Medigap Plans
A Big Picture View of Medigap Plans
There are 12 Medicare supplement plans available in 2023. Each plan must be compared side-by-side to understand how they differ.
It’s important not to confuse Medigap “plans” with Medicare “parts.” The parts of Medicare are A, B, C, and D. Parts A and B are Original Medicare and cover inpatient and outpatient services. Part C is Medicare Advantage and Part D includes prescription drug coverage. Medigap plans offer supplemental coverage to Medicare Parts A and B.
Medigap policies don’t cover for everything. To be more specific, Medigap policies generally don’t cover long-term care, dental or vision check-ups, hearing aid or eyeglasses for example. Nevertheless, there are many remaining healthcare costs left behind by Original Medicare that a Medigap policy can help you with.
What are Medigap plans?
Medicare supplement plans are secondary payers to Original Medicare. Since Parts A and B do not cover 100% of healthcare expenses, Medicare supplements help pay the remaining costs. As long as the provider accepts Medicare assignment, they will also accept a Medicare supplement plan.
Medigap plans are sold to individuals only. While spouses can have the same plan, they each have to carry their own policy. Some insurance companies offer household discounts if both people are on the same plan with the same carrier.
Depending on the plan, benefits in a Medicare supplement may include payment for coinsurance costs, inpatient and outpatient deductibles, extra days for hospital stays, hospice care, blood transfusions, and more.
Medigap Eligibility And Enrollment
The main condition that needs to be met in order to be eligible for a Medigap plan is to be enrolled in Original Medicare (Part A and Part B). Individuals who are 65 years old, who have been collecting social security disability benefits for 24 months, or who have been diagnosed with ALS or ESRD are all eligible to enroll in Medicare.
The best time to enroll in a Medigap plan would be during your Open Enrollment period which starts as soon as your Part B is activated. Outside of this enrollment window, they can still apply for a policy but usually are not granted guaranteed issue rights, which means they may be denied enrollment into a plan.
The 12 Medigap Plans
The 12 Medigap plans are lettered A-N and each offers different benefits. No matter which plan you choose, you will have some coverage for the out-of-pocket expenses leftover from your Original Medicare benefits. This may include coverage for deductibles, copays, and coinsurance costs.
Every insurance carrier that sells Medigap plans must offer Medigap Plan A. This is the most basic Medigap plan and offers the least amount of coverage.
Plan B offers a little more coverage than Plan A. With Plan B, the Medicare Part A inpatient deductible is covered.
Plan C covers all benefits except the Part B excess charges.
Plan D offers benefits for everything under Original Medicare, but does not pay for the Part B deductible or Part B excess charges.
Plan F is the most comprehensive coverage. It is considered first-dollar coverage because outside of the monthly premium, there are no out-of-pocket expenses. However, this plan is only available to those who turned 65 prior to January 1, 2020.
This plan is the same as Plan F, but offers a lower premium in exchange for a higher deductible.
For those who are ineligible for Plan F, Plan G is the next best option. It is currently one of the most popular Medigap plans. It offers coverage for everything except the Part B deductible.
This plan is the same as Plan G, but offers a lower monthly premium in exchange for a higher deductible.
Plan K only covers 50% of some of the benefits that other plans cover 100% of.
Plan L only covers 75% of some of the benefits that other plans cover 100% of.
Plan M only covers 50% of the Part A inpatient deductible and it does not cover the Part B deductible or the Part B excess charges.
Plan N is another of the more popular Medigap plans. It has small copays, but covers everything else except the Part B deductible and Part B excess charges.