What Is Medicare Supplement Insurance?

While Medicare Part A and Part B provide coverage for an array of services and types of care, there are many gaps in its coverage. Beneficiaries are therefore responsible for paying many expenses that are not covered, such as:

  • a deductible for inpatient hospital care
  • coinsurance on inpatient hospital care
  • charges for inpatient hospital care after the coverage limit is reached
  • coinsurance on skilled nursing facility care
  • charges for skilled nursing facility care after the coverage limit is reached
  • annual deductible on physician and other outpatient medical care
  • 20 percent coinsurance on physician and other outpatient medical care
  • charges that exceed the Medicare-approved amount if physicians do not accept assignment

Medicare supplement insurance is designed to help beneficiaries pay these costs. Because these cost-sharing requirements are specific to coverage under Medicare Part A and Part B—that is, they do not apply Medicare Advantage plans—Medicare supplement insurance may be sold only to individuals who are enrolled in Original Medicare.

Medicare coverage can be complex. Some of the rules of Medicare coverage can change without the beneficiary even knowing. Who even knows when their employer crosses an enrollment threshold? Best advice is to always speak to a health insurance specialist who is certified and experienced in the many facets of health insurance including the intersections between Medicare and Employer coverage. Contacting Total Benefit Solutions, Inc. at (215)355-2121  is the first step!