Original Medicare is a fantastic program for its beneficiaries. Providing fairly comprehensive coverage and allowing you to see any doctor in the United States who accepts Medicare. However, it has limitations: for example, some Medicare recipients find the 20% Medicare Part B coinsurance, along with other out-of-pocket expenses, unaffordable. But there is something you can do to avoid the out-of-pocket costs of Original Medicare: enroll in a Rhode Island Medicare Supplement Plan.
While the government controls Original Medicare, private insurance companies sell Medicare Supplement Plans. These plans typically cover major out-of-pocket expenses. Such as your Part A deductible and 20% coinsurance for Part B. Furthermore, the government standardizes these plans so that you’ll always know what you’re getting. The Centers for Medicare & Medicaid Services (CMS) regulates Medicare Supplement Plans. They require that all plans with the same letter name provide the same coverage across the country.
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Having said that, benefits will not vary, but premiums will vary depending on the insurance company you choose, so it is critical to compare both Medicare Supplement Plans and insurers to find the best plan for you. EZ can help you compare both, but first read our guide to Rhode Island Medicare Supplement Plans.
Rhode Island Medicare Supplement Plans
If you need more coverage to fill the gaps in Original Medicare a Medicare Supplement Plan is your best option.
So, if you’re looking for a Medicare Supplement Plan in Rhode Island, you should know that there are ten different standardized plans available. Each named with a different letter of the alphabet (A, B, C, D, F, G, K, L, M, and N). The government requires that Plan A be offered by all insurance companies that sell Medicare Supplement Plans. Plans C and F are only available to people who became eligible for Medicare before January 1, 2020.
You will be required to pay a monthly premium for one of these plans. But in return, you will get coverage for a significant portion of your out-of-pocket medical expenses. In Rhode Island, monthly premiums range from $49 to $500, depending on the plan and your location.
It can be difficult to keep track of everything with so many options available. We’ve outlined what each plan covers and how it works in Rhode Island to help you get started.
Plan A
Plan A is the most basic Medicare Supplement Plan. But even though it is relatively bare bones, it will cover one of the biggest gaps in Original Medicare coverage: the 20% of outpatient treatments that Medicare Part B requires you to pay. It also covers some other major expenses, as outlined below.
All Medicare Supplement Plan insurance carriers must offer Plan A, but some states do not require insurers to offer it to Medicare disability beneficiaries under the age of 65.
In Rhode Island, Plan A premiums range from $78 to $409 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.
Plan B is a step up from Plan A, though, because it covers the Medicare Part A hospital deductible, which Plan A does not. In 2023, the Medicare Part A deductible is $1,600 per benefit period; you must meet this deductible for each 60-day hospital stay rather than annually, so you may be required to pay it multiple times in a single year. As a result, having a plan that covers this could be extremely beneficial to you.
In Rhode Island, monthly premiums for Plan B range from $120 to $345.
Plan C
This is one of the most comprehensive Medicare Supplement Plans, but not all beneficiaries are eligible for it. The only thing Plan C does not cover is Medicare Part B excess charges, or the amount you must pay if your doctor refuses to accept Medicare assignment and charges more than the Medicare-approved amount for services. In this case, you will be responsible for the difference (known as an excess charge), and only certain plans will cover this cost. Part C is not among them.
But because excess charges are the only exclusion to coverage, Plan C covers both 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, and 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 $145 to $414 in Rhode Island.
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 Rhode Island, monthly Plan D premiums can cost between $127 and $291.
Plan F
Plan F has long been the most popular Medicare Supplement Plan on the market, but 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 beneficiaries who became eligible after January 1, 2020. If you were eligible for Medicare before 2020, you can purchase one of these plans; if you have already purchased Plan F and are grandfathered in, you can keep it indefinitely.
Monthly premiums for Plan F range between $132 and $417 in Rhode Island.
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 Plan G does not cover is the Medicare Part B deductible. The good news is that Plan G premiums in Rhode Island range from $123 to $399 per month, making these plans a better deal than Plan F.
Plan K
Medicare Supplement Plan K reduces the out-of-pocket costs of Original Medicare but does not fill all gaps. Plan K only covers half of certain expenses until you reach your out-of-pocket maximum. Because most other plans do not have an annual out-of-pocket maximum, this can be an appealing feature.
Plan K’s annual out-of-pocket maximum is $6,620 (as of 2023). Once you have spent that amount in a given year, Plan K will cover the remaining approved costs for that year. Your maximum will be reset at the start of each year.
When it comes to coverage, 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 Rhode Island are relatively low, ranging from $44 to $139.
Plan L
Medicare Supplement Plan L, like Plan K, covers the majority, but not all, Original Medicare-related expenses, although it covers them at a higher percentage than Plan K does. It also has a lower out-of-pocket maximum ($3,310 in 2023) than Plan K, which means that once you’ve paid this amount in covered expenses for the year, your insurer will pay the rest of your medical bills.
Plan L covers all Medicare Part A coinsurance and hospital costs in full. It also covers a portion of the following:
- 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 $81 and $235 a month in Rhode Island.
Plan M
Medicare Supplement Plan M covers the majority, but not all, costs associated with Original Medicare. But it fully covers a lot more expenses than either Plan K or Plan L does, making it a more comprehensive plan.
Medicare Supplement Plan M covers all coinsurance and hospital costs associated with Medicare Part A. It also covers:
- 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.
Plan M premiums cost between $117 and $305 a month in Rhode Island.
Plan N
Medicare Supplement Plan N fills the vast majority of Original Medicare gaps. 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, are the only exceptions. But unlike with other plans, you may have to pay copayments with Plan N.
This means that Medicare Supplement Plan N covers 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 $85 to $307 a month in Rhode Island.
When To Enroll
When you turn 65 and enroll in Original Medicare, you will be given a six-month window during which coverage for Medicare Supplement Plans is “guaranteed issue”. This means that insurance companies will not be able to deny you or charge you more for coverage based on your health.
With that being said, federal regulations do not guarantee access to a Medicare Supplement Plan if you are under 65 and eligible for Medicare due to a disability. Rhode Island is one of the states where Medicare Supplement insurers don’t have to offer plans to disabled beneficiaries under the age of 65, and very few Rhode Island Medicare Supplement insurers do so voluntarily.
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 give you all the guidance you need. EZ can assist you in enrolling in Medicare, comparing Medicare Supplement Plans, or simply weighing your options. Our agents work with the best insurance companies in the country. 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.
