If you decide to enroll in original Medicare, one way you can help pay the extra costs the program doesn’t cover is to buy a supplemental — or Medigap — insurance policy.
Private insurers sell Medigap policies, but states and the federal government strictly regulate them. These plans are available for people enrolled in Medicare parts A and B, not for those who elect a Medicare Advantage plan. Medigap plans pay for costs such as deductibles and copays and other charges that Medicare doesn’t cover.
In 2010 the federal government standardized the types of Medigap plans, creating 10 options designated by A, B, C, D, F, G, K, L, M and N. In January 2020 two of the more comprehensive and popular plans, C and F, ceased to be available to people newly eligible for the program. That’s because in 2015, Congress decided to prohibit Medigap from covering the annual deductible for Part B, which pays for doctor visits and other outpatient services.
Of the 10 Medigap plans, C and F currently pay that deductible, which is $233 for 2022. The difference between plans C and F is that C does not cover the 15 percent in excess charges that doctors who don’t participate in Medicare are allowed to charge their patients; Plan F does.
Plan G is the closest in design to Plan F. It covers everything F does except the Part B deductible. And Plan D is the closest to Plan C. It covers everything C does except the Part B deductible and the excess charges that nonparticipating doctors are allowed to charge their Medicare patients.
It’s been widely reported that Plan F is “going away,” says Casey Schwarz, senior counsel for education and federal policy at the Medicare Rights Center. “That shorthand has caused a lot of panic. I think it’s really important to highlight that for people who have been enrolled in Plan C and Plan F, there is absolutely nothing changing."
But if you turned 65 after January 2020 or became disabled after the first of the year and want to buy a Medigap plan, you will not be able to enroll in either C or F. Current Medicare enrollees and anyone eligible for Medicare before Jan. 1, 2020, still have those plans to choose from.
If you think a Medigap policy might be right for you, here is some basic information you’ll need to know to make your decision.
And it’s a big one. When you first enroll in Medicare (during your seven-month initial enrollment period (IEP), insurers offering Medigap policies cannot deny you coverage or charge you more for any preexisting condition. After that, anything goes.
For example, if you don’t buy a Medigap policy during your IEP but decide a year later that you want one, insurers may be able to turn you down based on your health, or set prices higher because of a preexisting condition. How that works differs widely from state to state.