Original Medicare is a great program for its beneficiaries, providing fairly comprehensive coverage, and allowing you to see any doctor who accepts Medicare nationwide. But it has its limitations: in fact, some Medicare recipients find the 20% Medicare Part B coinsurance, in addition to other out-of-pocket expenses, to be unaffordable. But there is something you can do to avoid the out-of-pocket expenses of Original Medicare: get supplemental coverage with a Delaware Medicare Supplement Plan.
While the government administers Original Medicare, Delaware Medicare Supplement Plans are sold by private insurance companies to fill the coverage gaps left by Medicare Parts A and B. These plans typically cover major out-of-pocket expenses like your Part A deductible and 20% Part B coinsurance. And the government standardizes these plans, so you’ll always know what you’re getting. In fact, the Centers for Medicare & Medicaid Services (CMS) regulates Medicare Supplement Plans and mandates that all plans with the same letter name provide the same coverage nationwide.
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With that being said, benefits won’t vary, but premiums can vary based on the insurance company you select, so it is essential to compare both Medicare Supplement Plans and insurers to find the best plan for you. EZ can assist you with comparing both, but first you should review our guide to Delaware Medicare Supplement Plans.
Delaware Medicare Supplement Plans
A Medicare Supplement Plan is your best option if you need more coverage to fill any gaps in Original Medicare, such as the 20% coinsurance you must pay each time you access Medicare Part B services.
So, if you’re looking for a Medicare Supplement Plan, you should know that there are 10 different standardized plans available in Delaware, each of which is designated by a different letter of the alphabet (A, B, C, D, F, G, K, L, M, and N). All insurance companies that sell Medicare Supplement Plans are required to offer Plan A. Plans C and F are only available to those who became Medicare eligible prior to January 1, 2020.
You will have to pay a monthly premium for one of these plans, but in return, you will get a significant portion of your out-of-pocket medical expenses covered. Monthly premiums in Delaware range from $49 to $500, depending on the plan and location.
With so many options available, it can be difficult to keep track of everything. To help you get started, we’ve outlined what each plan covers and how it operates in Delaware.
Plan A
Plan A is the most basic Medicare Supplement Plan available. But despite its simplicity, it will cover what is arguably the most important aspect of Medicare Supplement Plans: the 20% of outpatient treatments that you are required to pay by Medicare Part B. Plan A must be offered by all Medicare Supplement Plan insurance carriers, but some states do not require insurers to offer it to Medicare disability beneficiaries under the age of 65.
Medicare Supplement Plan A premiums in Delaware range from $89 to $438 per month.
Plan B
Medicare Supplement Plan B covers all the basics that Plan A does, including:
- Medicare Part A coinsurance and hospital costs – Part A only fully covers your first 60 days of inpatient hospital stays in a benefit period, after that you are required to pay a portion of your bills for each day after your initial 60 days. Days 61-90 have a coinsurance of $400 a day. If your stay is between 91 and 150 days, and you use your Lifetime Reserve days, your coinsurance will be $800 a day. Plan B covers 100% of these costs.
- Medicare Part B coinsurance or copay – You’ll typically have to pay Medicare Part B coinsurance for doctor visits and other outpatient care. That means Medicare Part B pays 80% of the Medicare-approved amount for covered services, leaving you to pay the remaining 20%. Plan B covers 100% of this.
- First 3 pints of blood – Original Medicare only pays for the fourth and subsequent pints of blood if you need blood during treatment. Plan B will pay for the first three pints.
- Part A hospice care and coinsurance – Hospice care is for patients who are nearing the end of their lives. These services are covered by Medicare, but copayments are required. These copayments include $5 for each symptom and pain relief medication prescription, as well as 5% of the Medicare-approved amount for inpatient assisted living. Plan B covers all expenses related to hospice care.
What makes Plan B a little less basic than Plan A is that it covers the Medicare Part A hospital deductible, which Plan A does not. The Medicare Part A deductible is $1,600 per benefit period in 2023; you will need to meet this deductible for every 60-day hospital stay, as opposed to on an annual basis, so you may be required to pay it multiple times in a single year. That means having a plan that covers this could be very beneficial for you.
Monthly premiums for Plan B in Delaware range from $111 to $377.
Plan C
This is one of the most comprehensive Medicare Supplement Plans, but it is not available to all beneficiaries. The only thing that Plan C does not cover is Medicare Part B excess charges, or the amount you will have to pay if your doctor does not accept Medicare assignment and chooses to charge more than the Medicare-approved amount for services. If they do so, you will have to pay the difference (called an excess charge), and only select plans will cover this expense. Part C is not one of them.
But, since excess charges are the only exclusion, this means that Plan C covers your Parts A and B deductibles, as well as the 20% coinsurance you would normally be responsible for paying for all outpatient care.
Part C covers all of the following:
- Part A hospital deductible and coinsurance
- Hospital costs up to an additional 365 days after Medicare benefits are exhausted
- Part A hospice care coinsurance or copayment
- Blood (the first 3 pints)
- Other Medicare-approved expenses associated with Part A hospitalization
- Medicare Part B coinsurance and copayments
- Part B deductible
- Other Medicare-approved expenses associated with Part B coverage
Again, Plan C is no longer available to Medicare recipients who became eligible for Medicare after January 1, 2020. If you had Plan C prior to that date, you can keep it. Additionally, if you were Medicare-eligible prior to January 1, 2020 but have not yet enrolled, you may still be able to purchase it.
Monthly premiums for Plan C range from $150 to $423 in Delaware.
Plan D
Plan D covers the majority of out-of-pocket expenses related to Original Medicare, including:
- Part A hospital coinsurance and hospital costs up to an extra 365 days after Original Medicare benefits are exhausted
- Part A hospice care coinsurance or copayment
- Part B coinsurance
- First 3 pints of blood
- Skilled nursing facility (SNF) care coinsurance – After the 20th day of your stay as an inpatient in a skilled nursing facility, Medicare Part A requires you to pay coinsurance. Part A coinsurance for skilled nursing facility care is $200 per day in 2023.
- Part A deductible
- 80% of foreign travel emergency costs (up to plan limits)
Medicare Supplement Plan D does not cover Medicare Part B deductibles or excess charges.
In Delaware, monthly Plan D premiums can cost between $109 and $319.
Plan F
Plan F has long been the most popular Medicare Supplement Plan on the market. However, like Plan C, it is not available to all beneficiaries. It covers all out-of-pocket expenses, so if you have this plan you will only pay the monthly premium for Plan F.
The expenses covered include:
- Part A hospital deductible and coinsurance
- Hospital costs up to an additional 365 days after Medicare benefits are exhausted
- Part A hospice care coinsurance or copayment
- Blood (the first 3 pints)
- Other Medicare-approved expenses associated with Part A hospitalization
- Medicare Part B 20% coinsurance and copayments
- Medicare-approved doctor’s office fees
- Part B deductible
- Medicare Part B excess charges
- Other Medicare-approved expenses associated with Part B coverage
Plan F is not available to Medicare-eligible individuals who became eligible after 2020. If you were eligible for Medicare before 2020, you can purchase one of these plans. Additionally, if you have already purchased Plan F and are grandfathered in, you can keep it indefinitely.
Monthly premiums for Plan F range between $147 and $500 in Delaware.
Plan G
If you like the sound of Plan F, but are not eligible to purchase one of those plans, look into Plan G. This plan covers almost everything that Plan F does, including:
- Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up
- Part A deductible
- Part A hospice care coinsurance or copayment
- Part B coinsurance or copayment
- Part B excess charges (if a provider is permitted to charge more than Medicare’s approved amount and does so)
- Blood transfusion (first 3 pints)
The only thing not covered by Plan G is the Medicare Part B deductible. The good news is that Plan G premiums are generally very affordable, ranging from $122-$410 per month in Delaware, making these plans a better deal than Plan F.
Plan K
Medicare Supplement Plan K reduces Original Medicare out-of-pocket costs. However, it does not fill all the gaps. Plan K only covers 50% of certain expenses until you reach your out-of-pocket maximum. Most other plans do not have an annual out-of-pocket maximum. So, this can be an attractive feature for those worried about medical expenses piling up.
The maximum annual out-of-pocket limit for Plan K is $6,620 (as of 2023). Once you spend that amount, Medicare Supplement Plan K will cover the remainder of the year’s approved costs. Your maximum will be reset at the beginning of every year.
Plan K covers a portion of the following:
- Medicare Part B coinsurance – Plan K covers half of these costs, so you will be responsible for 50% of your 20% coinsurance. For example, if your doctor charges $100 for a service, Medicare will cover $80, Plan K will cover $10, and you will cover the remaining $10.
- First 3 pints of blood
- Part A hospice care coinsurance or copayment – Plan K will pay for half of these costs.
- Skilled nursing facility care coinsurance – Plan K pays half of the coinsurance for medical care in skilled nursing care facilities.
- Medicare Part A deductible – Medicare Supplement Plan K will pay half of these deductibles, or $800.
So, because of its 50% coverage, Plan K requires you to pay more out-of-pocket than other plans. But its out-of-pocket maximum will mean that you won’t ever have to pay more than $6,620 a year.
In addition, while Plan K covers the majority of expenses at a rate of 50%, it covers 100% of Medicare Part A coinsurance. This is the only basic benefit fully covered by Medicare Supplement Plan K.
Plan K’s monthly premiums in Delaware are relatively low, ranging from $49 to $141.
Plan L
Like Plan K, Medicare Supplement Plan L also covers the majority, but not all of, Original Medicare-related expenses. It also has an out-of-pocket maximum, which is lower than Plan K’s ($3,310 in 2023), which means that once you’ve paid this amount in covered expenses for the year, your insurer will pay the remainder of your medical bills.
Plan L provides full coverage for all Medicare Part A coinsurance and hospital costs. It also covers a portion of:
- Medicare Part B coinsurance – Plan L covers 75% of your Part B coinsurance.
- Blood – If you require blood while in the hospital, Plan L will cover 75% of the cost of the first three pints.
- Part A hospice care copayments – Plan L pays 75% of your Part A copays for hospice care.
- Skilled nursing facility care coinsurance – Plan L pays 75% of the $200 per day (after the 20th day of your stay) coinsurance for medical care in skilled nursing care facilities.
- Part A deductible – Medicare Supplement Plan L will cover 75% of your Part A deductibles for each 60-day benefit period. You must still meet your Medicare Part B deductible, which is $226 per year in 2023, if you choose Plan L.
Plan L premiums are also competitive, costing between $82 and $300 a month in Delaware.
Plan M
Medicare Supplement Plan M covers the majority, but not all, costs associated with Original Medicare.
Medicare Supplement Plan M covers all coinsurance and hospital costs associated with Medicare Part A. It also includes:
- Medicare Part B coinsurance – Plan M pays your Part B coinsurance and/or copayments in full.
- Blood – If you require blood while in the hospital, Medicare Supplement Plan M will cover the first three pints of blood in full.
- Part A hospice care coinsurance or copayment – Plan M will cover all of your hospice care coinsurance and copays in full.
- Skilled nursing facility care coinsurance – Plan M covers the entire cost of Part A skilled nursing facility coinsurance.
- Part A deductible – Medicare Supplement Plan M will cover half of your Medicare Part A deductible. If you have Plan M, you will have to pay half of the $1,600 (or $800) deductible rather than the full $1,600.
Plan M premiums cost between $122 and $333 a month in Delaware.
Plan N
Medicare Supplement Plan N fills the majority of gaps in Original Medicare. The only exceptions are the Medicare Part B deductible ($226 in 2023) and any Medicare Part B excess charges. Which are portions of doctor bills that exceed the Medicare-approved amount. But unlike other plans, you might have to pay copayments with Plan N.
This means that Medicare Supplement Plan N includes coverage for the following:
- Medicare Part B coinsurance – Plan N will cover your Part B coinsurance costs in full, with the exception of a copayment of up to $20 for some office visits. For emergency room visits that do not result in an inpatient admission, a second copayment of up to $50 may be required.
- Blood – If you require blood while in the hospital, Medicare Supplement Plan N will cover the first three pints.
- Part A hospice care coinsurance or copayment – Plan N pays your hospice care coinsurance and copayments in full.
- Skilled nursing facility care coinsurance – Your skilled nursing facility coinsurance will be fully covered by Medicare Supplement Plan N.
- Part A deductible – Medicare Supplement Plan N pays your $1,600 deductible in full for each 60-day benefit period.
- Foreign travel emergency care – Original Medicare typically does not cover medical care received outside of the United States. If you need emergency care while traveling outside of the United States, Medicare Supplement Plan N will cover 80% of the costs of qualified emergency medical care.
Plan N premium prices range from $91 to $314 a month in Delaware.
When To Enroll
While there are technically multiple times when you can choose to enroll in a Medicare Supplement Plan, there is one time that will be most beneficial to you. This is your Medicare Supplement Open Enrollment Period. Which is the 6-month window that opens up to you when you turn 65 and enroll in Original Medicare.
You should purchase your Medicare Supplement Plan during this time because you will be given “guaranteed issue rights”. This means that insurers cannot use medical underwriting to determine eligibility or premiums. In other words, insurance companies will not be able to deny you coverage or charge you more because of health conditions. So, it’s important to take advantage of your Medicare Supplement Open Enrollment Period.
If you’re under 65 and on Medicare, you should know that Delaware is one of the states that requires insurers to offer Medicare Supplement Plans to people under the age of 65 who have a qualifying disability. But premiums will be higher for those under 65.
How To Choose
When it comes to Medicare coverage, don’t be afraid to ask questions. Speak to an EZ agent who can explain everything to you and tell you what you need to do to sign up. EZ can assist you in enrolling in Medicare, comparing Delaware Medicare Supplement Plans, or simply weighing your options. Our agents work with the best insurance companies in the country. So, they can provide you with a free comparison of all available plans in your area. We will go over your medical and financial needs with you and help you find a plan that works for you. To get started, simply enter your zip code in the bar below or give one of our licensed agents a call at 877-670-3602.
