Medigap Plans: Listing by Plan
There are 12 standard Medicare supplemental (Medigap) insurance plans that help pay some of your costs in the Original Medicare Plan and for some care it doesn't cover. (If you are in a Medicare Advantage Plan, such as a Medicare Health Maintenance Organization (HMO), you don't need a Medigap policy.)
Each standard plan, labeled A through L, offers a different set of benefits, fills different "gaps" in Medicare coverage, and varies in price. Medigap plans K and L are new plans that became available in 2006. 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 have 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. Check with your state insurance department or the 2008 Guide to Health Insurance for People with Medicare.
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 ($256 in 2008) and 91-150 ($496 in 2007)
- Coinsurance for each day 91-150 ($512 in 2008) (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 co-payment amounts after your meet the $135 (in 2008) 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: $1,024 in 2008 for each benefit period for hospital services
Medigap Plan C
- Basic Benefits
- Medicare Part A Hospital Deductible
- Skilled Nursing Home Costs: Your cost ($128 in 2008) for days 21-100 in a skilled nursing home
- Medicare Part B Deductible: Yearly deductible for doctor services ($135 in 2008)
- Foreign Travel Emergency
- 80% of the cost of emergency care outside the U.S.
- Up to $50,000 during your lifetime
- You pay 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
- Help for activities of daily living, such as bathing and dressing, if you are already receiving skilled home care covered by Medicare.
- Help for up to eight weeks after you no longer need skilled care
- Will pay up to $40 per visit, seven visits per week, or a total of $1,900 per year
Medigap Plan E
- Basic Benefits
- Medicare Part A Hospital Deductible
- Skilled Nursing Home Costs
- Foreign Travel Emergency
- Preventive Care: 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: Pays 100% 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: Pays 80% 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: Pays 100% 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: Pays 100% 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
- 100% of Part A coinsurance plus coverage for 365 days after Medicare benefits end
- 50% hospice cost-sharing
- 50% of Medicare-eligible expenses for the first three pints of blood
- 50% Part B coinsurance after you meet the yearly deductible for Medicare Part B, but 100% coinsurance for Part B preventive services
- 50% of Skilled Nursing Home Coinsurance
- 50% of Medicare Part A Hospital Deductible
- Annual out of pocket limit of $4,440 in 2008.
Medigap Plan L**
- Basic Benefits
- 100% of Part A coinsurance plus coverage for 365 days after Medicare benefits end
- 75% hospice cost-sharing
- 75% of Medicare-eligible expenses for the first three pints of blood
- 75% Part B coinsurance after you meet the yearly deductible for Medicare Part B, but 100% coinsurance for Part B preventive services
- 75% of Skilled Nursing Home Coinsurance
- 75% of Medicare Part A Hospital Deductible
- Annual out of pocket limit of $2,220 in 2008.
*Plans F and J also have a "high deductible option." If you choose the "high deductible option" on Medigap Plans F and J, you will first have to pay a $1,900 deductible in 2008 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, you can only go to certain doctors and hospitals for your care. Check with your state insurance department to find out if Medicare SELECT policies are available in your state.
AARP Resources
AARP on Medicare
A series of articles from AARP to help you better understand your Medicare
options.
Medicare Prescription Drug
Coverage
This series of articles will help you sort through your drug coverage
choices.
State-by-State,
Plan-by-Plan List of Pharmacy Assistance Programs
Prescription discount programs offered by states, drug makers, discount cards
and discount pharmacies.
Additional Resources
2008 Guide to Health Insurance for People with Medicare
Information about Medigap plans, what they cover and how to choose the best
policy.
Medicare
Options Compare Information on the insurance companies that sell Medigap policies in your area and the range of premiums they charge.
Medicare Savings Programs
Information on state programs for people with limited income and resources that
pay some or all of the costs of Medicare.
State Health Insurance
Assistance Program (SHIP)
How to contact your State Health Insurance Assistance Program (SHIP), an
important Medicare partner. Free one-on-one health insurance counseling for
people with Medicare.
National Association of Insurance
Commissioners (NAIC)
Link to your state insurance department Web site which often lists names and
phone numbers of the companies selling Medigap plans in your state.
