What is a Medicare Supplement or Medigap?

Original Medicare (Part A and Part B) requires beneficiaries to still pay copays, deductibles, and co-insurance. Medicare Supplement Insurance, or Medigap policies, help you cover some of the costs Original Medicare doesn’t. Frequent hospital or doctor visits can be expensive without the right coverage.

A Medicare Supplement insurance plan offers:

• Different coverage levels with standard benefits for each plan. 
• A range of services and plans, each assigned a letter from “A” to “N.” It’s important to note plans “E”, “H”, “I” and “J” are no longer sold.
• Basic Medigap coverage is the same across most states and insurance companies.
• Each Medigap plan follows federal and state laws to protect you and your policy.

The terms “standard benefits” and “basic coverage” mean that Medigap plan “A” in one state is the same as Plan “A” in a different state. However, there are exceptions to this rule with a few states. We discuss these states below.

What is Covered by a Medigap?

Medicare Supplement plans cover some costs not covered by Original Medicare. For example, a 20% co-insurance bill for a doctor visit could be covered with a Medigap plan. All Medicare Supplemental insurance plans must cover standard services. Additional benefits are available with specific plans. ^[1]

All Medicare Supplemental insurance plans must cover:

• Part A co-insurance costs up to an additional 365 days after Medicare benefits run out
• Part A Hospice Care Coinsurance or Copayment
• Part B co-insurance or copayments
• Up to three pints of blood

Other services covered depending on the plan:

• Skilled nursing facility care co-insurance 
• Part A deductible
• Part B deductible (no longer covered for new Medicare beneficiaries)
• Part B excess charges
• Foreign travel emergency care

Medicare Supplement plans generally don’t cover:

• Prescription drugs
• Vision
• Dental
• Long-term care
• Hearing aids

Compare Medicare Supplement Plans

With ten different plan options, it can be challenging to understand what each plan offers and whether it’s right for you.

We’ve created a chart for a side-by-side comparison of each plan. Any percentage less than 100% requires you to pay the remaining cost.

PLANS A AND B

Plans A and B offer the least amount of coverage of the 10 supplement plans. However, they are also significantly less expensive than the others. So, if you’re looking for decent coverage at a comparatively low rate, either of these may work for you.
Plan A covers:
• Part A Coinsurance & Hospital Costs
• Part B Coinsurance or Copayment
• First 3 Pints of Blood for Transfusions
• Part A Hospice Care Coinsurance or Copayment

Plan B offers identical coverage, also including, however, your Part A deductible.

PLANS C, F, AND G

Plan C covers:
• Part A Coinsurance & Hospital Costs
• Part B Coinsurance/Copayment
• First 3 Pints of Blood for Transfusions
• Part A Hospice Care Coinsurance/Copayment
• Skilled Nursing Care Facility Coinsurance
• Part A Deductible
• Part B Deductible
• 80% of Foreign Travel Emergency Care

Plan G, rather than covering your Part B deductible, covers Part B excess charges instead.
Plan F is the highest-coverage option of the 10 plans. It includes coverage for both the Part B deductible and excess charges, unlike Plans C and G, which only cover one or the other.

PLANS K AND L

These plans cover a certain percentage of benefits. Plan K, for example, covers:
• 100% of Part A Coinsurance and Hospital Costs
• 50% of Part B Coinsurance/Copayment
• 50% of the First 3 Pints of Blood for Transfusions
• 50% of Part A Hospice Care Coinsurance or Copayment
• 50% of Skilled Nursing Care Facility Coinsurance
• 50% of the Part A Deductible

Plan K will cover the first 50% of these expenses, while you pay the remaining costs out-of-pocket. This helps to reduce your overall monthly premiums.
If you want more than 50% coverage but still want a smaller monthly premium than the higher coverage plans (Plans C, G, and F), Plan L covers the exact same benefits (including 100% of Part A coinsurance and hospital costs) but at 75% rather than 50%.

PLAN M

Plan M is a good “middle-of-the-road” option. It offers similar coverage to plans D and N, but with a lower percent of your Part A deductible. This means a slightly lower cost than the other two, and significantly less expensive than the highest coverage options (Plans C, F, and G).
Plan M covers:
• Part A Coinsurance & Hospital Costs
• Part B Coinsurance/Copayment
• First 3 Pints of Blood for Transfusions
• Part A Hospice Care Coinsurance/Copayment
• Skilled Nursing Care Facility Coinsurance
• 50% of your Part A Deductible
• 80% of Foreign Travel Emergency Care

PLANS D AND N

These two plans are seemingly out of place. Why are they grouped together here? Well, let’s first take a look at what coverage Plan D has to offer.
Plan D covers:
• Part A Coinsurance & Hospital Costs
• Part B Coinsurance/Copayment
• First 3 Pints of Blood for Transfusions
• Part A Hospice Care Coinsurance/Copayment
• Skilled Nursing Care Facility Coinsurance
• Part A Deductible
• 80% of Foreign Travel Emergency Care

Plans D and N offer the exact same list of benefits, down to the percentage. The difference, then lies in your copayments. With Plan N, you will have to pay a copayment for doctor’s visits and emergency care. With Plan D, these costs are accounted for in your monthly premium.
If you are trying to choose between these plans, you will have to decide by preference—would you rather pay a bit more out-of-pocket when you receive medical care, or, would you rather pay it in advance on a monthly basis?
The more often you anticipate needing doctor care or hospitalization, the more you may want to consider Plan D, and vice versa.

MEDIGAP PLAN F

Medicare Supplement Plan F is usually seen as the most comprehensive of the ten Medicare Supplement plans. It provides extensive coverage for beneficiaries who need help paying their out-of-pocket costs for Medicare. But with that in mind, you can expect to pay higher premiums with Plan F.

The premiums are typically worth it for most people, though, because Plan F covers nearly all hospital and doctor costs that remain after Original Medicare pays its share. With Plan F, you can expect to have minimal leftover costs, making it ideal for people who want to simplify their health care expenses.

WHO SELLS PLAN F

Medigap Plan F is sold by private insurance companies that have been authorized by Medicare to sell Medicare Supplement Insurance products. The plans that are available in your area may vary, but if you are eligible and enrolled in Original Medicare, you have access to any plans that are servicing your area.

PLAN F BENEFITS

Medigap Plan F offers comprehensive benefits. The benefits covered under this plan include the following:

• Part A hospital coinsurance for 365 days following the end of Medicare benefits
• Part A hospice care copayments and coinsurance
• Part B coinsurance 
• Part B excess charges
• Part A and Part B deductibles
• 3 pints of blood to be used in a Medicare-approved procedure
• Skilled nursing facility coinsurance
• Travel emergencies

While Plan F may provide the widest range of coverage for policyholders, it does not cover all of your Original Medicare costs. For instance, you will still be required to pay your Part A and B premiums to maintain coverage.

WHAT DOES MEDIGAP PLAN G COVER?

Medicare Supplement Plan G covers almost all of the gaps that are left behind by Original Medicare. It helps pay for hospital costs, skilled nursing facility care, and hospice care. It also covers outpatient medical services, like doctor visits and diagnostic tests. If you experience a foreign travel emergency while covered by Plan G, you will also be protected. This plan provides coverage for up to $50,000 in foreign travel health emergency costs.

WHAT ISN’T COVERED IN PLAN G?

Plan G may seem to cover all of the gaps, but it doesn’t pay all of your Original Medicare costs. You will still be responsible for paying your Part B deductible, as well as your Part A and B premiums. In 2021, the Part B deductible is $203, so Plan G will pay everything after the first $203.