Medigap policies are standardized
In order to protect you, Medigap policies must follow state and federal laws. And they must be clearly identified as “Medicare Supplement Insurance.” The “standardized” policies are identified in most states by letters.
All policies offer the same basic benefits but some may offer additional benefits, so you can choose which one meets your needs.
The insurance companies can decide which Medigap policies they want to sell, however, state laws might affect which ones they offer.
Insurance companies that sell Medigap policies:
- Don’t have to offer every Medigap plan
- Must offer Medigap Plan A if they offer any Medigap policy
- Must also offer Plan C or Plan F if they offer any plan
NOTE: The Medigap policy only covers coinsurance after you’ve paid the deductibles (unless your Medigap policy also pays the deductible).
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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 charges | 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 | $4,940 | $2,470 | N/A | N/A |
* Plan F also offers a high-deductible plan. If you choose this option, you must pay for Medicare-covered costs up to the deductible amount of $2,180 in 2015 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.
