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 | $6,620 in 2022 ($6,220 in 2021) | $3,310 in 2022 ($3,110 in 2021) | N/A | N/A | |
Estimated premiums as per Medicare.gov (10/28/2021) Allegheny Co., Pennsylvania | |||||||||||
$65 to $763 | $103 to $774 | $148 to $642 | $129 to $547 | $129 to $949 | $32 to $252 | $108 to $983 | $46 to $367 | $78 to $714 | $123 to $803 | $77 to $670 | |
Estimated premiums as per Medicare.gov (10/28/2021) Los Angles Co., California | |||||||||||
$97 to $902 | $151 to $576 | $178 to $735 | $128 to $575 | $177 to $1,104 | $40 to $191 | $128 to $961 | $55 to $307 | $100 to $447 | $177 to $514 | $98 to $737 | |
Estimated premiums as per Medicare.gov (11/25/2019) Miami-Dade Co., Florida | |||||||||||
$181 to $1,636 | $238 to $1,287 | $76 to $1,767 | $268 to $1,185 | $272 to $1,900 | $61 to $867 | $220 to $1,656 | $87 to $568 | $171 to $833 | $258 to $958 | $170 to $1,250 | |
Medigap Benefits |
Medigap Plans | ||||||||||
A |
B |
C |
D |
F |
F* High Deductible | G |
K |
L |
M |
N |
* 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 $2,490 in 2022 ($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.
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.