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Medicare Plan J Supplement Benefits

The 10 Standard Medicare Supplement Insurance Plans

Medicare Supplement: Benefits

There are 10 Medicare supplement insurance plans. Each plan is labeled with a letter of the alphabet and has a different combination of benefits. Plan F has a high-deductible option. Plans K, L, M, and N have a different cost-sharing component.

Every company must offer Plan A. If they offer other plans, they must offer Plan C or Plan F.

Do You Need Medicare Supplement

Not everyone needs a Medicare supplement policy. If you have other health coverage, the gaps might already be covered. You probably dont need Medicare supplement insurance if:

  • You have group health insurance through an employer or former employer, including government or military retiree plans.
  • You have a Medicare Advantage plan.
  • Medicaid or the Qualified Medicare Beneficiary Program pays your Medicare premiums and other out-of-pocket costs. QMB is a Medicare savings program that helps pay Medicare premiums, deductibles, copayments, and coinsurance.

If you have other health insurance, ask your insurance company or agent how it works with Medicare.

Why Was It Expired

On June 1, 2010, the Government expired the said Medigap policy. Youve probably guessed some of the reasons by now. Medicare has updated and evolved and many features added by Plan J were made part of Traditional Medicare.

Even though it is expired, the policy remains in force for anyone admitted to it as of June 1, 2010. There is a separate annual deductible for current holders of Plan J.

Reasons Congress Expired Plan J

  • The prescription drug benefit was too expensive relative to the benefit. Less than one in 10 Medicare beneficiaries actually purchase a plan with prescription drugs because of the cost.
  • The Medicare Modernization Act was passed in 2003 but did not go into effect until 2010. Medicare Part D was added.
  • At-Home recovery care and Preventative Care were added to Medicare.
  • Plan J now had duplicate coverage to Traditional Medicare
  • Once expired, current enrollees in Plan J were able to keep their coverage. No one could enroll as a new customer into Plan J.
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    High Deductible Plan F*

    Same coverage as Plan F but you pay the calendar year deductibleLower monthly premiums than most other plansGood fit if you expect lower health care expenses

    Medicare Advantage and Medicare Part D Policy Disclaimers

    All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation. The Cigna name, logos, and other Cigna marks are owned by Cigna Intellectual Property, Inc. Cigna contracts with Medicare to offer Medicare Advantage HMO and PPO plans and Part D Prescription Drug Plans in select states, and with select State Medicaid programs. Enrollment in Cigna depends on contract renewal.

    Medicare Supplement Policy Disclaimers

    Medicare Supplement website content not approved for use in: Oregon and Texas.

    AN OUTLINE OF COVERAGE IS AVAILABLE UPON REQUEST. We’ll provide an outline of coverage to all persons at the time the application is presented.

    Our company and agents are not connected with or endorsed by the U.S. Government or the federal Medicare program. This is a solicitation for insurance. An insurance agent may contact you. Premium and benefits vary by plan selected. Plan availability varies by state. Medicare Supplement policies are underwritten by Cigna National Health Insurance Company, Cigna Health and Life Insurance Company, American Retirement Life Insurance Company or Loyal American Life Insurance Company. Each insurer has sole responsibility for its own products.

    Kansas Disclosures, Exclusions and Limitations

    What Is Medicare Supplement Plan J

    Medicare Supplement Insurance

    Until 2010, Medicare Supplement Plan J was one of several available Medigap plans. Anecdotal evidence suggests that the benefits that the policy offered made it one of the most popular.

    Medigap Plan J is not available to those who became eligible for Medicare after June 1, 2010. People who purchased Plan J before June 1, 2010, can usually keep the plan.

    Plan J has comprehensive coverage that includes:

    • Part A hospital costs for 365 days after Medicare benefits are exhausted
    • Part A coinsurance up to 365 days after Medicare benefits are exhausted
    • Part A yearly deductible
    • preventive services

    The plan sometimes includes coverage for prescription drugs with a deductible of $250 per year.

    When people were able to enroll in Medigap Plan J, they could select a high deductible option. A person would pay the higher deductible of $2,370 each year before the plan started to pay for approved costs.

    In 2003, the Medicare Prescription Drug Improvement and Modernization Act became law, and this changed the structure of benefits within Medicare.

    MMA added Medicare Part D, a prescription drug plan, to the list of available policies, creating many similarities between Part D and Plan J. Due to these similarities, sales of Plan J stopped as of June 1, 2010. However, those who still have Plan J may keep it.

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    Why Was Was Medigap Plan J Removed

    When Congress passed the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, the structure of Medicare was forever altered. Among other things, this act signaled the beginning of Medicare Part D . Because Plan J included coverage for prescription drugs, the advent of Medicare Part D made the Plan outdated.

    Rates Will Continue To Increase On Plan J

    From the perspective of an insurance company, the costs of prescription drugs for an aging population create consistent losses. The rates increase to offset the drug coverage increases the insurance company sees every year. Expenses to operate the plan are also increasing, and rates must follow for insurance companies to remain profitable.

    Medicare Part D has a more robust prescription drug plan than the former Plan J drug coverage. Medicare filled the gaps that Plan J was created for.

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    How To Switch Medigap Plans

    Switching plans is easy. Deciding is hard. We can help with both. The chart above provides the differences in all the current Plans.

    We can help you realistically analyze what you need in a plan based on your current budget and healthcare needs. Remember, supplement insurance plans do not differ between the various companies we represent. The differences are in the rates between private insurance companies and the extra services they offer. Once you pick a plan you are comfortable with, it will be time to choose the company.

    We do the comparison shopping for you and provide those options to you, so you can make the best possible decision.

    Contact us today and we can walk you through a series of questions to find the best plan. Then we will shop for the best pricing in your geographic area.

    Prefer to chat by phone? Give us a call at .

    Enroll In Your New Plan

    Understand Your Drug Costs with Medicare.gov/plan-compare

    Once you find a plan you like, simply enroll with the new provider to make the switch. Since all application data is sent through CMS, old plans are automatically canceled, says Rees.

    Your new policy will take effect on Jan. 1, 2023. And if you choose a Medicare Advantage plan and have second thoughts, theres a special Medicare Advantage open enrollment period that runs from January 1 to March 31 each year. During this time, you can switch to a different Medicare Advantage plan once or change to Original Medicare.

    Compare Top Medicare Plans From Blue Cross Blue Shield, a Forbes Health 5-Star Rated Carrier

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    When Folks Talk To Us About Their Medicare Needs We Listen

    Farm Bureau Health Plans has been protecting the health of Tennesseans for 75 years. And we’ve been serving as trusted Medicare advisors since 1966.

    Our mission has always been delivering the Medicare plan options our members are looking for plans that meet both their circumstances and budget.

    What are your Medicare plan requirements? We can help you get the coverage you need at a cost you can afford.

    Check out our wide range of plan options below.

    Medicare Advantage

    Do you want to manage all of your Medicare coverage including medical and prescription drug — with one plan? With Farm Bureau Advantage HMO, you can do just that. Plus youll have access to extras like dental, vision, hearing and a fitness membership.

    When Is The Best Time To Change Or Drop A Medigap Policy

    If a beneficiary is unhappy with their Medigap policy, they do have the option to drop or change their Medigap plan. Timing is crucial, however, in dropping or changing Medigap policies because there are instances a beneficiary may need to pay a late enrollment penalty as result.

    Note: Learn more about dropping or changing Medigap coverage at this resource.

    Read Also: At What Age Can You Start Getting Medicare Benefits

    How Do Medigap Policies Work

    After Medicare covers its agreed-upon costs, Medigap policies serve as additional coverage. Medigap pays a Medicare-approved amount of leftover costsincluding copayments, coinsurance, and deductibles. Additionally, Medigap can offer options that Original Medicare doesnt, like medical services when you travel outside of the U.S.

    There are currently 10 different Medigap plans: A, B, C, D, F, G, K, L, M, and N. However, some of these plans are no longer available to people newly enrolled in Medicaresuch as Plan J.

    What Does Medicare Supplement Insurance Cost

    Compare Medicare Supplement Plans

    The primary goal of a Medicare Supplement insurance plan is to help cover some of the out-of-pocket costs of Original Medicare . As a general rule, the more comprehensive the coverage, the higher the premium, however, premiums will also vary by insurance company, and premium amounts can change yearly.

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    Medicare Costs And Medicare Supplement

    Original Medicare doesn’t pay for everything. When you have a Medigap plan to work with Original Medicare it can help with some of the following costs that you would have to pay on your own:

    • About 20% in out-of-pocket expenses not paid by Medicare Part B for doctor and outpatient medical expenses .
    • Part A coinsurance, and most plans include a benefit for the Part A deductible
    • Hospital coverage up to an additional 365 days after Medicare benefits are used up.
    • Part A hospice/respite care coinsurance or copayment.

    What Is Medigap Plan J

    Medigap Plan J was one of several Medicare supplement plan options available to those eligible for Medicare. However, due to the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, this plan can no longer be purchased as of June 2010. If you bought this plan prior to this time, you may keep it for as long as the insurance company continues offering it.

    If you became eligible for Medicare after June 2010, there are a few current options that are similar to Plan J. Because Plan J was a very comprehensive plan, the two most similar plans offered today include Plan G and Plan N.

    For people who kept Medigap Plan J after it was no longer offered to new enrollees, the benefits include:

    • Part A coinsurance and hospital stays up to 365 days after Medicare benefits are used up
    • Part A deductible
    • prescription drug benefits

    With changes to Medicare over the years, some of this coverage is now redundant. Hospice and preventive care are now covered by Part A and Part B, respectively.

    Although Medigap Plan J had a prescription drug benefit that was unique at the time, there are now other options available, including:

    Both Medicare Part D and Medicare Advantage plans are offered by Medicare-approved private insurance companies. Review your options before making a decision on Medicare prescription coverage, because not only does coverage vary between plans, but the price does as well, including:

    • monthly premiums
    • yearly deductibles
    • copayments/coinsurance

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    Comparison Of Plan F And Plan J

    Medigap Plan J and Plan F coverage and rules are mainly standardized throughout the United States.

    However, it is important to note that if a person lives in Massachusetts, Minnesota, or Wisconsin, Medigap plans are differently standardized.

    The table below compares Medigap Plan J and Plan F coverage.

    Medigap Plan F
    yes, with payment of $250 yearly deductible

    Deductible Amount For Medigap High Deductible Options F G & J For Calendar Year 2023

    Medicare Supplement Plan N – Big News Mayo Clinic

    Summary:

    Medicare supplemental Plans F and G can be sold with a high deductible option. Before June 1, 2010, Medigap Plan J could also be sold with a high deductible. The high deductible version of Plan F is only available to those who are not new to Medicare before 1/1/2020. High deductible G is available to individuals who are new to Medicare on or after 1/1/2020. People new to Medicare are those who turn 65 on or after January 1, 2020, and those who first become eligible for Medicare benefits due to age, disability or ESRD on or after January 1, 2020.

    Effective January 1, 2023, the annual deductible amount for these three plans is $2,700. The deductible amount for the high deductible version of plans G, F and J represents the annual out-of-pocket expenses that a beneficiary must pay before these policies begin paying benefits. CMS updates the deductible amount for plans G, F and J each year, after release of the August Consumer Price Index for all Urban Consumers figures by the Bureau of Labor Statistics, which generally occurs in mid-September.

    Calculation of the Deductible:

    For Further Information:

    Contact: Martha Wagley at 410-786-3778 for actuarial issues or Derrick Claggett at 786-2113 for policy related issues.

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    Should I Switch From My Medigap Plan J To Another Medigap Plan

    As previously mentioned, beneficiaries who are currently enrolled in Medigap Plan J are allowed to remain in the plan. Only 3 percent of all Medigap beneficiaries are enrolled in Medicare Supplement Insurance Plan J.2

    So if you currently have Plan J, should you keep it?

    The first thing to consider is the plan cost. Because no new members are being accepted into Plan J, the overall plan risk pool can only increase in age and claim frequency. This may cause Plan J premiums to rise at a faster rate than other Medigap plan premiums.

    The second factor to consider is benefits. While no other Medigap plan matches the coverage of Plan J, there are a few that come close. In fact, Plan F and Plan J are nearly identical.

    Services Medicare Doesnt Cover

    • Most long-term care. Medicare only pays for medically necessary care provided in a nursing home.
    • Custodial care, if its the only kind of care you need. Custodial care can include help with walking, getting in and out of bed, dressing, bathing, toileting, shopping, eating, and taking medicine.
    • More than 100 days of skilled nursing home care during a benefit period following a hospital stay. The Medicare Part A benefit period begins the first day you receive a Medicare-covered service and ends when you have been out of the hospital or a skilled nursing home for 60 days in a row.
    • Homemaker services.
    • Most dental care and dentures.
    • Health care while traveling outside the United States, except under limited circumstances.
    • Cosmetic surgery and routine foot care.
    • Routine eye care, eyeglasses , and hearing aids.

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    What Is Medigap Insurance

    Medicare Supplement plans are insurance plans that work alongside your Medicare Part A and Part B benefits and help cover some of your Medicare deductibles, coinsurance, copays and other costs.

    Here are some key facts about Medicare Supplement Insurance:

    • Medigap insurance doesn’t typically offer any additional benefits. Instead, it picks up the out-of-pocket costs associated with Medicare.
    • Medigap insurance is accepted by any doctor, hospital or health care provider who accepts Medicare.
    • If your health care service or medical device is covered by Medicare, your Medigap plan would cover any additional out of pocket costs so that you don’t pay anything for your services .

    Open Enrollment For People Age 65 And Older

    Medicare Supplement Medigap plans and rates

    The open enrollment period for Medicare supplement plans is a six-month period during which you may buy any Medicare supplement plan offered in Texas. During this period, companies must sell you a policy, even if you have health problems. The open enrollment period begins when you enroll in Medicare Part B. You must have both Medicare parts A and B to buy a Medicare supplement policy.

    You can use your open enrollment rights more than once during this six-month period. For instance, you may change your mind about a policy you bought, cancel it, and buy any other Medicare supplement policy.

    Although a company must sell you a policy during your open enrollment period, it may require a waiting period of up to six months before it starts covering your preexisting conditions.

    Preexisting conditions are conditions for which you received treatment or medical advice from a doctor within the previous six months.

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    Why Was Medicare Supplement Insurance Plan J Discontinued

    Medicare experienced a change in 2003, when the Medicare Prescription Drug, Improvement and Modernization Act was passed. This benefits change introduced prescription drug coverage to Medicare , something that was previously only available through Medigap Plan J.1 Because Medigap plans can no longer offer prescription drug coverage, Plan J was eventually retired in June of 2010.

    This piece of legislation also added updates to Original Medicare, expanding its coverage of benefits that previously would only be covered with Medicare Plan J, such as at-home recovery care and preventive care. Without these benefits, Medigap Plan Js coverage became too similar to Plan F to warrant keeping both options.

    While no new Medicare beneficiaries may enroll for Medicare Supplement Insurance Plan J benefits, the plan remains in place for enrollees who purchased the plan prior to it being removed from the Medigap plan lineup. Enrollees who cancel their existing Medicare Supplement Insurance Plan J coverage may not re-enroll in the plan.

    Medigap High Deductible Benefits Of Plan J

    Medicare Supplement Plan J was the most comprehensive coverage of any of the supplements prior to its expiration. It filled every gap in Medicare Part A and Part B, including:

    • Medicare Parts A and Part B Deductibles
    • Medicare Parts A and Part B Coinsurance
    • Medicare Part B Excess Charges
    • Hospice Care Coinsurance
    • Part of the reason it was canceled?

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