- Medigap helps to pay for some of the healthcare costs that aren’t covered by original Medicare.
- The costs you’ll pay for Medigap depend on the plan you choose, your location, and a few other factors.
- Medigap usually has a monthly premium, and you may also have to pay copays, coinsurance, and deductibles.
Medicare supplement insurance (Medigap) policies are sold by private insurance companies. These plans help pay for some of the healthcare costs that aren’t covered by original Medicare. Some examples of the costs that may be covered by Medigap include:
- deductibles for parts A and B
- coinsurance or copays for parts A and B
- excess costs for Part B
- healthcare costs during foreign travel
- blood (first 3 pints)
The cost of a Medigap plan can vary due to several factors, including the type of plan you enroll in, where you live, and the company selling the plan. Below, we’ll explore more about the costs of Medigap plans in 2021.
So what are the actual costs associated with Medigap plans? Let’s examine the potential costs in more detail.
Each Medigap policy has a monthly premium. The exact amount can vary by individual policy. Insurance companies can set monthly premiums for their policies in three different ways:
- 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 at which you first purchase a policy, with younger buyers having lower premiums. Premiums don’t increase as you get older.
- Attained-age rated. Monthly premiums are tied to your current age. That means your premium will go up as you get older.
If you’d like to enroll in a Medigap plan, it’s important to compare multiple policies that are offered in your area. This can help you determine how premiums are set and how much you can expect to pay per month.
The Medigap monthly premium is paid in addition to other monthly premiums associated with Medicare. These can include premiums for:
- Medicare Part A (hospital insurance), if applicable
- Medicare Part B (medical insurance)
- Medicare Part D (prescription drug coverage)
Medigap itself isn’t typically associated with a deductible. However, if your Medigap plan doesn’t cover the Part A or Part B deductible, you’re still responsible for paying those.
Medigap Plan F and Plan G do have a high-deductible option. The monthly premiums for these plans are typically lower, but you’ll have to meet a deductible before they start to cover costs. For 2021, the deductible is $2,370 for these plans.
Coinsurance and copays
Like deductibles, Medigap itself isn’t associated with coinsurance or copays. You may still have to pay certain coinsurance or copays associated with original Medicare if your Medigap policy doesn’t cover them.
Medigap Plan K and Plan L have out-of-pocket limits. This is a maximum amount that you’ll have to pay out of pocket. In 2021, the Plan K and Plan L out-of-pocket limits are $6,220 and $3,110, respectively. After you meet the limit, the plan pays for 100 percent of covered services for the rest of the year.
There are some health-related services that aren’t covered by Medigap. If you need to use these services, you’ll have to pay for them out of pocket. These may include:
The following table shows a cost comparison of monthly premiums for the different Medigap plans in four sample cities across the United States.
|Washington, D.C.||Des Moines, IA||Aurora, CO||San Francisco, CA|
|Plan F (high deductible)||$27–$86||$27–$76||$32–$96||$28–$84|
|Plan G (high deductible)||$26–$53||$32–$72||$37–$71||$38–$61|
The prices shown above are based on a 65-year-old man who doesn’t use tobacco. To find prices specific to your situation, enter your ZIP code in Medicare’s Medigap plan finder tool.
Medigap is a type of supplemental insurance that you can purchase to help pay for health-related costs that aren’t covered by original Medicare. There are 10 different types of standardized Medigap plan.
The cost of a Medigap plan depends on the plan you choose, where you live, and the company from which you purchase your policy. You’ll pay a monthly premium for your plan and may also be responsible for some deductibles, coinsurance, and copays.
You can first enroll in a Medigap plan during the Medigap initial enrollment period. This is when you turn age 65 andenroll in Medicare Part B. If you don’t enroll during this time, you may not be able to enroll in the plan that you want or it may cost more.