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You are here: Home / MediGap – Medicare Supplemental Plans

MediGap – Medicare Supplemental Plans

 

Once you enroll in Medicare (either Parts A and B OR Medicare Advantage Part C); you may choose to buy a Medicare Supplement Insurance (Medigap) policy.  These are plans sold by private companies, to help pay some of the health care costs that Original Medicare doesn’t cover, like copayments, coinsurance, and deductibles. There are 10 standardized Medigap plans available in every state (excluding Massachusetts, Minnesota, and Wisconsin, which all have their own versions). They are identified by letters F through O. You enroll in Medicare Supplement insurance during your Medigap Open Enrollment Period which is the six months starting the first day of the month in which you are 65 or older and enrolled in Medicare Part B (so, if you delay enrollment, your delay this period, too). If you wait to apply for a Medigap policy until after your open enrollment period ends, the Medigap insurance companies do not need to sell you a plan and can charge you more for it.  The most commonly sold plan is Plan F.

  • Medicare Part F ( supplemental insurance)  Part F is a Medicare Supplement insurance plans that covers costs known as Medicare Part B excess charges. An excess charge is the difference between what a doctor or provider charges and the amount Medicare will pay. You pay a monthly premium for these plans (typical is $183). Insurance companies like Blue Cross, Aetna and Humana sell these plans. These plans will help protect you from additional out-of-pocket expenses if you have treatment that exceeds what Medicare will approve.  Medicare supplement plans have the same basic benefits, even from different insurance companies, so you can compare one company’s “plan F” to another company’s “plan F.”  See this page on the Humana website for more detailed information. Plan F is a popular choice that offers more overall coverage than any other Medicare Supplement plan. You can also choose a high-deductible Plan F for a lower premium.

Medigap policies generally don’t cover long-term care, vision or dental care, hearing aids, eyeglasses, or private-duty nursing.

Compare Medigap plans side-by-side

The chart below shows basic information about the different benefits Medigap policies cover.

Yes = the plan covers 100% of this benefit
No = the policy doesn’t cover that benefit
% = the plan covers that percentage of this benefit
N/A = not applicable

Medigap Benefits Medigap Plans
A B C D F* G K L M N
Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes
Part B coinsurance or copayment Yes Yes Yes Yes Yes Yes 50% 75% Yes Yes***
Blood (first 3 pints) Yes Yes Yes Yes Yes Yes 50% 75% Yes Yes
Part A hospice care coinsurance or copayment 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 A deductible No Yes Yes Yes Yes Yes 50% 75% 50% Yes
Part B deductible No No Yes No Yes No No No No No
Part B excess charge No No No No Yes Yes No No No No
Foreign travel exchange (up to plan limits) No No 80% 80% 80% 80% No No 80% 80%
Out-of-pocket limit** N/A N/A N/A N/A N/A N/A  $5,120 $2,560 N/A N/A

* Plan F also offers a high-deductible plan. If you choose this option, this means you must pay for Medicare-covered costs up to the deductible amount of $2,200 in 2017 before your Medigap plan pays anything.

** After you meet your out-of-pocket yearly limit and your yearly Part B deductible, the Medigap plan pays 100% of covered services for the rest of the calendar year.

*** Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don’t result in inpatient admission

Costs

A quick search on the Medicare website gave plans averaging $5,000 per year ( $416). See the screenshot below.

Go to this page to see which plans are available to you, as well as the specific coverage and costs.

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