Medigap Plan Benefits Chart
Medicare Supplement insurance, also known as Medigap insurance, may help cover your Original Medicare (Part A and Part B) out-of-pocket costs, such as deductibles and coinsurance. In most states, there are 10 standardized Medigap plans, each with a letter designation (Medigap Plan A, Medigap Plan B, and so on). Massachusetts, Wisconsin, and Minnesota have their own standardized plans not covered in this article.
Each lettered plan offers the same basic benefits no matter where you buy the plan (although prices and availability may vary). For example, a Medigap Plan M in Texas has the same basic benefits as a Medigap Plan M in Colorado. But the different lettered plans cover different portions of Original Medicare costs, as you can see in the following chart. Also, please note that some companies may offer additional innovative benefits.
Please note that Medigap plans are different from the “parts” of Medicare. That is, Medicare Part A, Part B, Part C, and Part D are not the same as Medigap Plan A, Medigap Plan B, Medigap Plan C, and Medigap Plan D.
|Medigap benefit||Medigap lettered plans|
|Medicare Part A coinsurance and hospital costs up to one more year after Medicare benefits are depleted||Yes||Yes||Yes||Yes||Yes||Yes||Yes||Yes||Yes||Yes|
|Medicare Part B coinsurance or copayment||Yes||Yes||Yes||Yes||Yes||Yes||50%||75%||Yes||Yes**|
|First three pints of blood||Yes||Yes||Yes||Yes||Yes||Yes||50%||75%||Yes||Yes|
|Hospice copayment or coinsurance (Medicare Part A)||Yes||Yes||Yes||Yes||Yes||Yes||50%||75%||Yes||Yes|
|Skilled nursing facility coinsurance||No||No||Yes||Yes||Yes||Yes||50%||75%||Yes||Yes|
|Medicare Part A Deductible||No||Yes||Yes||Yes||Yes||Yes||50%||75%||50%||Yes|
|Medicare Part B deductible||No||No||Yes||No||Yes||No||No||No||No||No|
|Medicare Part B excess charges||No||No||No||No||Yes||Yes||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||$5,240 (in 2018)||$2,620 (in 2018)||None||None|
*There’s also a high-deductible version of Medigap Plan F. Under high-deductible Medigap Plan F, you pay for all Medicare-covered costs until you’ve paid the $2,240 deductible (in 2018) before your Medigap plan starts paying your Medicare out-of-pocket expenses.
**Medicare Supplement Plan N pays your Medicare Part B coinsurance in full, with some exceptions. Office visits in certain situations may require a copayment of up to $20. Also, if you go to a hospital emergency room and don’t get admitted as an inpatient, you might pay a copayment of up to $50.
***After you have reached the annual out-of-pocket spending limit and paid your Medicare Part B deductible, your Medicare Supplement insurance plan pays for all Medicare-covered costs for the remainder of the calendar year.
****Medically Necessary Emergency Care in a Foreign Country: coverage to the extent not covered by Medicare for 80 percent of the billed charges for Medicare-eligible expenses for medically necessary emergency hospital, physician and medical care received in a foreign country, which care would have been covered by Medicare if provided in the United States and which care began during the first 60 consecutive days of each trip outside the United States, subject to a calendar year deductible of $250, and a lifetime maximum benefit of $50,000. For purposes of this benefit, “emergency care” shall mean care needed immediately because of an injury or an illness of sudden and unexpected onset.
Medigap insurance plans are available from private insurance companies. Prices and availability may differ from one insurance company to the next, and across geographic regions.
This website and its contents are for informational purposes only. Nothing on the website should ever be used as a substitute for professional medical advice. You should always consult with your medical provider regarding diagnosis or treatment for a health condition, including decisions about the correct medication for your condition, as well as prior to undertaking any specific exercise or dietary routine.
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