Anyone shopping for Medicare Supplement Insurance (Medigap) may naturally want to know which plan is right for them. There are 10 plans available in most states, and each one offers its own combination of standardized benefits.
We’ll help you compare the benefits and costs of each type of Medigap plan to find out which plan is right for your health care needs.
|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%||✓|
|MedicarePart 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.
Medigap Plan F is the only plan that offers coverage for all nine benefit areas standardized by the government.
As you can see in the Medicare Supplement Insurance plans comparison chart above, Plan F checks every box.
Plan F is by far the best-selling Medicare Supplement Insurance plan. In fact, 55 percent of everyone enrolled in Medicare Supplement Insurance in 2016 belonged to Plan F.1
The second-most popular Medigap plan, Plan G, accounted for only 10 percent of Medigap enrollees.1However, just because a plan is popular doesn’t mean it’s the right fit for your health care needs. Consult with a licensed insurance agent to determine which plan is right for you.
Due to the Medicare Access and CHIP Reauthorization Act of 2015, Medicare Supplement Insurance plans will no longer be allowed to cover the Medicare Part B deductible. Therefore, Medigap Plan F and Plan C (the only two plans that cover the Part B deductible) will be eliminated from plan selection.
Those who enroll in Plan F or Plan C before 2020 will be allowed to keep their coverage for as long as they wish. If you became eligible for Medicare prior to 2020 and decide you want Plan F after the law goes into effect, you may be able to buy it if it is available where you live.
As mentioned above, Medigap Plan G is the second-most popular plan among Medicare Supplement Insurance beneficiaries.
Plan G covers everything that Plan F does, with the exception of the Medicare Part B deductible, which is $185 per year in 2019.
Because the Medicare Part B deductible averages out to just over $15 per month in 2019, a Medigap Plan G option that is at least $15 cheaper per month than a Plan F option could save you some money over the year, compared to enrolling in Plan F.
Medigap Plan C is another option that can offer tremendous value to beneficiaries. Plan C covers everything that Plan F covers, with the exception of Medicare Part B excess charges.
Medicare Part B excess charges are incurred when a beneficiary receives services or products from a health care provider that does not accept Medicare assignment. In this case, the provider may charge up to 15 percent more than the Medicare-approved amount for the services.
While having coverage for Medicare Part B excess charges can certainly be helpful, it may not be necessary if beneficiaries only seek care from providers who accept Medicare assignment. Always ask a provider if they accept Medicare assignment — that is, they accept Medicare’s reimbursement as payment in full for their services — before arriving for an appointment.
As previously mentioned, Plan C will be closed to new enrollees beginning in 2020.
Medigap Plan D could be the best Medicare Supplement Insurance plan for some enrollees, depending on their coverage needs. Plan D covers everything that Plan F does, with the exception of the Medicare Part B deductible and Part B excess charges.
As previously discussed, the Part B deductible averages out to only $15 per month in 2019. A Plan D monthly premium plus the Part B deductible may actually be cheaper in the long run than a Plan F monthly premium, depending on the plan you enroll in.
And because Medicare Part B excess charges can be avoided in many cases, coverage for that benefit may not always be necessary, depending on your needs and situation.
Plan N offers the exact same coverage as Medigap Plan D, except for one difference: When it comes to Medicare Part B coinsurance, Medigap Plan N requires a coinsurance payment of up to $20 for some office visits and up to $50 for emergency room visits that do not result in an inpatient admission.
Given these minimal coinsurance requirements, Plan N can sometimes be a better value than Plan D if the difference in premiums is significant.
Medicare Supplement Plan L
Plan L covers only 75 percent of a number of out-of-pocket Medicare costs, but it can come with one potential advantage over other Medicare Supplement Insurance plans: Plan L includes an annual out-of-pocket spending limit of $2,780 in 2019.
This means that once a beneficiary spends $2,780 on Original Medicare costs in 2019, Medigap Plan L will cover 100 percent of all additional Medicare costs for the remainder of the year. With its out-of-pocket limit, Plan L can help protect beneficiaries from potentially high health care costs.
The only other Medicare Supplement Insurance plan to include an out-of-pocket limit is Medigap Plan K, which features a limit of $5,560 in 2019.
There is no definitive Medicare Supplement Insurance plan that is the “best.” The right plan for you is the one that is most closely aligned with your needs and budget. The right plan for one person may be quite different than the right Medigap plan for someone else.
Find the best Medicare Supplement Insurance plan for you by visiting MedicareSupplement.com.
1 AHIP. State of Medigap 2018 Trends in Enrollment and Demographics. (June 2018). Retrieved from https://www.ahip.org/wp-content/uploads/2018/06/State_of_Medigap18_FINAL.pdf.
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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.
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