Medigap (Medicare Supplement Insurance) Plans
Medigap policies are standardized and identified by letters A through N (in most states). Each lettered plan offers a different level of coverage. The benefits of each plan are the same regardless of which insurance company sells it. Here’s a detailed look at what each plan covers:
Plan A
Plan A is the most basic Medigap policy and includes:
- Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up
- Part B coinsurance or copayment
- The first three pints of blood
- Part A hospice care coinsurance or copayment
Plan B
Plan B includes everything in Plan A, plus:
- Part A deductible
Plan C
Plan C offers more comprehensive coverage, including:
- Everything in Plan B
- Skilled nursing facility care coinsurance
- Part B deductible
- Foreign travel emergency (up to plan limits)
Note: Plan C is no longer available to new Medicare beneficiaries who became eligible on or after January 1, 2020, due to changes in federal law.
Plan D
Plan D includes:
- Everything in Plan B
- Skilled nursing facility care coinsurance
- Foreign travel emergency (up to plan limits)
Note: Plan D does not cover the Part B deductible.
Plan F
Plan F is the most comprehensive Medigap plan, covering:
- Everything in Plan C
- Part B excess charges
Note: Plan F is also no longer available to new Medicare beneficiaries who became eligible on or after January 1, 2020. It remains available to those who were eligible before that date.
Plan G
Plan G is similar to Plan F but does not cover the Part B deductible. It includes:
- Everything in Plan F except the Part B deductible
Plan G is now the most comprehensive plan available to new Medicare beneficiaries.
Plan K
Plan K covers:
- 50% of Part B coinsurance or copayment
- 50% of the first three pints of blood
- 50% of Part A hospice care coinsurance or copayment
- 50% of skilled nursing facility care coinsurance
- 50% of Part A deductible
- Out-of-pocket limit: After you spend a certain amount out-of-pocket, Medigap Plan K covers 100% of covered services for the rest of the year.
Plan L
Plan L is similar to Plan K but offers higher coverage:
- 75% of Part B coinsurance or copayment
- 75% of the first three pints of blood
- 75% of Part A hospice care coinsurance or copayment
- 75% of skilled nursing facility care coinsurance
- 75% of Part A deductible
- Out-of-pocket limit: After you spend a certain amount out-of-pocket, Medigap Plan L covers 100% of covered services for the rest of the year.
Plan M
Plan M covers:
- 50% of Part A deductible
- Everything in Plan A
- Skilled nursing facility care coinsurance
- Foreign travel emergency (up to plan limits)
Note: Plan M does not cover the Part B deductible.
Plan N
Plan N offers similar coverage to Plan D, but with different cost-sharing:
- Everything in Plan D
- Copayments for some Part B services: Up to $20 for office visits and up to $50 for emergency room visits that do not result in an inpatient admission
Summary of Coverage
Here’s a comparative summary of what each plan covers:
| Benefit | A | B | C | D | F | G | K | L | M | N |
|---|---|---|---|---|---|---|---|---|---|---|
| Part A coinsurance and hospital costs | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ |
| Part B coinsurance or copayment | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | 50% | 75% | ✓ | ✓^1 |
| First three pints of blood | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | 50% | 75% | ✓ | ✓ |
| Part A hospice care coinsurance | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | 50% | 75% | ✓ | ✓ |
| Skilled nursing facility care coinsurance | ✓ | ✓ | ✓ | ✓ | 50% | 75% | ✓ | ✓ | ||
| Part A deductible | ✓ | ✓ | ✓ | ✓ | ✓ | 50% | 75% | 50% | ✓ | |
| Part B deductible | ✓ | ✓ | ||||||||
| Part B excess charges | ✓ | ✓ | ||||||||
| Foreign travel emergency | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ||||
| Out-of-pocket limit | $[X] | $[Y] |
^1 Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to $50 for emergency room visits that don’t result in an inpatient admission.
Choosing the Right Medigap Plan
When choosing a Medigap plan, consider the following:
- Current and expected healthcare needs: Your choice may depend on how often you visit the doctor, require hospital services, or travel abroad.
- Budget: Premiums and out-of-pocket costs vary by plan.
- Availability: Not all plans are available in every state, and not all insurers offer every plan.
For more detailed information and personalized advice, visit medicare.gov
