Medicare Supplements

 

 

How Medicare Supplement Prices are Determined

 

Insurance companies calculate their rates under three pricing structures. The table below shows how they work. Most companies in Indiana use the Attained Age rate structure. Some companies also use gender and smoking status in determining premiums. People switching Medicare Supplement policies may find companies using their medical history to set their premiums.

 

Type of Pricing How it’s Priced What this Means Examples
Attained Age Premium based on
your current age
Premiums increase
with age as well as
inflation and other
factors.
Mr. Smith’s
premium at age 65
is $120.
At 67 it is $130
At 72 it is $145
Community Rated Generally the same
premium is charged
to everyone enrolled
in the plan in that
community.
Premiums are not
based on age.
Increases occur
based on inflation
and other factors
Mrs. Jones at age 65
has the same $190
premium as Mr. Till
who is 89.
Issue Age Premium is based
on the age in which
you purchase the
policy
Premiums are lower
for people who buy
at a younger age.
Premiums increase
based on inflation
and other factors.
Mrs. Tam buys a
policy at age 65 and
pays a $150
monthly premium.
Mr. Green buys the
same policy at age
72 and pays $180
per month.
Medicare Supplement Plan Benefit Chart

 

All plans include these basic benefits:

  • Hospitalization – Part A coinsurance plus an additional 365 days of benefits after Medicare benefits end
  • Medical Expenses – Will pay for part or all of Part B coinsurance or co-payments for hospital outpatient services
  • Blood – First three pints of blood each year
  • Hospice – Part A coinsurance
Percentage of Benefit the Plan Pays
A B C D F G K L M N
Hospitalization2 100% 100% 100% 100% 100% 100% 100% 100% 100% 100%3
Skilled Nursing
Facility
Coinsurance
100% 100% 100% 100% 50% 75% 100% 100%
Part A
Deductible
100% 100% 100% 100% 100% 50% 75% 50% 100%
Part B
Deductible
100% 100%
Part B
Coinsurance
100% 100% 100% 100% 100% 100% 50% 75% 100% 100%3
Preventative
Care
100% 100% 100% 100% 100% 100% 100% 100% 100% 100%
Part B Excess
Charges
100% 100%
Foreign Travel
Emergency
80% 80% 80% 80% 80% 80%
Out-of-pocket
limit; 100%
paid after limit
$4,960 $2,480

 

1. Plan F also has a high deductible option. High Deductible Plan F offers the same benefit as Plan F after an annual deductible of $2,180 is met. Foreign Travel Emergency expenses are not counted toward
the $2,180 deductible.

2. Does not include Part A deductible.

3. Plan N requires a $20 copayment for office visits and up to a $50 copayment for an ER visit.

Selecting a Medicare Supplement

 

1. Which benefits do you want covered by your Medicare Supplement? Each plan offers a unique set of benefits. All plans cover Part A coinsurance and preventative care Part B coinsurance.

2. What is the financial strength of the insurance company?

3. How long has the insurance company been offering Medicare Supplements?

4. What is the price of the plan? Remember plans are standardized so a Plan F is exactly the same, regardless of the company offering it

5. How is the plan’s pricing based? Is it Attained Age, Community Rated or Issue Age?

6. What is the company’s history of rate increases?

7. If you are switching Medicare Supplement plans, how does the company underwrite applications? Do they accept or deny, or due they increase premiums based upon medical conditions?