Medigap Benefits |
Medigap or Medicare Supplement Plans | ||||||||||
A |
B |
C |
D |
F |
F* High Deductible | 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 | Yes | |
Part B coinsurance or copayment | |||||||||||
Yes | Yes | Yes | Yes | Yes | Yes | Yes | 50% | 75% | Yes | Yes*** | |
Blood (first 3 pints) | |||||||||||
Yes | Yes | Yes | Yes | Yes | Yes | Yes | 50% | 75% | Yes | Yes | |
Part A hospice care coinsurance or copayment | |||||||||||
Yes | Yes | Yes | Yes | Yes | Yes | Yes | 50% | 75% | Yes | Yes | |
Skilled nursing facility care coinsurance | |||||||||||
No | No | Yes | Yes | Yes | Yes | Yes | 50% | 75% | Yes | Yes | |
Part A deductible | |||||||||||
No | Yes | Yes | Yes | Yes | Yes | Yes | 50% | 75% | 50% | Yes | |
Part B deductible | |||||||||||
No | No | Yes | No | Yes | Yes | No | No | No | No | No | |
Part B excess charge | |||||||||||
No | No | No | No | Yes | Yes | Yes | No | No | No | No | |
Foreign travel exchange (up to plan limits) | |||||||||||
No | No | 80% | 80% | 80% | 80% | 80% | No | No | 80% | 80% | |
Out-of-pocket limit** | |||||||||||
N/A | N/A | N/A | N/A | N/A | N/A | N/A | $7,220 in 2025 ($7,060 in 2024) | $3,610 in 2025 ($3,530 in 2024) | N/A | N/A | |
Estimated premiums as per Medicare.gov (10/20/2024) Allegheny Co., Pennsylvania | |||||||||||
$91 to $937 | $113 to $946 | $151 to $793 | $126 to $486 | $143 to $1,150 | $34 to $287 | $114 to $956 | $60 to $198 | $104 to $327 | $88 to $362 | $82 to $716 | |
Estimated premiums as per Medicare.gov (10/20/2024) Los Angles Co., California | |||||||||||
$112 to $842 | $183 to $722 | $204 to $900 | $148 to $556 | $178 to $1,368 | $34 to $265 | $148 to $1,189 | $67 to $367 | $121 to $535 | N/A | $114 to $912 | |
Estimated premiums as per Medicare.gov 10/20/2024) Miami-Dade Co., Florida | |||||||||||
$181 to $1,988 | $238 to $1,447 | $298 to $1,535 | $262 to $1,431 | $278 to $2,758 | $66 to $950 | $233 to $2,016 | $86 to $613 | $182 to $920 | $293 to $1,088 | $183 to $1,470 | |
Medigap Benefits |
Medigap Plans | ||||||||||
A |
B |
C |
D |
F |
F* High Deductible | G |
K |
L |
M |
N |
* Plans F, G and J also offer a high-deductible plan in some states.
With this option, you must pay for Medicare-covered costs (coinsurance,
copayment, and deductible) up to the deductible amount of $2,870 in
2025 ($2,800 in
2024) 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.
Reminder: Since 2020, no Medicare Part C, F, and high-deductible F are no longer being offered.
As part of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA),
starting in 2020, Medigap plans that cover the Medicare Part B
deductible (Plan C, Plan F, and high-deductible Plan F) will no longer be sold. Medigap
members who purchased their plans before 2020 can keep their Plan C or Plan F policies, but can expect
increasing monthly premiums as plan healthcare costs rise without the
addition of new, healthier plan members.
With the outlook of increasing
premiums, some current Medigap plan members are expected to move to more
affordable Medicare
Supplement plans. For example, you might expect people currently
enrolled in Medigap Plan F to move to
the similar Plan G (that does not cover the Medicare Part B deductible,
but has a slightly lower premium as compared to a Plan F) and if the
person stays
with the same Medicare Supplement carrier, there should be no medical
underwriting as Plan G offers less coverage (the Part B deductible) than
the Plan F.
If you live in Massachusetts, Minnesota, or Wisconsin . . .
If you live in one of these 3 states, Medigap policies are standardized in a different way.