• Newly eligible Medicare beneficiaries won’t be able to enroll in some Medigap plans in 2020.
  • Medigap premiums, deductibles, and coinsurance costs went up to keep pace with inflation.
  • Picking a Medigap plan in 2020 may be easier with the updated Medicare Plan Finder tool.

Medigap (Medicare Supplement) is a private insurance policy that helps you pay for medical expenses that aren’t covered by Medicare Part A and Part B (original Medicare).

There are 10 plans from which to choose, and the plans are standardized by state and federal regulations. If you have a Medicare Advantage (Part C) plan, you can’t purchase Medigap insurance.

The Medicare Access and CHIP Reauthorization Act (MACRA) changed Medigap plans in every state beginning in January 2020.

On January 1, 2020 and beyond, people who are newly eligible for Medicare benefits cannot purchase Medigap plans that pay your Part B deductible (Plan C, Plan F, plus the high-deductible Plan F).

If you enrolled in Medicare before January 1, 2020, and you have a Medigap Plan C, Plan F, or high-deductible F, you can keep your plan and renew it in the future.

MACRA also introduced a new Medigap plan: high-deductible plan G, which is available to newly eligible Medicare beneficiaries. This plan is similar to the high-deductible Plan F, except that it does not cover your Part B deductible. The 2020 deductible in the high-G plan is $2,340.

  • Premiums, deductibles, and coinsurance costs for Medicare parts A and Part B increased.
  • The Medicare Plan Finder tool has been updated for the first time in 10 years.
  • The “donut hole” in Medicare Part D (prescription drug coverage) has shrunk considerably.
  • In Medicare Part D, the catastrophic coverage phase (where your prescription costs are drastically reduced) begins once you have paid $6,350.
  • Income brackets that trigger premium hikes in Medicare parts B and D have been adjusted to account for inflation.

Plan
Benefits
Plan APlan BPlan CPlan DPlan FPlan GPlan KPlan LPlan MPlan N
Does this plan pay coinsurance and hospital costs for an extra 365 days after my Part A benefits have been used?YesYesYesYesYesYesYesYesYesYes
Does this plan pay coinsurance or copay for services covered under Part B?YesYesYesYesYesYes50%75%YesYes
Does this plan pay for the first three pints of blood? YesYesYesYesYesYes50%75%YesYes
Does this plan pay coinsurance or copay for hospice care covered under Part A?YesYesYesYesYesYes50%75%YesYes
Does this play pay coinsurance for skilled nursing facility care?
NoNoYesYesYesYes50%75%YesYes
Does this plan pay my deductible for Part A? NoYesYesYesYesYes50%75%50%Yes
Does this plan pay my deductible for Part B?NoNo YesNoYesNoNoNoNoNo
Does this plan pay the excess charge for services covered under Part B? NoNoNoNoYesYesNoNoNoNo
Does this plan pay for care I receive while traveling outside the U.S.? NoNo80%80%80%80%NoNo80%80%
Is there an out-of-pocket plan limit for 2020?N/AN/AN/AN/AN/AN/A$5,880$2,940N/AN/A

In some states, Medicare plans F and G offer a high-deductible option. If you choose one of these plans in 2020, you are responsible for paying for all your Medicare costs (your copays, coinsurance, and deductibles) up to $2,340. After you’ve met that deductible, your policy will begin to pay benefits.

It’s important to note that plans C and F are not available to anyone who is newly eligible for Medicare as of January 1, 2020.

If you choose Medicare plan K or L, you must pay your annual Part B deductible ($198 in 2020), and you must also meet an out-of-pocket annual limit before your benefits begin. After you have paid the deductible and met the out-of-pocket limit, your plan pays 100 percent of the approved cost for covered services for the rest of the calendar year.

In Massachusetts, Minnesota, or Wisconsin, Medigap plans are standardized according to different rules. Here’s what you need to know about your options if you live in one of these states.

Massachusetts

In Massachusetts, you have guaranteed issue rights to purchase a Medigap plan. Here’s what coverage under these plans looks like in 2020.

BenefitCore planSupplement 1 planSupplement 1A plan
Does this plan cover my basic Medicare benefits?YesYesYes
Does this plan pay my deductible for hospital care covered under Part A?NoYesYes
Does this plan pay my coinsurance for care I receive in a skilled nursing facility?NoYesYes
Does this plan pay my Part B deductible?NoYesNo
Does this plan pay for my care if I have a medical emergency while I am traveling outside the U.S.?NoYesYes
How many days does this plan cover for my inpatient care in a mental health hospital?60 days per calendar year120 days per benefit year120 days per benefit year
Does this plan pay for yearly Pap tests, mammograms, and other state-mandated benefits?NoYesYes

Minnesota

In Minnesota, you can choose between basic and extended plans.

BenefitBasic planExtended plan
Does this plan pay for basic Medicare benefits?YesYes
Does this plan pay the deductible for inpatient hospital care under Part A?NoYes
Does this plan pay my coinsurance for care I receive in a skilled nursing facility?Yes: 100 days Yes: 120 days
Does this plan pay my Part B deductible?NoYes
Does this plan pay for my care if I have a medical emergency while I am traveling outside the U.S.?80%80%
Does this plan pay for medical care I receive while traveling outside the U.S.?No80%
Does this plan pay my usual and customary fees?No80%
Does this plan pay for Medicare-approved preventive care?YesYes
Does this play pay for physical therapy?20%20%

Does this plan pay for my outpatient mental health care?
50%50%
Does this plan pay for diabetic equipment and supplies, routine cancer screening, reconstructive surgery, immunizations, and other state-mandated benefits?YesYes

In Minnesota, you can purchase plans that are very much like plans K, L, M, and N. You may also be able to purchase riders to cover these benefits:

  • your Part A inpatient hospital deductible
  • your Part B deductible
  • usual and customary fees
  • preventive care that isn’t covered by Medicare

Wisconsin

You have guaranteed issue rights to plans in Wisconsin. Here’s what Medigap plan coverage looks like in this state.

BenefitBasic plan
Does this plan pay for basic Medicare benefits?Yes
Does this plan pay the coinsurance for inpatient hospital care under Part A?Yes
Does this plan pay my coinsurance for care I receive in a skilled nursing facility?Yes
Does this plan pay my coinsurance for medical care I receive under Part B?Yes
Does this plan pay for the first three pints of blood every year?Yes
Does this plan pay my coinsurance or copay for Part A hospice care?Yes
Does this plan pay my Part B deductible?No, but you may be able to purchase this benefit through a rider. Note that newly eligible Medicare participants are not eligible for this benefit after January 1, 2020.
Does this plan pay my Part A deductible?No, but you may be able to purchase this benefit through a rider.
Does this plan pay for my care if I have a medical emergency while I am traveling outside the U.S.?No, but you may be able to purchase this benefit through a rider.
Does this plan pay for inpatient mental health care beyond the benefit provided by Medicare?Yes: 175 days per lifetime
Does this plan pay for home healthcare visits beyond those covered by Medicare?Yes: 40 extra visits
Does this plan pay excess charges for Part B services?No, but you may be able to purchase this benefit through a rider.
Does this plan pay for state-mandated benefits?Yes

In Wisconsin, you can also buy “50% and 25% Cost-sharing Plans” that offer coverage like plans K and L in the standardized plan program. Wisconsin residents can also buy high-deductible plans, where the plan pays benefits after you have met a deductible of $2,340 every year.

If you have enrolled in original Medicare (parts A and B), you are eligible to purchase a Medigap policy. It is a good idea to purchase a Medigap policy during your six-month Medigap open enrollment period because during that period you can buy any of your state’s available policies. The insurance company cannot refuse to sell you a policy during open enrollment.

If you buy during open enrollment, the insurance company must charge you the same premiums it charges healthy people, even if you have some health issues.

Be sure you are enrolled in original Medicare. If you have a Medicare Advantage (Part C) plan, you’ll have to switch back to Medicare parts A and B before you apply for a Medigap policy.

Use this Medigap tool to research the pricing of plans in your area.

Contact your insurance company, and apply for the plan you want during open enrollment, if possible. After open enrollment periods end, the insurance company can refuse to sell you a policy, charge you higher rates, or make you wait to start coverage.

Tips for choosing a Medigap plan
  • Use the Medicare Plan Finder tool to see which plans cover what you need.
  • Purchase your plan during open enrollment, when you have more plan choices and better rates
  • Premiums and benefits vary widely from plan to plan. Make sure you understand what’s covered and what you’ll pay each month.
  • Some states offer Medigap protections called “guaranteed issue rights” that keep insurers from denying you coverage. Talk to your state’s insurance department or your State Health Insurance Program (SHIP) about your rights.

  • Beginning in 2020, newly eligible Medicare beneficiaries won’t be able to enroll in plans that pay the deductible for Part B coverage (Plan C, Plan F, and high-deductible Plan F). If you were already enrolled in one of these plans before January 1, 2020, you can keep the plan and renew it when it’s time.
  • A new high-deductible Plan G rolled out in 2020. Its benefits are similar to high-deductible Plan B, but without paying the deductible for Medicare Part B benefits.
  • Premiums, deductibles, and coinsurance costs were adjusted for inflation in 2020. And Medicare updated its Plan Finder tool to make the user experience easier and more informative.

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