EmblemHealth Medicare Supplement Insurance Plan A (PLH-5372MSA-19)

Plan at a Glance

  • Hospitalization: EmblemHealth pays Part A coinsurance* plus coverage for 365 additional days in your lifetime after Medicare stops paying.
  • Medical Expenses: EmblemHealth pays Part B coinsurance* (20 percent of Medicare-approved expenses), Medicare pays 80 percent.
  • Blood: First three pints of blood each year.
  • Hospice care: EmblemHealth pays Part A coinsurance.*

*Coinsurance is the portion or percentage of the cost of a Medicare covered service that you are responsible to pay.

Basic Benefits

Benefit Chart of Medicare Supplement Plans

When Benefits Begin

Once you send in your completed application with the first payment, we will verify your eligiblity and send you an identification card, a contract along with the schedule page, which will show you the effective date of your coverage.

When Benefits Begin for Current EmblemHealth Members

Coverage usually begins immediately after your previous EmblemHealth plan ends so that there is no break in your coverage. Simply complete the application and return it within 60 days of the end of your pervious coverage in order for your Medcicare Supplement plan to take effect on the termination date.

You may apply after the 60-day period, but you may have a break in coverage.

* Coinsurance is the percentage of the Medicare approved expenses that you pay.

** Part A inpatient deductible is the amount you pay for Madicare Part A hospitaliation services, including semi-private room and board, general nursing and other services and supplies during the first 60 days of a hospital stay covered by Medicare.

*** Part B annual deductible is the amount you pay for health care outside of the hospital before your plan starts to pay.

Plan F+ is a high deductible plan. If you choose this option, this means you must pay for Medicare-covered costs up to the deductible amount of $2,300 in 2019 before your Medigap plan pays anything.

Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don't result in inpatient admission.

Last Updated 10/29/18