Medicare Supplement Insurance (also called Medigap) is a type of private insurance plan that can work alongside your Original Medicare coverage to help cover some out-of-pocket Medicare costs such as copayments, coinsurance and deductibles.
If you have Original Medicare (Medicare Part A and Part B), you may incur some out-of-pocket Medicare costs when you use your coverage.
For example, you have to meet the Medicare Part B deductible ($185 in 2019) before Part B will start covering some of the costs of your care. And once it does, you are still typically responsible for a 20 percent Part B coinsurance for approved services.
A Medicare Supplement Insurance plan can help provide coverage for some of these out-of-pocket Medicare costs.
You typically pay a monthly premium to belong to a Medigap plan.
|Medicare Supplement Benefits||A||B||C||D||F1||G||K2||L3||M||N4|
|Part A co-insurance and hospital costs||✓||✓||✓||✓||✓||✓||✓||✓||✓||✓|
|Part B co-insurance or co-payment||✓||✓||✓||✓||✓||✓||50%||75%||✓||✓|
|First 3 pints of blood||✓||✓||✓||✓||✓||✓||50%||75%||✓||✓|
|Part A hospice care co-insurance or co-payment||✓||✓||✓||✓||✓||✓||50%||75%||✓||✓|
|Co-insurance for skilled nursing facility||✓||✓||✓||✓||50%||75%||✓||✓|
|Medicare Part A deductible||✓||✓||✓||✓||✓||50%||75%||50%||✓|
|Medicare Part B deductible||✓||✓|
|Medicare Part B excess charges||✓||✓|
|Foreign travel emergency||80%||80%||80%||80%||80%||80%|
|1. Plan F offers a high-deductible plan. This plan requires you to pay a $2,300 deductible in 2019 before it covers anything.
2. Plan K has an out-of-pocket yearly limit of $5,560 in 2019. After you pay the out-of-pocket yearly limit and yearly Part B deductible, it pays 100% of covered services for the rest of the calendar year.
3. Plan L has an out-of-pocket yearly limit of $2,780 in 2019. After you pay the out-of-pocket yearly limit and yearly Part B deductible, it pays 100% of covered services for the rest of the calendar year.
4. Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don’t result in an inpatient admission.
View an image version of this table.
Medicare Supplement Insurance can provide coverage for some or all of the following costs:
There are 10 Medicare Supplement Insurance plans available in most states. They are designated a plan letter (Medigap Plan A, B, C, D, F, G, K, L, M and N), and each type of plan offers a different combination of some or all of the above coverage.
Not every plan will be available in every state.
You can request more information from licensed insurance agents at MedicareSupplement.com to learn more about Medicare Supplement Insurance plans.
Medicare Supplement Insurance is sold by private insurance companies, so the cost of a plan can differ between one carrier or location and another.
There are a few other things that may affect the cost of a Medigap plan:
In order to be eligible for a Medicare Supplement Insurance plan, you must be at least 65 years old, enrolled in Medicare Part A and Part B and reside in the area that is serviced by the plan.
Some states – but not all – allow Medicare Supplement Insurance enrollment for Medicare beneficiaries under the age of 65.
Your six-month Medigap Open Enrollment Period begins when you are 65 years old and enrolled in Part A and Part B.
During your Medigap Open Enrollment Period, insurance companies are not allowed to use medical underwriting to determine your premium rates when you apply for a policy. This means that if you apply for a plan during this period, you cannot be charged more due to your age or health history.
Once your six-month open enrollment window ends, you may be subject to underwriting and may pay higher plan premiums. Insurance companies also reserve the right to deny you a policy based on the results of the underwriting. That’s why it’s highly advisable to take advantage of your Medigap open enrollment period.
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MedicareAdvantage.com is a website owned and operated by TZ Insurance Solutions LLC. TZ Insurance Solutions LLC and TruBridge, Inc. represent Medicare Advantage Organizations and Prescription Drug Plans having Medicare contracts; enrollment in any plan depends upon contract renewal.
Plan availability varies by region and state. For a complete list of available plans, please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.
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