South Carolina Life and Health Practice Exam

What must a Medicare Supplement policy avoid including?

1. Duplicate Medicare benefits

2. Additional hospitalization coverage

3. Extended nursing care benefits

4. Long-term care insurance options

The correct answer is: Duplicate Medicare benefits

A Medicare Supplement policy, often referred to as Medigap, is specifically designed to fill in the gaps of coverage that are not provided by Medicare. An essential aspect of these policies is that they must avoid including duplicate benefits that are already covered under Medicare. This means that the Medigap plans cannot offer benefits that replicate what Medicare offers, such as hospital stays or physician services, because this would not serve the intended purpose of supplementing—but rather overlapping—Medicare coverage. The goal of a Medigap policy is to help pay for deductibles, coinsurance, and other out-of-pocket costs that Medicare does not cover. Thus, including duplicate Medicare benefits in a Medigap policy could lead to unnecessary confusion and conflicts in coverage, potentially causing beneficiaries to pay more than needed for their healthcare services. Ensuring that Medicare Supplement policies do not duplicate these benefits maintains clarity in what the coverage provides, and keeps the focus on supplementing Medicare rather than replicating its offerings. The other options, while relevant to the insurance landscape, do not directly align with the regulatory requirements surrounding what a Medicare Supplement policy must avoid including. For instance, additional hospitalization coverage or extended nursing care benefits can be part of supplemental options or separate policies but do not explicitly