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 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.