Medigap Plans A to N: Your Guide to Medicare Supplement Insurance

Medigap Plans A to N

Medicare Supplement Insurance, commonly referred to as Medigap, helps pay some of the healthcare costs not covered by Original Medicare (Parts A and B). The plans are offered by private insurance companies that have been approved by Medicare.

Medigap plans are standardized. That means that, no matter which insurance company you choose, Plan A will always be the same, as will the other nine plan options. Pricing, however, varies from provider to provider.

Unlike Medicare Parts A, B, C, or D, you must go through a process called medical underwriting to buy Medicare Supplement Insurance. That means that the insurance company may refuse to sell you a policy, or charge you a higher rate, if you have health conditions it considers high risk. The only time you can buy a Medigap policy without undergoing medical underwriting is during your Medigap Open Enrollment Period. This period lasts for six months after you enroll in Medicare Part B and are aged 65 or older.

If you have a Medicare Advantage plan, Medicare does not allow any insurance company to sell you a Medigap plan.

Medigap Plan A

All insurance companies that offer Medicare Supplement Insurance must offer Medigap Plan A. This is not the most comprehensive plan, but it does allow beneficiaries to pay only for those benefits that they think they’ll use.

Plan A covers 100 percent of the costs for:

  • Part A co-insurance for 365 days after Medicare benefits run out
  • Co-insurance and co-payments for Part B
  • The first three pints of blood in a transfusion
  • Hospice care co-insurance and co-payment

There is no out-of-pocket limit for Plan A. However, it does not cover co-insurance for skilled nursing facility care, the deductibles for Parts A and B, or any Part B excess charges. Excess charges are any fees your provider charges that exceed the Medicare-approved amount. Plan A also does not cover any medical care you receive while traveling in another country.

Medigap Plan B

Medigap Plan B offers the same basic benefits as Plan A, but it also includes coverage for the Part A deductible. It does not offer the same comprehensive coverage as other plans, such as skilled nursing care, your Part B deductible and excess charges, or any medical care received in other countries.

Guide to Medicare Supplement Insurance

Medigap Plan C

Medigap Plan C is much more comprehensive than either A or B. It covers everything listed under Part A, as well as skilled nursing facility care, the deductibles for both A and B, and 80 percent of the cost of care received in foreign countries. It has no out-of-pocket limit. The only thing you don’t get with Plan C is coverage for Part B excess charges.

Carriers who offer Medicare Supplement Insurance must include Plan C in their offerings.

Medigap Plan D

Designed to cover the gaps that represent the highest risk at the most affordable price point, Medigap Plan D offers the following benefits:

  • Part A co-insurance
  • Part A deductible
  • 365 hospital reserve days
  • Part B co-insurance
  • The first three pints of blood in a transfusion
  • Hospice co-insurance
  • Skilled nursing facility co-insurance
  • Foreign travel benefit of 80 percent

Plan D does not cover the Part B deductible or excess charges and has no out-of-pocket limit.

Medigap Plan F

The most comprehensive offering is Medigap Plan F. It’s the third plan that insurers must offer if they sell Medicare Supplement Insurance. This is typically the most expensive plan. Coverage includes:

  • Part A co-insurance
  • 365 hospital reserve days
  • Part B co-insurance
  • First three pints of blood
  • Hospice co-insurance
  • Skilled nursing facility co-insurance
  • Part A deductible
  • Part B deductible
  • Part B excess
  • Foreign travel benefit of 80 percent

There is no out-of-pocket limit with Plan F.

Plan F also comes with a high deductible option. It comes with a lower premium but you must meet the out-of-pocket limit before the plan starts paying. In 2018, this amount is $2,240.

Please note that, beginning in 2020, Plan F will no longer accepting new patients.

Guide to Medicare Supplement Insurance

Medigap Plan G

Medigap Plan G offers all of the benefits of Plan F except for the Part B deductible. If the difference in premiums between F and G is greater than your Part B deductible, you may prefer Plan G. In addition, it’s the only plan that covers home-based recovery care.

Medigap Plan K

Plan K employs a cost-sharing method that includes a yearly out-of-pocket maximum. Even if your spending never reaches that level, it covers your Part A co-insurance and 365 hospital reserve days at 100 percent. Other covered services are at 50 percent until you reach your yearly maximum. These include:

  • Part B co-insurance
  • Three pints of blood
  • Hospice co-insurance
  • Skilled nursing facility co-insurance
  • Part A deductible

Once your out-of-pocket spending reaches $5,240, Plan K pays 100 percent of these costs.

Medigap Plan K does not cover the Part B deductible, excess charges, or foreign travel benefits.

Medigap Plan L

Similar to the above, Medigap Plan L has a yearly out-of-pocket limit. Once you reach it, the plan pays 100 percent of covered services for the rest of the year. The differences are:

  • Plan L pays 75 percent until you meet the out-of-pocket limit
  • The out-of-pocket is only $2,620

Medigap Plan M

Medigap Plan M offers the same benefits as Plan D, but it only covers half of the Part A deductible.

Medigap Plan N

Another option that mimics Plan D, Medigap Plan N incorporates some additional cost-sharing measures.

  • Plan N pays 100 percent of Part B co-insurance, but does have a $20 co-pay on some office visits
  • Some emergency room trips have a $50 co-pay

Determining which Medigap plan best fits your needs at the best price can be confusing. Our agents can help you choose the best plan for your needs and your budget. Call us toll-free at 855-350-8101 to speak to a licensed agent.

 

Paula Walker

Paula Walker

Licensed Insurance Agent at Medicare Solutions
For over a decade, Paula Walker has advised clients across the country on their insurance needs. Although she has sold a variety of insurance policy types, Paula's first love is Medicare, because it lets her make a difference in people's lives every day. She takes a great deal of pride in helping Medicare recipients. Raised by her grandparents and seeing the power of the program firsthand, Paula approaches each client as though she were helping a relative find the perfect plan. She believes that the customer always comes first, which Paula says is easy when she works for such amazing clients.
Paula Walker
Paula Walker

Author: Paula Walker

For over a decade, Paula Walker has advised clients across the country on their insurance needs. Although she has sold a variety of insurance policy types, Paula's first love is Medicare, because it lets her make a difference in people's lives every day. She takes a great deal of pride in helping Medicare recipients. Raised by her grandparents and seeing the power of the program firsthand, Paula approaches each client as though she were helping a relative find the perfect plan. She believes that the customer always comes first, which Paula says is easy when she works for such amazing clients.

GET FREE MEDICARE PLAN QUOTES!