What is a Medicare Supplement?
Simply put, Medicare doesn’t cover all of your medical expenses. Medicare typically covers roughly 80% of allowable charges (excluding drugs), and you are generally responsible for the other 20%. A Transamerica Medicare Supplement can help cover all or part of that 20%. Transamerica offers several different supplement plans to help cover those extra charges.
Are all supplements the same?
No. There are 10 different standardized Medicare Supplement plans, and federal and state laws regulate each plan. The plans are A, B, C, D, F, G, K, L, M, and N. There is also a “high deductible” plan F. Each plan differs from the others in how much of your responsibility it covers. Carriers are not required to offer all ten plans.
Which plans does Transamerica offer?
Transamerica offers plans A, G, F, and N. For a brochure of what each plan covers, click the following pdf:
Transamerica Supplement Brochure
What benefits are covered?
Hospital Coverage
Plans F, G and N pay the Part A (inpatient) deductible for each benefit period. For 2019, the deductible is $1,364.
For the first 60 days of hospital confinement, Medicare pays all eligible hospital expenses beyond the Part A deductible. Eligible expenses are items such as a semi-private room and board, general nursing and
miscellaneous hospital services, and supplies.
Beginning with the 61st day of confinement, and running through the 90th day, Medicare pays all but $341 (as of 2019) per day. Plans A, F, G, and N cover this $341 co-insurance.
When you are hospitalized from the 91 st day through the 150th day, Original Medicare covers all but $682 per day if you have not already used your 60 days of lifetime reserve coverage. The Transamerica Medicare supplement plans (A, F, G, and N) cover that $682 per day co-insurance.
If you are in the hospital longer than 150 days during a benefit period and you have exhausted your 60 days of lifetime reserve coverage offered by original Medicare, the supplement plans A, F, G, and N will continue to pay the Part A Medicare eligible expenses for hospitalization, up to a lifetime maximum additional 365 days.
When a patient needs blood, original Medicare pays for all but the first three pints each year. The Transamerica Medicare supplement plans A, F, G, and N cover this first three pints of blood.
Skilled Nursing Care
Original Medicare pays for eligible expenses in a skilled nursing facility for up to 20 days. For days 21 through 100, Medicare pays all but $170.50 per day (as of 2019). The Transamerica Medicare supplement plans F, G, and N pay up to $170.50 from the 21st through the 100th day. (Note: Plan A does not cover skilled nursing care). In order to qualify for skilled nursing care, you must enter a Medicare certified skilled nursing facility within 30 days of being hospitalized for at least three days.
Hospice Care
Original Medicare pays all but a very limited co-insurance/co-payment for outpatient drugs and inpatient respite care. Plans A, F, G, and N pay the co-insurance/co-payment.
Part B Deductible
For 2019, the Medicare Part B deductible is $185. Plan F pays this deductible.
Physicians Services and Supplies
Original Medicare generally pays 80% of eligible expenses for physician services, supplies, tests, physical and speech therapy, and durable medical equipment. Plans A, F, G, and N cover 20% of eligible expenses after the Part B deductible (Plan F covers the Part B deductible as well). Plan N pays the balance except for a $20 per office visit and $50 emergency room co-pay.
Excess charges
In the event that your bill for Part B services exceeds the Medicare eligible amount, Plans F and G pay 100% of the excess, up to the limitation established by Medicare.
Emergency Care While Out of the Country
Generally, Original Medicare does not cover medical services received while out of the country. Plans F, G, and N will pay 80% of eligible expenses incurred during the first 60 days of a trip up to a lifetime maximum of $50,000.
Can I be dropped?
Your policy is guaranteed renewable, and therefore you cannot be dropped so long as the information provided on your application is accurate and premiums are paid in a timely manner.
Can I be singled out for a rate increase?
No. Premium increases are tied to the plan you are enrolled in, the other policyholders in your classification, and the your geographic area. You cannot be singled out for a rate increase, no matter how often you use medical services.
What is the Transamerica Medicare Supplement refund policy?
You have thirty days to review your policy, once it goes into effect. If you aren’t 100% happy Transamerica will refund your premium.
