Medigap Policies
A Medigap policy is a health insurance policy sold by private insurance companies to fill "gaps" in Original Medicare Plan coverage. Medigap policies must follow federal and state laws.
These laws protect you. The front of the Medigap policy must clearly identify it as "Medicare Supplement Insurance."
Outline of Medicare Supplement Coverage(Benefit Plans A-N)
Medicare Supplement Insurance can be sold in only twelve standard plans. This chart shows the benefits included in each plan. Every company must make available Plan "A".
Some plans may not be available in your state as indicated below.
Benefits | Medicare Supplement Plans | |||||||||
A | B | C* | D | F* | G | K | L | M | N | |
Medicare Part A Deductible | No | 100% | 100% | 100% | 100% | 100% | 50% | 75% | 50% | 100% |
Medicare Part B Deductible | No | No | 100% | No | 100% | No | No | No | No | No |
Medicare Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are exhausted | 100% | 100% | 100% | 100% | 100% | 100% | 100% | 100% | 100% | 100% |
Medicare Part B coinsurance or copayment | 100% | 100% | 100% | 100% | 100% | 100% | 50% | 75% | 100% | 100%** |
First three pints of blood | 100% | 100% | 100% | 100% | 100% | 100% | 50% | 75% | 100% | 100% |
Medicare Part A hospice coinsurance or copayment | 100% | 100% | 100% | 100% | 100% | 100% | 50% | 75% | 100% | 100% |
Skilled Nursing Facility (SNF) coinsurance | No | No | 100% | 100% | 100% | 100% | 50% | 75% | 100% | 100% |
Medicare Part B Excess Charges | No | No | No | No | 100% | 100% | No | No | No | No |
Foreign Travel Emergency (Up to Plan Limits) | No | No | 80% | 80% | 80% | 80% | No | No | 80% | 80% |
Out-of-Pocket Limit*** | None | None | None | None | None | None | $6,220 | $3,110 | None | None |
*The chart above is sited from page 72 of the CMS Approved 2021 Medicare and You Handbook*
Plans A-N are standardized by the federal government. Not all plans may be available in your area. Consider the benefits offered by each plan and look for one that best meets your individual needs.
*Medigap Plan F also offers a high-deductible option. This high-deductible option pays the same benefits as Plan F after a $2340 annual deductible
Plan C and plan F are only available to those who are not new to Medicare.
**You must also pay a separate deductible for foreign travel emergency ($250 per year).
***After you meet your out-of-pocket yearly limit and your yearly Part B deductible ($203 in 2021), the plan pays 100% of covered services for the rest of the calendar year.
Call: |
With your questions about: |
1-800-MEDICARE |
– Medicare (in general) |
Social Security Administration |
– Address/name changes |
*All data collected through www.medicare.gov