The government provides minimum coverage under original Medicare (Parts A & B). Patients enrolled in Medicare alone are at risk for large medical bills with no maximum out-of-pocket protection for covered expenses. One solution for protecting from these out-of-pocket expenses is to purchase additional insurance commonly referred to as “Medigap”, or a Medicare Supplement policy from a private carrier. The chart below outlines the standard Medigap plan options that can be purchased from private insurance companies.
Medigap Plan Benefits | Medigap Plans | ||||||||
A | B | C | D | F* | G | K | L | N | |
| Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up | l | l | l | l | l | l | l | l | l |
| Part B coinsurance or copayment | l | l | l | l | l | l | 50% | 75% | l |
| Blood (first 3 pints) | l | l | l | l | l | l | 50% | 75% | l |
| Part A hospice care coinsurance or copayment | l | l | l | l | l | l | 50% | 75% | l |
| Skilled nursing facility care coinsurance | l | l | l | l | 50% | 75% | l | ||
| Part A deductible | l | l | l | l | l | 50% | 75% | l | |
| Part B deductible | l | l | |||||||
| Part B excess charge | l | l | |||||||
| Foreign travel exchange (up to plan limits) |
|
| 80% | 80% | 80% | 80% |
|
| 80% |
| Out-of-pocket limit** | n/a | n/a | n/a | n/a | n/a | n/a | $5560 | $2780 | n/a |
Beginning in year 2020, Medigap polices can no longer cover the Part B deductible. Currently the Part B deductible is $185. Plans C and F will not be available for purchase beginning January 1, 2020.
Note: Those who have purchased one of these Medigap policies prior to 2020 can be grandfathered in, meaning you can keep those plans moving forward.
Many of our clients who prefer Medigap options over Medicare Advantage plans often consider Plan G over Plan F anyway, because of the lower premium. This year the difference in premium between Plans F and G, over 12 months, provides more savings than the cost of paying the Part B deductible.