What You Need To Know About Medicare Supplement Plan J

What You Need To Know About Medicare Supplement Plan J

Should you keep your Medicare supplement Plan J or compare other plans?

Oftentimes referred to as Medigap Supplement Plan J, Medicare Supplement Plan J covers certain costs that are not covered in basic Medicare benefits coverage. Unfortunately, Plan J is no longer available (effective May 31, 2010). However, the plan will remain in effect for those individuals who were enrolled in it by the 1st of June, 2010. Additionally, there is a separate $250 annual deductible.

What Does Plan J Cover?

As with any Medicare Advantage or Medigap Insurance plans, Plan J covered certain gaps in Medicare Part A and B coverages. This includes:

• at-home recovery

• care provided by skilled nursing facilities

• emergency care when traveling overseas

• excess Part B charges/expenses

• Medicare co-insurance (Part B)

• Part A and B deductibles

• up to $120 of preventative care that Medicare does not cover

What The Plan Does Not Cover

Unfortunately, there are certain health care issues that are not covered by Plan J (according to the Centers for Medicare and Medicaid Services) including the following:

• dental care

• eyeglasses

• hearing aids

• long-term nursing home care

• private-duty nursing

• vision care

The bottom line is that the elimination of Plan J resulted from the need to modernize the entire Medicare Insurance infrastructure.

Elimination By Default

It has oftentimes been said that Plan J was simply eliminated by default because there were two benefits covered that were similar to the ones covered by Plan F. Plan F has oftentimes been considered the most comprehensive of all the MA/Medigap plans. The two specific benefits that set Plan J apart from Plan F are at-home recovery and preventative care. The Centers for Medicare & Medicaid Services have eliminated these two coverages due to a lack of use. Therefore, Plan J was eliminated because of this duplication.

Additional Considerations

It is important to note that existing Plan J policy holders who are not affected by the above will be subject to what is referred to as a “closed block of business”, meaning that no new policies will be offered after the June 1st eligibility date. There is considerable speculation that the rates for Plan J coverage are going to increase as a result of the above. Although this does make sense to some, the impact on current policy holders remains to be seen. It is a good idea for anyone who has Plan J to evaluate the current Medigap Plans available and compare the benefits and premiums to what they are currently paying. They may be surprised to learn they can save money and get comparable benefits to Plan J.


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