dcsimg

Health Insurance Quotes

Find Affordable Health Insurance Now

Yes No
Yes No

The 12 Standardized Medigap Plans

Because Medicare does not pay for all health care services, you have the option of buying supplemental coverage. Medigap policies are sold by private health insurance companies.

[Let Insure.com help you find affordable health insurance now.]

IMedigap policies can be standardized into 12 plans, lettered A through L,, to make it easier for consumers to shop for coverage and avoid scams. All companies that sell Medigap plans must sell at least Plan A, which offers the "basic benefits." But not all companies offer the full range of Medigap plans, and some plans might not be available at all in your state. Insurers in Massachusetts, Minnesota, and Wisconsin are permitted to sell somewhat different combinations of benefits.

Two of the plans, F and J, have the option of a high deductible and, under federal law, states can allow insurance companies to add "innovative benefits" to any of the 12 plans. Discounts for coverage such as eyeglasses or prescription drugs from mail-order pharmacies are also allowed. In addition, any of the plans can be sold as a "Medicare SELECT" policy. Those policies generally cost less because you must use specified hospitals and doctors, except in emergencies.

Plans H and I offer the basic prescription-drug benefit. After you pay your $250 per year deductible, the plan pays 50 percent of the costs of your prescription drugs up to a maximum of $1,250 per year. Plan J offers the extended prescription-drug benefit. After you pay your $250 per year deductible, the plan pays 50 percent of the costs of your prescription drugs up to a maximum of $3,000 per year.

Medigap plans K and L will only pay a portion of the cost that Medicare does not cover until you reach a yearly out-of-pocket limit.

There is one important consideration to keep in mind: Although the plans themselves are standardized, the premiums are not. In fact, the costs can vary widely, even by hundreds of dollars, from one insurer to the next. That means it is vital to shop around not only for the plan best suited to your needs but also for cost.

The chart below provides an overview of the benefits offered by each plan.

Medigap
benefits
A B C D E F* G H I J* K L
 
Basic benefits
Part A: Inpatient hospital deductible
Part A: Skilled-nursing facility co-insurance 50% 75%
Part B: deductible
Foreign travel emergency
At-home
recovery
Part B: excess
charges
100% 80% 100% 100%
Preventive
care
Prescription
drugs
** ** **


* Plans F and J have a high-deductible option.

**Medigap drug coverage stopped being sold in 2006. If you have a Medigap H, I, or J policy with drug coverage that you bought before 2006, you cannot have drug coverage through both Medigap and Medicare's drug benefit.

A dash in a column means that benefit is not offered.

Medigap Plan A Basic Benefits

•  Coverage for the Part A co-insurance amount for days 61 through 90 of a hospital stay in each Medicare benefit period
•  Coverage for the Part A co-insurance amount for days 91 through 150 of a hospital stay for each of Medicareœs 60 lifetime reserve days, which may be used only once
•  After all Medicare hospital benefits are exhausted, coverage for 100 percent of the Medicare Part A eligible hospital expenses. Coverage is limited to a maximum of 365 days of additional inpatient hospital care during your lifetime. You may be responsible for payment when Medigap hospital benefits are exhausted
•  Coverage under Medicare parts A and B for the reasonable cost of the first 3 pints of blood or equivalent quantities of packed red blood cells per calendar year unless this blood is replaced
•  Coverage for the co-insurance amount for Part B services (generally 20 percent of Medicare-approved amount) after annual deductible is met

Medigap Plan B

•  All the basic benefits of Plan A
•  Coverage for the Medicare Part A inpatient hospital deductible

Medigap Plan C

•  All the basic benefits of Plan A
•  Coverage for the Medicare Part A inpatient hospital deductible
•  Coverage for the skilled-nursing facility co-insurance amount
•  Coverage for the Medicare Part B deductible
•  80 percent coverage for medically necessary emergency care in a foreign country, after a deductible

Medigap Plan D

•  All the basic benefits of Plan A
•  Coverage for the Medicare Part A inpatient hospital deductible
•  Coverage for the skilled-nursing facility co-insurance amount
•  80 percent coverage for medically necessary emergency care in a foreign country, after a deductible
•  Coverage for at-home recovery. The at-home recovery benefit pays an amount per year for short-term, at-home assistance with activities of daily living (like bathing, dressing, personal hygiene, etc.) for those recovering from an illness, injury, or surgery

Medigap Plan E

•  All the basic benefits of Plan A
•  Coverage for the Medicare Part A inpatient hospital deductible
•  Coverage for the skilled-nursing facility co-insurance amount
•  80 percent coverage for medically necessary emergency care in a foreign country, after a deductible
•  Coverage for preventive medical care. The preventive medical care benefit pays an amount per year for things like a physical exam, serum cholesterol screening, hearing test, diabetes screening, and thyroid function test

Medigap Plan F

• All the basic benefits of Plan A
• Coverage for the Medicare Part A inpatient hospital deductible
• Coverage for the skilled-nursing facility co-insurance amount
• Coverage for the Medicare Part B deductible
• 80 percent coverage for medically necessary emergency care in a foreign country, after a deductible
• Coverage for 100 percent of Medicare Part B excess charges

Medigap Plan G

• All the basic benefits of Plan A
• Coverage for the Medicare Part A inpatient hospital deductible
• Coverage for the skilled-nursing facility co-insurance amount
• 80 percent coverage for medically necessary emergency care in a foreign country, after a deductible
• Coverage for at-home recovery. The at-home recovery benefit pays an amount per year for short-term, at-home assistance with activities of daily living (like bathing, dressing, personal hygiene, etc.) for those recovering from an illness, injury, or surgery
• Coverage for 80 percent of Medicare Part B excess charges

Medigap Plan H

•  All the basic benefits of Plan A
•  Coverage for the Medicare Part A inpatient hospital deductible
•  Coverage for the skilled-nursing facility co-insurance amount
•  80 percent coverage for medically necessary emergency care in a foreign country, after a deductible

Medigap Plan I

•  All the basic benefits of Plan A
•  Coverage for the Medicare Part A inpatient hospital deductible
•  Coverage for the skilled-nursing facility co-insurance amount
•  80 percent coverage for medically necessary emergency care in a foreign country, after a deductible
•  Coverage for at-home recovery. The at-home recovery benefit pays an amount per year for short-term, at-home assistance with activities of daily living (like bathing, dressing, personal hygiene, etc.) for those recovering from an illness, injury, or surgery
•  Coverage for 100 percent of Medicare Part B excess charges

Medigap Plan J

•  All the basic benefits of Plan A
•  Coverage for the Medicare Part A inpatient hospital deductible
•  Coverage for the skilled-nursing facility co-insurance amount
•  Coverage for the Medicare Part B deductible
•  80 percent coverage for medically necessary emergency care in a foreign country, after a deductible
•  Coverage for at-home recovery. The at-home recovery benefit pays up to an amount per year for short-term, at-home assistance with activities of daily living (like bathing, dressing, personal hygiene, etc.) for those recovering from an illness, injury, or surgery
• Coverage for 100 percent of Medicare Part B excess charges
• Coverage for preventive medical care. The preventive medical care benefit pays up to an amount per year for things like a physical exam, serum cholesterol screening, hearing test, diabetes screening, and thyroid function test

Medigap Plan K

• All the basic benefits of Plan A
• Coverage for the Medicare Part A inpatient hospital deductible
• 50% coverage for the skilled-nursing facility co-insurance amount
• 50% coverage for Medicare Part B Coinsurance or Copayment
• 50% coverage for Hospice Care Coinsurance or Copayment
• 50% coverage for Skiled Nursing Facility Care Coinsurance

• Preventive Care Coinsurance (Included in Part B Coinsurance)

• 2008 out-of-pocket-limits: $4,440.00

Medigap Plan L

• All the basic benefits of Plan A
• Coverage for the Medicare Part A inpatient hospital deductible
• 75% coverage for the skilled-nursing facility co-insurance amount
• 75% coverage for Medicare Part B Coinsurance or Copayment
• 75% coverage for Hospice Care Coinsurance or Copayment
• 75% coverage for Skiled Nursing Facility Care Coinsurance

• Preventive Care Coinsurance (Included in Part B Coinsurance)

• 2008 out-of-pocket-limits: $2,220.00

Ready to get a quote?

Get quick and easy health insurance quotes


Yes No

Insure.com Redesign Survey