not network based; you can see any doctor in Connecticut, or any other state in the union, who accepts Medicare. You will not have to search long to find, for example, primary doctors who accept Medicare; virtually all US medical providers do. This is the main reason someone would choose to purchase one of the CT Medigap plans instead of a Medicare Part C (Medicare Advantage) Plan.

Positives for Advantage Plans (Part C Plans)

Medicare Part C covers the same medical expenses a Medigap covers, however you will have different cost shares (deductibles, copays and coinsurance) with different plans. You will generally get more coverage per dollar with an Advantage plan.

CT Medigap Plan K

This is one of the Medicare Plans I recommend often to my Connecticut clients. Based on the 2017 Medigap rates for Connecticut. You will have less coverage than you’d get with most other plans in this category, however the low premium makes this plan attractive.

A Plan K Medicare Supplement cost (or premium) is still higher than most Medicare Advantage plan premiums. However, it is one of the lowest cost policies with no network restrictions.

Part A or Hospital Coverage

Without a Medicare Supplement, you will be responsible for the first $1,316 (in 2017) of each benefit period if you are admitted to a hospital. This is the Medicare Part A deductible. Plan K will cover half of this deductible. You will be responsible for $658 in 2017. After the Part A deductible is paid Plan K can cover all subsequent copays until you have been in the hospital for over a year.

Skilled Nursing Facility Coverage

This coverage is limited to skilled care with all Medicare options. Most nursing home stays require custodial care and therefore are not covered by Medicare or any of the Medicare Plans.

Plan K covers half the skilled nursing facility care copay. This means that you are responsible for $82.25 a day (based on 2017 costs) for days 21 through 100 if your nursing home stay is covered. You will be responsible for all costs after 100 days.

Coverage in the Doctor’s Office

Plan K pays nothing toward the annual doctors’ office deductible. You will be responsible for the first $183 (in 2017) each year. After you have met your deductible, Medicare Part B will pay 80% of the approved cost of each visit. Plan K will pay 10%. You will be responsible for the remaining 10%.

Your physician can charge 15% more than the approved amount. Only about a third of physicians do, however. If yours does, this will be your responsibility since neither Medicare nor a Medigap Plan K will cover this expense for you.

CT Medigap Plan L

This plan provides better coverage than Medicare Plan K and is reasonably priced, it is not one of my favorite Medicare Supplement Plans, but it is a good one. My clients tend to prefer plans that cost less or plans that cover more, such as Medicare Supplement Plan K or CT Medigap Plan N.

Part A or Hospital Coverage

Without a Medicare Supplement, you will be responsible for the first $1,316 of each benefit period if you are admitted to a hospital. This is the Medicare Part A deductible. Plan L will cover three quarters of this deductible. You will be responsible for $329 in 2017. After the deductible is paid, this plan can cover subsequent copays until you have been in the hospital for over a year.

Skilled Nursing Facility Coverage

Plan K covers three quarters of the skilled nursing facility care copay. This means that you are responsible for $41.12 a day (based on 2017 costs) for days 21 through 100 if your nursing home stay is covered. You will be responsible for all costs after 100 days.

Coverage in the Doctor’s Office

Plan L pays nothing toward the Part B or doctors’ office deductible. So, you will be responsible for the first $183 (in 2017) each year. After you have met your deductible, Medicare Part B will pay 80% of the approved cost of each doctor visit. Plan K will pay 15% and you will be responsible for the remaining 5%.

Your physician can charge 15% more than the approved amount. However only about a third of physicians do. If yours does, this will be your responsibility since neither Medicare nor a Medigap Plan L will cover this expense for you.

CT Medigap Plan M

This plan provides better coverage than most Medigap plans, but is not well priced. The least expensive Plan M offered in Connecticut is more expensive than a competitively-priced Plan N. Plan N offers more coverage, so this is not a plan I recommend.

Part A or Hospital Coverage

Plan M provides the same hospital coverage you will get from a Plan K.

Without a Medicare Supplement, you will be responsible for the first $1,316 of each benefit period if you are admitted to a hospital. This is the Part A deductible. Plan M will cover half of this. You will be responsible for $658 in 2017. After the deductible is paid it can cover all the subsequent copays until you have been in the hospital for over a year.

Skilled Nursing Facility Coverage

Plan K covers the skilled nursing facility care copay. This means that you will be responsible nothing until after day 100, if your nursing home stay is covered. You will be responsible for all costs after 100 days.

Coverage in the Doctor’s Office

Plan M pays nothing toward the Part B or doctors’ office deductible. So, you will be responsible for the first $183 (in 2017) each year. After you have met your deductible, Medicare Part B will pay 80% of the approved cost of each doctor visit. You will be responsible for the remaining 20%

You may be responsible for more. Your physician can charge 15% more than the approved amount. However only about a third of all physicians do. If yours does, this will be your responsibility since neither Medicare nor a Medigap Plan M will cover this expense for you.

CT Medigap Plan N

This is one of the plans I recommend most often. If you shop around (or ask us to shop for you), you will find this policy to be competitively priced. The coverage is nearly as good as the two most comprehensive plans. This plan is a bargain.

Part A or Hospital Coverage

Plan N provides the same hospital coverage you will get from a Plan F, which means no Medicare Supplement plan will give you better coverage.

This plan can cover all hospital costs Medicare Part A does not until you have been in the hospital for over a year.

Skilled Nursing Facility Coverage

Plan N covers the full skilled nursing facility care copay also.

Coverage in the Doctor’s Office

Plan N pays nothing toward the Part B or doctors’ office deductible. So, you will be responsible for the first $183 (in 2017) each year. After you mret your deductible, you will only be responsible for a $20 copay for each doctor visit.

You physician can charge 15% more than the approved amount. If yours does, this will be your responsibility neither Medicare nor a Medigap Plan covers this expense for you.

For More Information

To get quotes and request recommendations for CT Medicare Supplemental Insurance plans on our site.

About Post Author

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Alston J. Balkcom

“ Connecticut-licensed insurance agent since 1985.”

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Comparing CT Medicare Supplemental Insurance plans? Here is the third in the series. It covers benefits for CT Medigap Plan K through CT Medigap Plan N.