Medigap plans can help you cover the out-of-pocket costs of Medicare. You can choose from 10 different plans, which are the same nationwide. Purchasing a Medigap plan when you first become eligible can save you money in the long run.
Medicare supplement insurance plans, also known as Medigap plans, are available to help cover some of the costs of Medicare.
Each Medigap plan has a monthly premium, and the plan covers costs that would normally be your responsibility, such as copayments for doctor’s office visits.
You can choose among 10 Medigap plans, standardized across the United States. But, your cost will depend on your location and on the company you purchase your plan from.
If you’re new to Medicare as of 2020, you actually have only 8 Medigap plan choices.
Due to recent changes to Medicare regulations, Plan C and Plan F are no longer available to new Medicare enrollees. This change applies only if you became eligible for Medicare starting on January 1, 2020, or later.
If you were eligible for Medicare in 2019 or earlier, you can still buy plans C and F.
You can check out the coverage offered by each plan in the chart below.
Plan A | Plan B | Plan C | Plan D | Plan F | Plan G | Plan K | Plan L | Plan M | Plan N | |
---|---|---|---|---|---|---|---|---|---|---|
Part B deductible | no | no | yes | no | yes | no | no | no | no | no |
Part A (hospital coinsurance) | yes | yes | yes | yes | yes | yes | Yes | yes | yes | yes |
Part A deductible | no | yes | yes | yes | yes | yes | 50% | 75% | 50% | yes |
Part B coinsurance | yes | yes | yes | yes | yes | yes | 50% | 75% | yes | yes (but with copays) |
blood (first 3 pints) | yes | yes | yes | yes | yes | yes | 50% | 75% | yes | yes |
hospice care | yes | yes | yes | yes | yes | yes | 50% | 75% | yes | yes |
Skilled nursing facility care coinsurance | no | no | yes | yes | yes | yes | 50% | 75% | yes | yes |
Part B excess charge | no | no | no | no | yes | yes | no | no | no | no |
foreign travel emergencies | no | no | 80% | 80% | 80% | 80% | no | no | 80% | 80% |
out-of-pocket maximum | no | no | no | no | no | no | $6,220 | $3,110 | no | no |
Medigap plans are offered by private insurance companies. Although the plans themselves are standardized, the monthly premiums may vary based on the company offering the plan, your geographic location, and your overall health.
Medigap plans also typically don’t have deductibles, but some high-deductible options do exist, such as Plan F and Plan G. In addition, Plan K and Plan L have maximum out-of-pocket limits.
Most Medigap policies will also cover your coinsurance after you’ve met your deductible
You can enroll in Medigap if you’re eligible for Medicare. This typically happens when you turn 65, or earlier if you have certain health conditions like end stage renal disease (ESRD) and amyotrophic lateral sclerosis (ALS), or receive Social Security Disability Insurance.
The best time to sign up is during the Open Enrollment Period, which typically starts 6 months after you turn 65 or become eligible for Medicare. To apply, simply fill out an application directly with the company of your choice.
The right plan for you will depend on your needs and budget.
For example, if you’re planning on foreign travel, you can select a plan that covers foreign travel emergencies. Plans A, B, K, and L don’t offer foreign travel coverage, so they might not be the best choice for you.
Other considerations include:
- How much can you spend on a premium each month?
- How much do you typically spend on each covered expense?
- Do you have any surgeries or procedures that might require an upcoming hospital stay?
Looking ahead at your needs can help you select the best plan for you. The right Medigap plan might be very different depending on your care needs.
Which Medigap plan is the most comprehensive?
Plan F is considered to be the most comprehensive Medigap plan. However, it’s being phased out.
That said, Plan G is almost as comprehensive. It covers your Part A deductible ($1,632 in 2024), Part A coinsurance, and skilled nursing facility coinsurance. The only difference is that it doesn’t cover the Part B deductible ($240 in 2024).
Let’s say you were planning a total knee replacement in the coming months. During your recovery, you might need to stay in both an inpatient hospital and an inpatient skilled nursing facility. In this case, a plan like Medigap Plan G could be helpful.
Are there downsides to Medigap plans?
Medigap plans don’t cover prescription drugs, vision, dental, hearing, or other health benefits like gym memberships or transportation.
To get these services covered, you’ll need a Medicare Part D plan or a Medicare Advantage (Part C) plan. In addition, not all plans cover skilled nursing facilities or hospice care.
You can select from among 10 different Medigap plans. Each plan covers a different combination of Medicare costs that you’d typically pay out of pocket.
The plans are standardized no matter where you live or what company you select, but your price can vary. Medigap companies evaluate your coverage application based on your health, gender, and age. If your health has declined, you could be charged a higher rate or even denied coverage.
However, if you purchase a Medigap plan during your initial enrollment, you’re guaranteed to get a plan at the company’s best rates.