Medicare Supplement Plan E Policy Coverage
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Medicare Supplemental Plan E
Medicare Supplement Insurance Plan E is a middle of the road policy as it covers many of the major gaps left by Medicare Insurance but lacks other coverages. Though the Medicare Supplement Plan E can in some cases be a cost effective plan, it is recommended to only purchase a Medicare Supplemental Plan E under rare conditions.
The only reason to purchase a plan Medicare Supplemental Plan E rather than a more comprehensive Medicare Supplemental Plan F or Plan J is because of price. Normally more comprehensive Medicare Supplement Insurance Plans will cost you less if you shop around multiple Medicare Supplement Insurance Companies.
Covered by Medicare Supplemental Plan E
Basic Benefits:
* Part B Coinsurance (Generally 20% of outpatient expenses)
* Hospital Coinsurance
* 365 Additional Days Hospitilization Coverage
* Blood Deductible Coverage
Skilled Nursing Coinsurance
Part A Deductible
Foreign Travel
Preventative Care
Not Covered by Medicare Supplement Plan E
At Home Recovery
Part B Deductible
Part B Excess
Medigap Plan E is only recommended in rare circumstances. For the most part, you are better off with a more Comprehensive Medicare Supplementsl Insurance Plan such as Medigap Plans F or J.
Medicare Supplement Plan E:
| Medigap Plan E MEDICARE INSURANCE (PART A) - HOSPITAL SERVICES - PER BENEFIT PERIOD |
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| A benefit period begins on the first day you receive service as an inpatient in a hospital and ends after you have been out of the hospital and have not received skilled care in any other facility for 60 days in a row. | |||
| Service: | HOSPITALIZATION Semiprivate room and board, general nursing and miscellaneous services and supplies: |
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| MEDICARE INSURANCE PAYS | PLAN PAYS | YOU PAY | |
| First 60 days | All but $1068 | $1068 (Part A Deductible) | $0 |
| 61st through 90th day | All but $267 a day | $267 a day | $0 |
| 91st day and after: | |||
| While using 60 lifetime reserve days | All but $534 a day | $534 a day | $0 |
| Once lifetime reserve days are used: |
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| Additional 365 days | $0 | 100% of Medicare Eligible Expenses | $0 |
| Beyond the Additional 365 days | $0 | $0 | All costs |
| Service: | SKILLED NURSING FACILITY CARE You must meet Medicare's requirements, including having been in a hospital for at least 3 days and entered a Medicare-approved facility within 30 days after leaving the hospital: |
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| First 20 days | All approved amounts | $0 | $0 |
| 21st through 100th day | All but $133.50 a day |
Up to $133.50 a day |
$0 |
| 101st day and after | $0 | $0 | All costs |
| Service: | BLOOD |
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| First 3 pints | $0 | 3 pints | $0 |
| Additional amounts | 100% | $0 | $0 |
| Service: | HOSPICE CARE Available as long as your doctor certifies you are terminally ill and you elect to receive these services. |
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| All but very limited coinsurance for outpatient drugs and inpatient respite care | $0 | Balance | |
| NOTICE: When your Medicare Part A hospital benefits are exhausted, the insurer stands in the place of Medicare and will pay whatever amount Medicare would have paid for up to an additional 365 days as provided in the policy's "Core Benefits." During this time the hospital is prohibited from billing you for the balance based on any difference between its billed charges and the amount Medicare would have paid. | |||
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| Medigap Plan E MEDICARE INSURANCE (PART B) - MEDICAL SERVICES - PER CALENDAR YEAR |
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| Once you have been billed $135 of Medicare-Approved amounts for covered services your Medicare Part B Deductible will have been met for the calendar year. | |||
| Service: | MEDICAL EXPENSES - In or Out of the Hospital and Outpatient Hospital Treatment, such as Physician's services, inpatient and outpatient medical and surgical services and supplies, physical and speech therapy, diagnostic tests, durable medical equipment: |
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| MEDICARE INSURANCE PAYS | PLAN PAYS | YOU PAY | |
| First $135 of Medicare Approved Amounts | $0 | $0 | $135 (Part B Deductible) |
| Remainder of Medicare Approved Amounts | Generally 80% | Generally 20% | $0 |
| Part B Excess Charges (Above Medicare Approved Amounts) | $0 | $0 | All costs |
| Service: | BLOOD | ||
| First 3 pints | $0 | All cost | $0 |
| Next $135 of Medicare Approved Amounts | $0 | $0 | $135 (Part B Deductible) |
| Remainder of Medicare Approved Amounts | 80% | 20% | $0 |
| Service: | CLINICAL LABORATORY SERVICES | ||
| Blood tests for Diagnostic Services | 100% | $0 | $0 |
| MEDICARE INSURANCE PARTS A & B | |||
| Service: | HOME HEALTH CARE Medicare Approved Services: |
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| MEDICARE INSURANCE PAYS | PLAN PAYS | YOU PAY | |
| Medically necessary skilled care services and medical supplies | 100% | $0 | $0 |
| Durable medical equipment: | |||
| First $135 of Medicare Approved Amounts | $0 | $0 | $135 (Part B Deductible) |
| Remainder of Medicare Approved Amounts | 80% | 20% | $0 |
OTHER BENEFITS - NOT COVERED BY MEDICARE INSURANCE |
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| Service: | FOREIGN TRAVEL Medically necessary emergency care services beginning during the first 60 days of each trip outside the USA: |
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| First $250 each calendar year | $0 | $0 | $250 |
| Remainder of charges | $0 | 80% to a lifetime maximum of $50,000 | 20% and amounts over the $50,000 lifetime maximum |
| Service: | PREVENTIVE MEDICAL CARE BENEFIT-NOT COVERED BY MEDICARE INSURANCE Some annual physical and preventative tests and services such as: digital rectal exam, hearing screening, dipstick urinalysis, diabetes screening, thyroid function test, tetanus and diphtheria booster and education, administered or ordered by your doctor when not covered by Medicare: |
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| First $120 each calendar year | $0 |
$120 |
$0 |
| Additional charges | $0 | $0 | All costs |
| Medicare benefits are subject to change. Please consult the latest Guide to Health Insurance for People with Medicare. | |||