Traditional (Basic) Medicare Supplement policies provide coverage for the out-of-pocket costs beneficiaries encounter in Medicare Parts A and B. These policies will pay after Medicare and can be used at any provider that accepts Medicare. The following riders may be attached, if eligible, to a Traditional Medicare supplement policy to modify what that policy will cover, typically adding coverage. These riders must be added at the time of purchase to avoid potential health underwriting. All riders are optional.
Part A Deductible Rider: This rider requires a Medicare Supplement policy to cover the Medicare Part A deductible in full. Medicare Part A has a deductible for each benefit period; without this rider a beneficiary is required to pay this deductible for each benefit period before Medicare starts to pay.
Part B Deductible Rider (Not Available After 1/1/2020): This rider requires the Supplement policy to pay the Part B deductible (annual deductible). It is available to any person eligible to start Medicare prior to 1/1/2020 even if Medicare enrollment was delayed.
Part B Excess Charges Rider: Providers that accept Medicare but do not accept Medicare assignment may charge up to 15% more than the Medicare-approved amount for services. The Part B excess charges rider requires the Supplement policy to cover the difference between the excess charge and what Medicare has approved as the full payment amount.
Additional Home Health Care Rider: This rider extends the Wisconsin Supplement policy coverage of 40 home health care visits up to 365 home health care visits per year (in addition to those covered by Medicare).
Foreign Travel Emergency Rider: Adds up to $50,000 per lifetime for Medicare-eligible expenses incurred outside the United States. This rider pays at least 80% of the billed charges for medically necessary emergency care. Emergency care must begin during the first 60 consecutive days outside the United States.
Note: the following riders may decrease the policy premium but may also increase out-of-pocket cost-sharing requirements if selected.
Part A 50% Deductible Rider: This rider provides coverage of 50% of the Medicare Part A deductible per benefit period.
Part B Copayment/Coinsurance Rider: This rider requires the policyholder to cover the Medicare Part B deductible, 20% copays (up to a maximum of $20) per doctor's office visit, and 20% copays (up to $50 maximum) per emergency room visit (copay is waived if the emergency room visit results in hospitalization).
Cost Sharing Medicare Supplement policy
Cost Sharing Medicare Supplement Policy (50% or 75%): These policies include full Medicare Supplement benefit coverage after the annual Medicare Part B deductible and out-of-pocket limit have been met. Out-of-pocket costs that count towards the limit are determined based on the 20% Original Medicare does not cover being shared between the policyholder and insurer. This cost sharing is either 50% insurer and 50% policyholder or 75% insurer and 25% policyholder. Out-of-pocket limits change each year.
High Deductible Medicare Supplement Policy
High-Deductible Medicare Supplement Policy: These policies require policyholders to pay all costs after Medicare on Medicare-approved services (typically 20%) until the deductible is met. Once the policy deductible is met, the supplement policy will cover the costs after Medicare pays for covered services. The policyholder is responsible for the Medicare Part A deductible and the Part B deductible until their policy deductible is met. The deductible amount can change each year.
Note: High-deductible policies include all of the above Traditional policy riders (other than cost sharing) once the deductible is met.
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