Medicare Supplement Plan E is a former Medicare supplement insurance (Medigap) plan that has not been available to new enrollees since 2010. However, if a person already has Plan E, they may keep it.
Original Medicare pays for most, but not all, healthcare costs. Medigap plans help cover some of the remaining costs that a person may otherwise have to pay for out of pocket.
Since 2010, those new to Medicare have been unable to enroll in Plan E. If a person enrolled in Plan E before 2010, they may keep their Plan E policy. However, some of these individuals may wish to switch plans, as less costly options may now be available.
We may use a few terms in this piece that can be helpful to understand when selecting the best insurance plan:
- Deductible: This is an annual amount that a person must spend out of pocket within a certain time period before an insurer starts to fund their treatments.
- Coinsurance: This is a percentage of a treatment cost that a person will need to self-fund. For Medicare Part B, this comes to 20%.
- Copayment: This is a fixed dollar amount that an insured person pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
Medicare-approved private health insurance companies administer Medigap plans, which help fill any gaps that original Medicare has in its coverage. These coverage gaps include:
- copayments
- coinsurance
- deductibles
- excess charges
Medigap plans do not help with Medicare premium costs.
Different Medigap plans have various benefits and levels of coverage. Covered expenses may include:
- deductibles for a hospital stay
- coinsurance for a skilled nursing facility (SNF)
- emergency healthcare that a person receives outside the United States
- at-home recovery
- some preventive care
- excess charges
The Medigap policies available today have different benefits than those that companies sold before June 1, 2010.
If a Medigap plan is no longer available, a person can keep it, and the private insurance company that administer the policy are required to renew it.
This Medigap plan benefits chart gives an overview of the benefits of all of the Medigap plans that people could purchase between July 31, 1992, and May 31, 2010.
Medicare Plan E is a Medicare supplement (Medigap) plan that is no longer available to new enrollees in Medicare. However, some of the people who purchased this plan before its discontinuation still have it.
What does Plan E cover?
The benefits of Plan E include coverage of:
- Part A copayment
- Part B coinsurance
- the first 3 pints of blood that a person may need
- Part A deductible
- SNF daily copayment
- 80% of emergency care costs outside the U.S.
- up to $120 per year for extra preventive care that original Medicare does not cover
As of June 1, 2010, private insurance companies offering Medicare supplement insurance have not been able to sell Plan E policies.
Before 2003, original Medicare did not cover certain types of durable medical equipment (DME) or some home healthcare, and Medigap Plan E helped cover some of these costs.
In 2003, Congress passed the Medicare Prescription Drug, Improvement, and Modernization Act, which saw an increase in original Medicare coverage. Added benefits included at-home recovery and new preventive care options.
The passing of this Act made the benefits of Medigap Plan E redundant, which meant that insurers could no longer offer the plans.
However, many of the current Medigap plans offer greater benefits that may make them more cost effective for an individual.
If a person already has Medicare Plan E, they can keep the policy, and their plan provider should renew the plan each year.
As Plan E has no new enrollees, relatively few people have this plan. Due to this and the higher claim spend, a person could pay more for their monthly premium than those enrolled in other Medigap plans.
Most current Medigap plans offer similar coverage to Plan E, and a person may receive extra benefits. Switching to another policy could, therefore, prove cost effective.
A person looking for further advice may wish to talk with an insurance company that provide Medicare supplement insurance or their local State Health Insurance Assistance Program (SHIP).
As of 2021, 10 Medigap plans are available. However, plans C and F are not available to those who became eligible for Medicare after January 1, 2020.
Medigap Plan D and Plan G are popular alternatives to Plan E.
Medigap Plan D covers:
- Part A coinsurance
- Part B coinsurance or copayment
- the first 3 pints of blood
- Part A hospice care coinsurance or copayment
- SNF care coinsurance
- Part A deductible
- 80% of foreign travel emergency care (up to plan limits)
Medigap Plan G covers everything above, plus Part B healthcare provider excess charges. Some states offer Plan G as a high deductible plan.
Anyone considering switching to another Medicare supplement plan can search and compare plans using Medicare’s plan comparison tool.
As of 2010, Medicare Supplement Plan E is unavailable to new enrollees, but a person who already has Plan E can keep it.
Benefits that were only available in Plan E are now available under original Medicare, which led to the withdrawal of the policy.
Medigap plans D and G are popular alternatives to Plan E, as they offer similar coverage.
A person can compare all available Medigap plans online, but a SHIP may be able to offer further advice.