Medigap Health Supplements

Why Some People Choose Medigap Health Supplements

(And why you may want to as well.)

Standard Medicare coverage includes Part A, which covers hospitalization care, and Part B, which covers medical expenses. These cover only a portion of your healthcare costs, which can leave you with excess charges, also referred to as a “gap.” 

Medigap insurance closes this gap by providing additional coverage for copayment, coinsurance, and deductible amounts.

Medigap is offered through private insurance companies, and while plans are standardized by law, prices are not. There are 10 supplemental bundles to choose from. It's a good idea to research your Medigap insurance plan options and make sure you're choosing a plan that's right for your needs and budget.

you can use this independent agent matching tool to find the best insurance solution in your area. Provide some details about what you're looking for, and the tool will recommend the best agents for you. Any information you provide will be sent only to the agent you pick.

Am I Qualified for Medigap Insurance?

  • You must be enrolled in Medicare Part A and B.
  • You must be over 65, disabled, or meet other specific Medicare qualifications.
  • You may be medically screened.
  • You cannot be enrolled in a Medicare Advantage Plan.

How Do I Enroll in Medigap Insurance?

When you turn 65, there is a period of six months known as open enrollment. During this time, you can obtain any form of Medicare coverage, including Medigap insurance, without medical screening. 

Outside of open enrollment, those who are eligible can apply for Medigap insurance through private insurance companies. It’s essential that you have Medicare Part A and Part B first, which you can get online or through your Medicare state representatives.

How Much Does Medigap Insurance Cost?

While plans are standardized by the law, Medigap insurance companies have the right to charge different prices for the same plan. Because of this, it is essential that you compare plans in your state to find the right Medigap coverage plan for your budget.

Typical Medigap plan rates vary. The factors that play a role in determining your premium include the following:

  • The Medigap supplement plan you buy
  • The rates set by the Medigap insurance company
  • Your state
  • Your age
  • Any discounts offered within the plan, such as a discount for a clean bill of health, if medical underwriting is involved

When searching for Medigap insurance in your state, make sure you get multiple Medigap insurance quotes before you buy, to ensure you're getting a policy at a competitive rate.

What Do Medigap Supplemental Insurance Plans Cover?

Medigap supplemental policies are designed to cover the gaps in healthcare costs that original Medicare does not cover, and help seniors and those with disabilities to manage the costs of their care. These costs include Medicare Part A coinsurance and hospital costs and Medicare Part B coinsurance or copayments.

Medigap does not cover long-term care or vision and dental services. If you need eyeglasses, hearing aids or orthodontia, you will need to purchase additional coverage. 

Private duty nurses are also not covered, and Medigap doesn’t include any form of prescription drug coverage. Purchasing Medicare Part D can help pay for necessary medications.

In the following sections you will find a brief overview of each of the supplement plans that are currently available.

Medigap Supplement Plan A: Basic Coverage

Medicare Supplement Plan A is a minimal plan that covers some deductibles and coinsurance and a few other items of care. It is a fairly simple and affordable plan designed to cover several specific Medicare coverage gaps:

  • Gap costs covered by Supplement Plan A:
    • Hospitalization costs after Medicare stops paying at day 60, up to 90 days
    • Hospitalization costs for the 91st day and after
    • All Medicare-eligible hospitalization expenses for an additional 365 days
    • The cost of the first three pints of blood if admitted to a hospital
    • Your coinsurance costs if you need hospice care
  • Costs not covered:
    • Medicare Part A deductible 
    • Skilled nursing facility coinsurance from the 21st through the 100th day
    • Care in a skilled nursing facility after the 100th day
    • Medicare Part B hospital deductible
    • Hospitalization costs after 365 days
    • Excess charges if you need to see a practitioner who provides services beyond what is Medicare-approved

Medigap Supplement Plan B: Basic Coverage Plus

Medicare Supplement Plan B is also a basic and simple plan, but with an enhanced set of benefits. It is a bit more comprehensive than Plan A, and covers five specific Medicare gaps.

  • Costs covered Medicare Supplement Plan B:
    • The  Medicare Part A deductible you must pay if admitted to the hospital and your hospital coinsurance after 60 days (the first 60 are covered under Medicare Plan A)
    • The full cost of hospitalization for which you are responsible for after 150 days
    • The 20% coinsurance for approved in-patient care that Medicare Part B does not cover
    • The cost of the first three pints of blood if admitted to a hospital
    • The 5% coinsurance costs you would otherwise be responsible for if you need hospice care
  • Costs not covered:
    • Hospital coinsurance from the 21st through the 100th day of hospitalization
    • Your Medicare Part B hospitalization deductible
    • Your Part B deductible for blood
    • Your Part B deductible for home health care

Medigap Supplement Plan C: Full Coverage (Not Available for New Enrollees)

Medicare Supplement Plan C is a comprehensive plan designed to cover most costs you can anticipate, and is second only to Medicare Supplement Plan F for the amount of coverage it provides. Plan C covers the following:

  • Costs covered:
    • Medicare Part A deductible
    • Coinsurance for hospital stays
    • Coinsurance for skilled nursing care
    • Coinsurance for hospice care
    • 80% of foreign travel emergency expenses, after you pay the first $250
    • The cost of the first three pints of blood if admitted to a hospital
  • Costs not covered:
    • Excess charges (for example, compared to Plan F) if you need to see a practitioner who provides services beyond the Medicare-approved services

Medigap Supplement Plan D: Almost Full Coverage

Medicare Supplement Plan D is an almost comprehensive plan that is very similar to plans C and F, with the following similarities and differences:

  • Costs covered:
    • Medicare Part A deductibles
    • Coinsurance for hospital stays
    • Coinsurance for hospice care and skilled nursing care
    • 80% of foreign travel emergency expenses after you pay the first $250
    • The cost of the first three pints of blood if admitted to a hospital
  • Costs not covered:
    • Excess charges if you need to see a practitioner who provides services beyond the Medicare-approved services
    • The Medicare Part B deductible
    • May not cover your Medicare Part A premiums if you have a certain income level
    • Hospitalization costs after 365 days
    • Skilled nursing costs after 100 days

Medigap Supplement Plan F: Full Coverage Plus (Not Available for new Enrollees)

Medicare Supplement Plan F is one of two “Cadillac” Medicare supplement plans (the other is Plan C), and is considered the most comprehensive plan.

  • Costs covered:
    • Medicare Part A deductible
    • Coinsurance for hospital stays
    • Coinsurance for skilled nursing care
    • Coinsurance for hospice care
    • 80% of foreign travel emergency expenses after you pay the first $250
    • The cost of the first three pints of blood if admitted to a hospital
    • Excess charges that if you need to see a practitioner who provides services beyond what is Medicare-approved
  • Costs not covered:
    • Hospitalization costs after 365 days
    • Skilled nursing costs after 100 days

Medigap Supplement Plan G: Almost Full Coverage Plus

Medicare Supplement Plan G is a fairly complete plan similar to Plan D in that it provides nearly full coverage for Medicare gaps with one exception: It pays for the cost of additional expenses if you need to see a specialist outside of the Medicare-approved providers.

  • Costs covered:
    • Medicare Part A deductibles
    • Coinsurance for hospital stays
    • Coinsurance for hospice care and skilled nursing care
    • 80% of foreign travel emergency expenses after you pay the first $250
    • The cost of the first three pints of blood if admitted to a hospital
    • Does cover excess charges if you need to see a practitioner who provides services beyond what is Medicare-approved
  • Costs not covered:
    • The Medicare Part B deductible
    • May not cover your Medicare Part A premiums if you have a certain income level
    • Hospitalization costs after 365 days
    • Skilled nursing costs after 100 days

Medigap Supplement Plan K: Reduced Coverage

Medicare Supplement Plan K provides minimal coverage and may be appropriate for those who are healthy and do not foresee needing much medical care:

  • Costs covered:
    • 50% of your Medicare Part A deductible
    • Coinsurance for hospital stays up to a set limit with 365 additional days
    • 50% of skilled nursing care for 21st day through 100th day
    • 50% of the cost of the first three pints of blood if admitted to a hospital
    • 50% of copays and coinsurance for hospice care
  • Costs not covered:
    • Hospitalization costs after limit with 365 additional days
    • Skilled nursing care after 100 days
    • Excess charges if you need to see a practitioner who provides services beyond what is Medicare-approved
    • The Medicare Part B deductible
    • 10% of medical expenses after Medicare Part B deductible is paid

Medigap Supplement Plan L: Minimal Coverage

Medicare Supplement Plan L is a plan with very limited benefits.

  • Costs covered:
    • 75% of Part A deductible
    • Coinsurance for hospital stays up to a set limit, with 365 additional days
    • 75% of skilled nursing care coinsurance for 21st day through 100th day
    • 70% of the cost of the first three pints of blood if admitted to a hospital
  • Costs not covered:
    • Hospitalization costs after limit with 365 additional days
    • 25% of skilled nursing care coinsurance for 21st day through 100th day
    • Skilled nursing care after 100 days
    • 50% of the cost of the first three pints of blood if admitted to the hospital
    • 25% of skilled nursing care co-insurance
    • Excess charges if you need to see a practitioner who provides services beyond what is Medicare-approved
    • The Medicare Part B annual deductible
    • 5% of medical expenses after Medicare Part B deductible is paid
    • The annual $250 foreign travel emergency expenses deductible

Medigap Supplement Plan M: 50% Cost-Sharing

Medicare Supplement Plan M is a plan that requires you to share a full 50% of your supplement plan costs for deductibles, and was designed to encourage people to visit practitioners only when needed in order to reduce unnecessary healthcare spending.

  • Costs covered:
    • 50% of your Medicare Part A deductible
    • Coinsurance for hospital stays up to a set limit with 365 additional days
    • 21st through 100th day of skilled nursing care
    • The cost of the first three pints of blood if admitted to a hospital
  • Costs not covered:
    • The other 50% of your Medicare Part A deductible
    • Skilled nursing care after the 100th day
    • Excess charges if you need to see a practitioner who provides services beyond what is Medicare-approved
    • The Medicare Part B annual deductible
    • The annual $250 foreign travel emergency expenses deductible

Medigap Supplement Plan N: Affordable and Nearly Full Coverage

Medicare Supplement Plan N is an affordable but limited plan that is appropriate for those in excellent health.

  • Costs covered:
    • Your Medicare Part A deductible
    • Coinsurance for hospital stays up to a set limit with 365 additional days
    • 21st through 100th day of skilled nursing care
    • The cost of the first three pints of blood if admitted to a hospital
  • Costs not covered:
    • Hospitalization costs after limit with 365 additional days
    • Skilled nursing care after the 100th day
    • Excess charges that Plan F does cover if you need to see a practitioner who provides services beyond the Medicare approved services
    • The Medicare Part B annual deductible
    • Copays for doctor’s visits
    • The annual $250 foreign travel emergency expenses deductible

Choosing a Medigap Insurance Plan

If you already have original Medicare but find that you’re spending a lot of your money on copayments and coinsurance, investing in a Medigap plan may be a good idea. It can save you money and help to manage your healthcare costs. It is important to find the right bundle for your specific needs.

Use this independent agent matching system to find the best insurance plan in your area. Describe what you’re looking for, and the technology will recommend the best agents for your needs. Any information you provide will be sent only to the agents you pick.

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TrustedChoice.com Article | Reviewed by Jeffrey Green

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