What is a Medigap Plan?

When someone signs up for Medicare Parts A and B, they will typically also sign up for either a Medicare Advantage Plan (which replaces Parts A and B) or a Medigap Plan (Medicare Supplement Insurance).  They work differently, and if you’d like to understand the differences, watch my 20-minute video called Making Medicare Decisions.

You will be automatically enrolled into Medicare Parts A & B if you meet any of the following requirements:

  • You’re receiving benefits from the Social Security or Railroad Retirement Board (RRB)
  • You have a disability and are under the age of 65
  • You’re receiving Social Security or
  • You have Lou Gehrig’s Disease

Remember that you’ll have to enroll yourself once you turn 65 if you meet any of the following requirements:

  • You do not receive Social Security or RRB benefits
  • You’re not disabled
  • You’re receiving Social Security or Rail Road Benefits and live in Puerto Rico & want to sign up for Part B
  • You have End-Stage Renal Disease

For the purposes of this article, we’ve assumed that you’ve decided that you are interested in a Medigap Plan rather than a Medicare Advantage Plan.  But let’s just recap what it is before we compare Medigap plans.

Medigap PlanA Medigap Plan is an insurance policy that goes hand in hand with original Medicare.  The policy letter signifies which standardized plan you purchase.  All plans with the same plan letter cover exactly the same thing.  For example, a Plan F with Company A covers the exact same thing as a Plan F with Company B or Company C.

What is a Medigap Policy

A Medigap policy is a Medigap plan that someone has purchased.  They’ve been given a policy and a card to signify that they have purchased the plan.

You’ll normally receive a policy in the mail, along with a card that you can use at your doctor’s office.  This card is given alongside your Medicare card.

When you receive your policy, it’s a good idea to keep it somewhere safe, such as your safety deposit box.

The insurance company can’t cancel your Medigap policy due to your health.  They can, however, cancel you for non-payment so I suggest that you have these paid directly out of your checking account.

The info you need to compare Medigap Plans

Keep in mind that before you can purchase any Medigap Plan, you must have Medicare Part A and Part B. Once you have original Medicare, then you can compare Medigap plans to see which one works best for you.

Medigap Plan A – remember this when you compare Medigap Plans:

In order to compare Medigap Plans, let’s start with Medigap Plan A.  This is the basic policy.  All Medicare Supplement Insurance Companies must offer Medigap Plan A. Not all companies carry all available Medigap policies.

To compare Medigap Plans you must remember that Plans are different from “Parts”.  

Part A is the part of Medicare that pays for hospitalization.  Plan A is a Medigap Plan and it fills some gaps in original Medicare.

The Federal government regulates all Medigap insurance policies meaning that all Medigap Plan A policies are uniform wherever you purchase it. The only difference is the price.

It’s actually easier to compare Medigap Policies with what they DON’T cover, so that’s what I’ll do here.

Plan A covers everything at 100% except the following, which it does not cover:

  • Skilled nursing facility care coinsurance
  • Part B deductible
  • Excess doctor charges
  • Foreign travel emergency

Medigap Plan B

Just as Medigap Plan A is different from Medicare Part A, Plan B is also different from Part B. 

Medicare Part B is the part of Medicare that covers 80% of doctor visits.  Plan B is a Medigap Plan that helps cover not only the remaining 20% of the doctor visit but also part of hospitalization deductibles and coinsurance as well.

Just as earlier we used what the plan doesn’t cover to compare Medigap plans, we’ll do it here also.

Plan B does NOT cover:

  • Skilled nursing facility care coinsurance
  • Part B deductible
  • Part B excess charges
  • Foreign travel emergency

Medigap Plan C

compare Medigap plans

When comparing Medigap plans, it’s important to note that Medigap Plan C is NOT Medicare Part C.  Medicare Part C is Medicare Advantage, and actually REPLACES Original Medicare Parts A and B.  Medigap doesn’t replace original Medicare, it supplements it.

Just as we used what the plan did not cover on the other plans, we’ll do that now also to compare Medigap Plans with Plan C.

Medigap Plan C does NOT cover

  • Part B excess doctor charges.

Medigap Plan D

This is the last of the confusing letters when you need to compare Medigap plans.  Plan D is not the same as Part D. Part D covers drugs, and Plan D is a Medigap Plan.

Medigap Plan D fills the gaps of Original Medicare except it does not cover:

  • Deductible for Part B
  • Part B excess doctor charges

Medigap Plan F

Medigap Plan F is currently (in 2018) the most comprehensive Medigap Plan.  It covers 100% of everything that Medicare covers.  So if you have a Medigap Plan F and your service is a Medicare-covered service, you’ll never have a copay or deductible.

Medigap Plan F is not “going away” in 2020.  However, it will be closed to new Medicare beneficiaries at that time.

Medigap Plan G

Plan G will be the most comprehensive Medigap Plan starting in 2020.  That’s because it covers at 100% everything that Medicare offers, except it doesn’t cover the Part B deductible.

The Part B deductible in 2021 is $203 and is set by the Center for Medicare and Medicaid Services (CMS) every year.

Medigap Plan K

Medigap Plan K works a little differently than the plans we just discussed.  Like all Medigap Plans, it offers 100% of the Part A coinsurance for hospitalization and an extra 365 days in the hospital.

It offers the following at a 50% co-insurance amount:

  • Part B coinsurance amount
  • First 3 pints of blood
  • Part A Hospice Care
  • Skilled Nursing Facility
  • Part A deductible

It does NOT cover at all the following:

  • Part B deductible
  • Part B excess doctor charges
  • Foreign Travel Emergency

Because it offers coverage with a co-insurance amount, there is also an annual Maximum out of Pocket.  This MOOP is $5120 in 2018.

Medigap Plan L

Medigap Plan L is very similar to Medigap Plan K in the sense that it offers only partial coverage of costs (75%) not covered by traditional Medicare plans. The real draw of this policy is the low monthly premiums. Medigap Plan L is available in all states with the exception of Wisconsin, Minnesota, and Massachusetts.

When you compare Medigap Plans keep in mind how Plan L covers the following at 75%.  In other words, you would pay 25% of the costs for the following:

  • Medicare Part B coinsurance or co-payment
  • Blood
  • Part A hospice care coinsurance or co-payment
  • Skilled nursing facility care coinsurance

It does NOT cover at all the following:

  • Part B deductible
  • Part B excess doctor charges
  • Foreign Travel Emergency

Because it offers coverage with a co-insurance amount, there is also an annual Maximum out of Pocket.  This MOOP is $2560 in 2018.

Medigap Plan M

Medigap Plan M is relatively new and took effect on June 1, 2010, the same day that Plan J was discontinued.

If you have Plan M, you’ll pay the Part A deductible at 50%, and it doesn’t cover the following:

  • Deductible for Part B
  • Part B excess charges

Medigap Plan NMedigap Plan N

Another Medigap Plan that was instated at the same time that Plan J was discontinued is Medigap Plan N.

This plan is considered the cheaper alternative to Medigap Plan F. The beauty of Plan N is that it covers almost all of the costs incurred that are not covered by Medicare, but requires a much lower monthly premium than Plan F. You pay $20 copay to see a doctor, and you’ll pay $50 for emergency room care that doesn’t result in an inpatient stay at the hospital.

However, when you compare Medigap Plans, please note that Plan N does not cover excess doctor charges.

Alternative Medicare Supplement Plans

These are the alternative Medicare Supplement plans to choose from.  Medigap plans give the most flexibility in seeing providers, but there is also a cost involved.

That cost is based on where you live and your zip code, among other factors.

To get a free quote, fill out our form, and let me know what plan you are considering.  Or better yet, schedule a time to talk with me.

Choose The Right Medigap Insurance For You

There you have it. All the Medigap plans from A-N. There were a lot more details that we weren’t able to cover but those are the coverages overall. Of course, if given a choice, we would all like to enroll in Plan F or G.

But not everyone can afford those plans.

We’re here to help you find a plan that is right for you, and that can fit your budget.

Image of cartoon character with red phone inviting the reader to call or email MedicareQuick with questionsFor more information, give us a call at 866-445-6683 or use our contact form to send us an email.

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