Medigap Plans: Listing by Plan

A listing of the specific benefits offered by each of the 12 Medigap plans, A through L.

Source: AARP.org | 2008-10-24

There are 12 standard Medicare supplemental (Medigap) insurance plans that help pay some of your costs in the Original Medicare plan and some health care costs that Original Medicare doesn't cover.

Each standard plan, labeled "A" through "L," offers a different set of benefits, fills different "gaps" in Medicare coverage, and varies in price. The basic benefits for Medigap plans K and L are different from the basic benefits offered in plans A through J. These plans are designed to have lower monthly premiums but higher out-of-pocket costs.

If you are in a Medicare Advantage Plan, such as a Medicare Health Maintenance Organization (HMO), you don't need a Medigap policy. If you live in Massachusetts, Minnesota, or Wisconsin, you have different standard Medigap plans to buy.

To learn more about Medigap plans in your area, visit the Medicare Options Compare tool.

Basic Benefits

All Medigap plans must cover certain basic benefits. These basic benefits are as follows:

Medicare Part A Coverage:
• Coinsurance for hospital days 61-90 ($267 in 2009) and
• Coinsurance for each day 91-150 ($534 in 2009) (up to 60 days in your lifetime)
• Cost of 365 extra hospital days in your lifetime, once you've used all Medicare hospital benefits

Medicare Part B coverage:
• Generally, all coinsurance and copayment amounts after you meet the $135 (in 2009) yearly deductible for Medicare Part B
• The first three pints of blood

Medigap Plan A
• Basic Benefits

Medigap Plan B
• Basic Benefits
• Medicare Part A Hospital Deductible
   o $1,068 in 2009 for each benefit period for hospital services

Medigap Plan C
• Basic Benefits
• Medicare Part A Hospital Deductible
• Skilled Nursing-Home Costs
   o Your cost ($133.50 in 2009) for days 21-100 in a skilled nursing home
• Medicare Part B Deductible
   o Yearly deductible for doctors' services ($135 in 2009)
• Foreign Travel Emergency
   o 80 percent of the cost of emergency care outside the United States
   o Up to $50,000 during your lifetime
   o Patient pays a yearly deductible of $250

Medigap Plan D
• Basic Benefits
• Medicare Part A Hospital Deductible
• Skilled Nursing-Home Costs
• Foreign Travel Emergency
• At-Home Recovery
   o Help for activities of daily living, such as bathing and dressing, if you are already receiving skilled home care covered by Medicare
   o Help for up to eight weeks after you no longer need skilled care
   o Will pay up to $40 per visit, seven visits per week, or a total of $1,600 per year

Medigap Plan E
• Basic Benefits
• Medicare Part A Hospital Deductible
• Skilled Nursing-Home Costs
• Foreign Travel Emergency
• Preventive Care
   o Up to $120 per year for preventive services not covered by Medicare

Medigap Plan F*
• Basic Benefits
• Medicare Part A Hospital Deductible
• Skilled Nursing-Home Costs
• Medicare Part B Deductible
• Medicare Part B Excess Charges
   o Pays 100 percent of the difference between your doctor's charge and the Medicare-approved amount, if your doctor does not accept assignment
• Foreign Travel Emergency

Medigap Plan G
• Basic Benefits
• Medicare Part A Hospital Deductible
• Skilled Nursing-Home Costs
• Medicare Part B Excess Charges
   o Pays 80 percent of the difference between your doctor's charge and the Medicare-approved amount, if your doctor does not accept assignment
• Foreign Travel Emergency
• At-Home Recovery

Medigap Plan H
• Basic Benefits
• Medicare Part A Hospital Deductible
• Skilled Nursing-Home Costs
• Foreign Travel Emergency

Medigap Plan I
• Basic Benefits
• Medicare Part A Hospital Deductible
• Skilled Nursing-Home Costs
• Medicare Part B Excess Charges
   o Pays 100 percent of the difference between your doctor's charge and the Medicare-approved amount, if your doctor does not accept assignment
• Foreign Travel Emergency
• At-Home Recovery

Medigap Plan J*
• Basic Benefits
• Medicare Part A Hospital Deductible
• Skilled Nursing-Home Costs
• Medicare Part B Deductible
• Medicare Part B Excess Charges
   o Pays 100 percent of the difference between your doctor's charge and the Medicare-approved amount, if your doctor does not accept assignment
• Foreign Travel Emergency
• At-Home Recovery
• Preventive Care

Medigap Plan K**
• Basic Benefits
   o 100 percent of Part A coinsurance plus coverage for 365 days after Medicare benefits end
   o 50 percent of hospice cost-sharing
   o 50 percent of Medicare-eligible expenses for the first three pints of blood
   o 50 percent Part B coinsurance after you meet the yearly deductible for Medicare Part B, but 100 percent coinsurance for Part B preventive services
• 50 Percent of Skilled Nursing-Home Coinsurance
• 50 Percent of  Medicare Part A Hospital Deductible
• Annual Out-of-Pocket Limit of $ 4,620 in 2009

Medigap Plan L**
• Basic Benefits
   o 100 percent of Part A coinsurance plus coverage for 365 days after Medicare benefits end
   o 75 percent of hospice cost-sharing
o 75 percent of Medicare-eligible expenses for the first three pints of blood
• 75 Percent Part B Coinsurance (after you meet the yearly deductible for Medicare Part B, but 100 percent coinsurance for Part B preventive services)
• 75 Percent of Skilled Nursing-Home Coinsurance
• 75 Percent of  Medicare Part A Hospital Deductible
• Annual Out-of-Pocket Limit of $ 2,310 in 2009

*Plans F and J also have "high-deductible" options. In 2009, if you choose the high-deductible options on Medigap plans F and J, you will first have to pay $2,000 in health care expenses before the plan pays anything. This amount can go up every year. High-deductible policies have lower premiums, but if you get sick, your costs will be higher.

**The basic benefits for plans K and L include similar services as plans A-J, but the cost-sharing for the basic benefits is at different levels. The annual out-of-pocket limit increases each year for inflation.

In addition to the A-L standard Medigap policies, Medicare SELECT is a type of Medigap policy that can cost less than standard Medigap plans. However, if you enroll in SELECT, you can only go to certain doctors and hospitals for your care. Check with your state’s insurance department to find out whether or not Medicare SELECT policies are available in your state.