- Medigap plans can help you cover the out-of-pocket costs of Medicare.
- You can often choose from among 10 different Medigap plans.
- Medigap plans are standardized, which means they’re the same nationwide.
- Purchasing a Medigap plan when you first become eligible can save you money in the long run.
You can purchase Medicare supplement insurance, also known as Medigap plans, to help cover some of the costs of Medicare.
You’ll pay a monthly premium for your Medigap plan, and the plan will pay for costs that would normally fall to you, such as copayments for doctor’s office visits.
You can choose from among 10 Medigap plans. The plans are standardized across the United States; however, your cost will depend on your location and on the company you purchase your plan from.
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, sometimes also called Medicare supplement plans, are optional plans you can add to your Medicare coverage to help pay for some of the out-of-pocket costs of Medicare.
The plans work alongside original Medicare. Original Medicare is made up of Medicare Part A (hospital insurance) and Medicare Part B (medical insurance). Medigap plans are specifically designed to cover the costs of original Medicare that normally fall to you.
Some costs that Medigap plans often cover include:
- coinsurance
- copayments
- deductibles
- extra fees
- healthcare while you travel
There are 10 different Medigap plans. The plans are standardized – so no matter what you state you live in or what company you purchase a plan from, your coverage will always be the same.
Here is an overview of each of the Medigap plans:
- Plan A. This is the most basic of all 10 plans in terms of coverage. If an insurance company sells a Medicare supplement plan, they must offer at least Plan A. This plan focuses on covering some of the copays and coinsurance associated with Medicare Part A and Part B.
- Plan B. Plan B includes the same coverage as Plan A, as well as the Medicare Part A deductible.
- Plan C. Plan C covers the deductibles, copays, and coinsurance associated with Medicare parts A and B, as well as foreign travel emergency care. If you were eligible for Medicare before January 1, 2020, you can buy this plan.
- Plan D. Plan D covers coinsurance and copays leftover from Medicare parts A and B. It also covers the Medicare Part A deductible and foreign travel emergency care.
- Plan F. Plan F is considered the most inclusive Medigap option. This plan covers all of what Plan C covers, plus Medicare Part B excess charges. You must also have been eligible for Medicare prior to 2020 to buy this plan.
- Plan G. Plan G is similar to Plan F, except for the Medicare Part B deductible. If you’re new to Medicare in 2020 and would like a very inclusive Medigap plan, Plan G might work well for you.
- Plan K. Plan K covers copays and coinsurance for Medicare parts A and B, along with the Medicare Part A deductible. However, coverage for many of these costs is only partial. Plan K also has an out-of-pocket limit.
- Plan L. Plan L offers similar coverage to Plan K, but the partial coverage amounts are higher. Plan L also has a yearly out-of-pocket limit.
- Plan M. Plan M is one of the newer Medigap plan options. This plan may work well for people who want to pay a lower monthly premium in exchange for paying for half of the annual Part A deductible.
- Plan N. Plan N covers the copays and coinsurance for Medicare parts A and B. It also covers the Medicare Part A deductible and foreign travel emergency medical care.
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.
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.
As another example, let’s say you were planning a total knee replacement in the coming months. You might need both an inpatient hospital and an inpatient skilled nursing facility stay during your recovery.
In this case, it could be helpful to have a plan like Medigap Plan G that covers your Part A deductible, Part A coinsurance, and skilled nursing facility coinsurance.
- 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 by looking at your health, gender, and age. You could be charged a higher rate or even denied coverage if your health has declined.
- However, if you purchase a Medigap plan during your initial enrollment, you’re guaranteed to get a plan at the company’s best rates.