Medicare Supplement Plan J (also known as Medigap Plan J) was discontinued for new enrollees due to the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. Although new sales of this plan have stopped after June 1, 2010, anybody who already had the plan can keep it and still receive its benefits.
Keep reading to learn about Medigap Plan J coverage and what to do if you’re currently enrolled.
For people who kept Medigap Plan J after it was no longer offered to new enrollees, the benefits include:
- Part A coinsurance and hospital stays up to 365 days after Medicare benefits are used up
- Part A deductible
- Part B deductible
- Part B excess charges
- Part B coinsurance or copayments
- blood (first 3 pints)
- hospice care coinsurance or copayments
- skilled nursing facility care coinsurance
- foreign travel (up to plan limits)
- preventive care
- prescription drug benefits (with some plans)
Although Medigap Plan J had a prescription drug benefit that was unique at the time, there are now other options available, including:
- Medicare Part D. This optional benefit is available for everyone who has Medicare through private insurance companies approved by Medicare. Since the cost of professionally administered prescription drugs is typically covered in Medicare Part B, Medicare Part D covers self-administered brand-name and generic prescription drugs.
- Medicare Advantage (Part C). This option is offered through private insurance companies approved by Medicare. Medicare Advantage plans provide your Medicare Part A and Part B benefits, commonly offer prescription drug coverage, and often offer extra benefits not available through Medicare, such as vision, dental, and hearing.
Both Medicare Part D and Medicare Advantage plans are offered by Medicare-approved private insurance companies. Review your options before making a decision on Medicare prescription coverage, because not only does coverage vary between plans, but the price does as well, including:
- monthly premiums (the amount you pay for the coverage)
- yearly deductibles (the amount you have to pay before the coverage starts)
- copayments/coinsurance (your share of the price, if any, after your plan pays its share)
You must have original Medicare (parts A and B) to qualify for Medicare prescription drug coverage.
Your Medigap policy also has a monthly premium. The exact amount can vary by individual policy. Insurance companies can set monthly premiums for their policies in a few different ways, so it’s important to know which type you have:
- Community rated. Everyone that buys the policy pays the same monthly premium regardless of age.
- Issue-age rated. Monthly premiums are tied to the age when you first purchased the policy, with younger buyers having lower premiums. Premiums don’t increase as you get older.
- Attained-age rated. Monthly premiums are based on your current age. That means your premium will go up as you get older.
Contact your plan provider directly about any specific questions you have about your costs or how your plan is structured.
Even though Medigap Plan J is no longer sold, it’s still honored. So if you have Medigap Plan J, you’re still covered.
In fact, if you still have a Medigap Plan J, you have the most coverage that you can buy. For example, it pays the Medicare Part B deductible, which new Medigap plans are no longer allowed to cover as of January 1, 2020.
Because there are some newer Medigap plans with different offerings, some people decide to switch from Medigap Plan J to another Medigap plan that offers the coverage they want for a lower premium. You may also find that Medicare Part D typically offers a more comprehensive prescription drug plan.
Medigap Plan J has not been available since June 1, 2010. People who opted for Medigap Plan J and its comprehensive coverage before this time are able to keep it.
It might be worth exploring other Medigap plans offered each year, as your needs and budget may change over time.
This article was updated on October 20, 2020 to reflect 2021 Medicare information.
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