Powered by Q1Group LLC
Education and Decision Support Tools for the Medicare Community

What are the basic Medicare Supplement plan benefits?


Medicare Supplements (also called Medigap policies) work together with your original Medicare coverage, filling the “gaps” (deductibles, coinsurance, and co-payments) in your Medicare Part A (in-patient or hospital insurance) and Medicare Part B (out-patient or physician insurance) coverage.  In short, Medicare Supplements offered by private insurance companies provide additional coverage to your original Medicare coverage.

The following is a chart showing the different Medicare Supplement or Medigap policies and the coverage benefits associated with each plan.

Please note that Medicare Supplements are regulated on a state basis (not a federal basis) and not all Medicare Supplements are available in each state.

However, 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.

Remember that all Medicare Supplements are "standardized", offering the same coverage benefits for a particular plan (such as Plan G), but the monthly premiums for a Medicare Supplement can vary depending on the insurance company - and premiums can increase over time, with approval from your state.

For more information about the Medigap offerings in your area, please either contact a Medicare representative (1-800-Medicare) or a local insurance agent representing a Medicare Supplement carrier (insurance company).

Here is a key to the chart below:
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

Note: Please see the article below for important changes to Medigap plans:


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 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  $5,120 $2,560 N/A N/A
Estimated premiums as per Medicare.gov (03/10/2017) Allegheny Co., Pennsylvania
  $45 to $168 $56 to $192 $67 to $248 $83 to $216 $111 to $212 $34 to $67 $108 to $195 $53 to $73 $70 to $90 Not Availble Not Availble
Estimated premiums as per Medicare.gov (03/10/2017) Los Angles Co., California
  $71 to $194 $112 to $193 $125 to $250 $106 to $221 $119 to $372 $21 to $74 $110 to $253 $45 to $106 $125 to $256 $107 to $199 $73 to $231
Estimated premiums as per Medicare.gov (03/10/2017) Miami-Dade Co., Florida
  $152 to $363 $179 to $394 $207 to $500 $239 to $416 $209 to $505 $79 to $179 $240 to $472 $75 to $181 $125 to $256 $231 to $374 $151 to $379

Medigap Benefits
Medigap Plans

A

B

C

D

F
F* High Deductible
G

K

L

M

N

* 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.

You live in Massachusetts, Minnesota, or Wisconsin

If you live in one of these 3 states, Medigap policies are standardized in a different way.

(source: https://www.medicare.gov/supplement-other-insurance/compare-medigap/compare-medigap.html   and https://www.medicare.gov/supplements-other-insurance/whats-medicare-supplement-insurance-medigap)








Medicare Supplements
fill the gaps in your
Original Medicare
1. Enter Your ZIP Code:
» Medicare Supplement FAQs


Browse FAQ Categories


Check for Savings Using a Drug Discount Card
Prescription Discounts are
easy as 1-2-3
  1. Locate lowest price drug and pharmacy
  2. Show card at pharmacy
  3. Get instant savings!
Your drug discount card is available to you at no cost.







Tips & Disclaimers
  • The Medicare Advantage and Medicare Part D prescription drug plan data on our site comes directly from Medicare and is subject to change.
  • Medicare has neither reviewed nor endorsed the information on our site.
  • We provide our Q1Medicare.com site for educational purposes and strive to present unbiased and accurate information. However, Q1Medicare is not intended as a substitute for your lawyer, doctor, healthcare provider, financial advisor, or pharmacist. For more information on your Medicare coverage, please be sure to seek legal, medical, pharmaceutical, or financial advice from a licensed professional or telephone Medicare at 1-800-633-4227.
  • We are an independent education, research, and technology company. We are not affiliated with any Medicare plan, plan carrier, healthcare provider, or insurance company. We are not compensated for Medicare plan enrollments. We do not sell leads or share your personal information.
  • Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. Our PDP-Compare.com and MA-Compare.com provide highlights of annual plan benefit changes.
  • The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan.
  • Limitations, copayments, and restrictions may apply.
  • We make every effort to show all available Medicare Part D or Medicare Advantage plans in your service area. However, since our data is provided by Medicare, it is possible that this may not be a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.
  • When enrolling in a Medicare Advantage plan, you must continue to pay your Medicare Part B premium.
  • Medicare beneficiaries with higher incomes may be required to pay both a Medicare Part B and Medicare Part D Income Related Monthly Adjustment Amount (IRMAA). Read more on IRMAA.
  • Medicare Advantage plans that include prescription drug coverage (MAPDs) are considered Medicare Part D plans and members with higher incomes may be subject to the Medicare Part D Income Related Monthly Adjustment Amount (IRMAA), just as members in stand-alone Part D plans. In certain situations, you can appeal IRMAA.
  • You must be enrolled in both Medicare Part A and Part B to enroll in a Medicare Advantage plan. Members may enroll in a Medicare Advantage plan only during specific times of the year. Contact the Medicare plan for more information.
  • If you are enrolled in a Medicare plan with Part D prescription drug coverage, you may be eligible for financial Extra Help to assist with the payment of your prescription drug premiums and drug purchases. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or your state Medicaid Office.
  • Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next.
  • A Medicare Advantage Private Fee-for-Service plan (PFFS) is not a Medicare supplement plan. Providers who do not contract with the plan are not required to see you except in an emergency.
  • Disclaimer for Institutional Special Needs Plan (SNP): This plan is available to anyone with Medicare who meets the Skilled Nursing Facility (SNF) level of care and resides in a nursing home.
  • Disclaimer for Dual Eligible (Medicare/Medicaid) Special Needs Plan (SNP): This plan is available to anyone who has both Medical Assistance from the State and Medicare. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.
  • Disclaimer for Chronic Condition Special Needs Plan (SNP): This plan is available to anyone with Medicare who has been diagnosed with the plan specific Chronic Condition.
  • Medicare MSA Plans combine a high deductible Medicare Advantage Plan and a trust or custodial savings account (as defined and/or approved by the IRS). The plan deposits money from Medicare into the account. You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins.
  • Medicare MSA Plans do not cover prescription drugs. If you join a Medicare MSA Plan, you can also join any separate (stand-alone) Medicare Part D prescription drug plan
  • There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. Those who disenroll during the calendar year will owe a portion of the account deposit back to the plan. Contact the plan provider for additional information.
  • Medicare beneficiaries may enroll through the CMS Medicare Online Enrollment Center located at www.medicare.gov.
  • Medicare beneficiaries can file a complaint with the Centers for Medicare & Medicaid Services by calling 1-800-MEDICARE 24 hours a day/7 days or using the medicare.gov site. Beneficiaries can appoint a representative by submitting CMS Form-1696.