6 Things to Know About Medigap Policies

​Medicare Supplement Insurance, often referred to as Medigap, is insurance that helps fill "gaps” in Original Medicare insurance and is sold by private companies. Original Medicare pays a significant portion of the cost for covered health care services and supplies but not the full cost. A Medicare Supplement Insurance policy (Medigap) can help pay some of the remaining health care costs such as copayments, coinsurance, and deductibles.

1. A Medigap policy is different from a Medicare Advantage Plan. Medicare Advantage plans are ways to get Medicare benefits, while a Medigap policy only supplements your Original Medicare benefits.
2. You pay a private insurance company a monthly premium for your Medigap policy. This monthly premium in addition to the monthly Medicare Part B premium that you pay.
3. You can buy a Medigap policy from any insurance company that's licensed in your state to sell one.
4. Any standardized Medigap policy is guaranteed renewable even if you have health problems. This means the insurance company can't cancel your Medigap policy as long as you pay the premium.
5. Some Medigap policies sold in the past cover prescription drugs. But, Medigap policies sold after January 1, 2006 aren't allowed to include prescription drug coverage. If you want prescription drug coverage, you can join a Medicare Prescription Drug Plan (Part D). If you buy Medigap and a Medicare drug plan from the same company, you may need to make 2 separate premium payments. Contact the company to find out how to pay your premiums.
6. It's illegal for anyone to sell you a Medigap policy in conjunction with a Medicare Advantage Plan, unless you're switching back to Original Medicare.

 
There are significant overlaps between many of the plans so you may find the chart below helpful to compare and contrast your options.

* Plans F and G also offer a high-deductible plan in some states. With this option, you must pay for Medicare-covered costs (coinsurance, copayments, and deductibles) up to the deductible amount of $2,340 in 2020 ($2,370 in 2021) before your policy pays anything. (Plans C and F aren't available to people who were newly eligible for Medicare on or after January 1, 2020.)
** For Plans K and L, 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.

Medicare Supplement Plan A: Medicare Supplement insurance Plan A is different from Medicare Part A, although their similar names may be confusingly similar. Medicare Part A covers inpatient hospital care and is one half of Medicare (Part A and Part B). Medicare Supplement insurance Plan A provides coverage that helps pay for out-of-pocket costs from Medicare Part A and Part B.
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Medicare Supplement Plan B: Medicare Supplemental insurance Plan B is different from Medicare Part B, although their similar names may be confusingly similar. Medicare Supplemental Plan B covers

• Medicare Part B copayments and coinsurance
• the first three pints of blood you receive as a hospital inpatient or outpatient (Original Medicare usually covers any pints you receive after the first three)
• Medicare Part A deductible
• Medicare Part A hospital expenses and coinsurance up to 365 additional days after your Medicare benefits are depleted
• Hospice care coinsurance or copayment (Part A)

Medicare Supplement Plan C covers:

• Medicare Part A hospital coinsurance and hospital costs up to 365 days after Original Medicare benefits are exhausted
• Medicare Part A hospice care coinsurance or copayments
• Medicare Part B copayments and coinsurance
• First three pints of blood for a medical procedure
• Skilled Nursing Facility care coinsurance
• Medicare Part A deductible
• Medicare Part B deductible
• Foreign travel emergency coverage (80% of approved costs up to plan limits)

 
Medicare Supplement Plan D Covers:

• Medicare Part A hospital and coinsurance costs up to 365 days after Original Medicare benefits are used up
• Medicare Part A deductible
• Medicare Part A hospice care coinsurance and copayments
• Medicare Part B coinsurance and copayments
• First three pints of blood used in a medical procedure
• Skilled Nursing Facility care coinsurance
• Foreign travel emergency care (80% of approved costs up to plan limits)

 
Medicare Supplement Plan F covers:

• Part A hospital and coinsurance costs up to an additional 356 days after Medicare benefits are exhausted
• Medicare Part A hospice care copayment or coinsurance
• Medicare Part B coinsurance
• Medicare Part B excess charges
• Medicare Part A deductible
• Medicare Part B deductible
• First three pints of blood used in an approved medical procedure (annually)
• Skilled nursing facility coinsurance
• Foreign travel emergency coverage (80%, up to plan limits)

Medicare Supplement Plan G covers:

• Medicare Part A inpatient hospital coinsurance and hospital costs up to 365 days after Original Medicare benefits are exhausted
• Medicare Part A hospice care coinsurance or copayment
• Medicare Part A deductible
• Medicare Part B coinsurance or copayment
• Medicare Part B excess charges
• First three pints of blood for a medical procedure used in a year
• Skilled nursing facility care coinsurance coverage
• Foreign travel emergency coverage (80%, up to plan limits)

Medicare Supplement Plan K covers:

• Medicare Part A deductible
• Medicare Part A hospice care coinsurance or copayment
• Skilled nursing facility care coinsurance
• Medicare Part B copayment or coinsurance
• First three pints of blood for a covered medical procedure (yearly)

 
Medicare Supplement Plan L covers:
100% of the cost of:

• Medicare Part A coinsurance and hospital costs up to one year after Original Medicare benefits are exhausted

75% of the costs of:

• Medicare Part A hospice care coinsurance or copayment
• Medicare Part A deductible
• Medicare Part B coinsurance or copayment
• First three pints of blood used in a medical procedure
• Skilled Nursing Facility care coinsurance

 
Medicare Supplement Plan M covers:

• Medicare Part A hospital coinsurance and hospital costs up to a year after Original Medicare benefits are used up
• Part A hospice care coinsurance and copayments
• Medicare Part B copayments and coinsurance
• First three pints of blood for a medical procedure
• Skilled Nursing Facility care coinsurance
• Medicare Part A deductible (50%)
• Foreign travel emergency coverage (80% of approved costs up to plan limits)

 
Medicare Supplement Plan N covers:

• Medicare Part A hospital coinsurance and other costs up to an additional 365 days after Original Medicare benefits are exhausted
• Medicare Part A hospice care coinsurance or copayment
• Medicare Part A deductible
• Medicare Part B coinsurance or copayments (except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that do not result in inpatient admission)
• First three pints of blood used in a medical procedure (yearly)
• Skilled nursing facility care coinsurance
• Foreign travel emergency care (80%, up to plan limits)