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Medigap Plans

Medigap plans are offered by private health insurance carriers. They provide additional coverage and help close the “gap” between what Medicare Part A and Part B pays and what you would have to pay for out-of-pocket. Medigap plans are also known as Medicare Supplement plans.

The best time to enroll in a Medigap plan is when you first qualify for Medicare Part A and Part B. The Medigap Enrollment Period begins on your 65th birthday and lasts for 6 months after you turn 65. During this time, private insurance companies are required by law to offer you a Medigap plan. They also cannot increase your premiums because of pre-existing conditions. Those who are under 65 years old may be eligible toenroll if they are disabled. If you miss the Medigap Enrollment Period, you may still have an opportunity to get a Medigap policy, but carriers may require you take a physical exam. Based on the results, they can increase your premiums or even deny you coverage if you have a pre-existing condition. If you find yourself having to pay a higher premium or are denied coverage, don’t give up. Some carriers may still enroll you at a competitively lower rate.

Medigap: Coverage and Costs

There are 10 “letter” Medigap plans. They are Plan A, Plan B, Plan C, Plan D, Plan F, Plan G, Plan K, Plan L, Plan M, and Plan N.

In most states, each Medigap plan will have the same standardized coverage and benefits per letter category. For example, Plan N will have the same level of coverage in California as it would in New York. Though the coverage is standardized, their availability can differ from state to state, and carrier to carrier.

Depending on the plan you select, most Medigap plans may help pay for:

  • Medicare Part A and Part B deductibles, such as the $1,316 deductible for Part A.
  • Coinsurance when visiting the doctor, such as covering the 20% of out-of-pocket costs that Medicare Part A and Part B does not pay for.
  • Overseas emergency health care.

Here are is a summary of the benefits across each letter Medigap plan:

Medigap Benefits

Plan A

Plan B

Plan C

Plan D

Plan F

Plan G

Plan K

Plan L

Plan M

Plan N

Medicare Part A co-insurance and hospital costs

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Medicare Part B co-insurance or co-payment

Y

Y

Y

Y

Y

Y

50%

75%

Y

Y

First three pints of blood

Y

Y

Y

Y

Y

Y

50%

75%

Y

Y

Part A hospice care co-insurance or co-payment

Y

Y

Y

Y

Y

Y

50%

75%

Y

Y

Skilled nursing facility co-insurance

N

N

Y

Y

Y

Y

50%

75%

Y

Y

Medicare Part A deductible

N

Y

Y

Y

Y

Y

50%

75%

Y

Y

Medicare Part B deductible

N

N

Y

N

Y

N

N

N

N

N

Medicare Part B excess charges

N

N

N

N

Y

Y

N

N

N

N

Foreign travel emergency

N

N

80%

80%

80%

80%

N

N

80%

80%

Y=Yes, the plan covers 100% of the benefit. N=No, the plan does not cover the benefit. %=The plan covers this percentage of the benefit.

 

Medigap premiums tend to start around $89* per month in 2017. Higher coverage plans can cost $129* or more in 2017. Though the plans are standardized, rates can vary from state to state. Plan A tends to have the lowest premiums, however you may end up paying more out-of-pocket on deductibles, copays, and coinsurance costs. By comparison, Plan F tends to have the highest premiums, but offers the most comprehensive set of benefits, which may result in minimal out-of-pocket costs.

Quick Facts:

  • Generally speaking, the more coverage you purchase, the higher your monthly premium. But if you think you’ll use your plan frequently, like going to regular doctor appointments for example, you may save money in the long-run since you’ll have lower out-of-pocket costs.
  • Rates and availability can vary by carrier and by state.
  • The plans are all standardized into 10 “letter” plans, and their coverage does not vary by carrier and state.
  • You must be enrolled in Medicare Part A and Part B to get a Medigap plan.
  • The best time to enroll is during the Medigap Enrollment Period, which begins on your 65th birthday and ends 6 months after you turn 65. It may be harder to get a Medigap plan at a competitive rate after the enrollment period. Individuals under the age of 65 may be eligible to enroll if they are disabled.

Please submit your zip code to start comparing Medigap plans. You can also call (855) 902-9647 to speak with a licensed sales agent.

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