Medicare Supplement Insurance, also called Medigap, is a type of private insurance that is used alongside your Original Medicare coverage (Medicare Part A and Part B) to help cover certain Medicare out-of-pocket expenses, such as copays and deductibles.
Medigap Plan E was discontinued for new enrollees in 2010. Anyone who enrolled in Medicare Supplement Insurance Plan E prior to 2010 was allowed to keep the plan.
There are 10 Medigap plans that are currently available in most states, however. These plans include Plan A, B, C, D, F, G, K, L, M and N. Each type of Medigap plan offers a different combination of standardized benefits, which are outlined below.
You can use the Medigap plans comparison chart below to compare the benefits of each type of Medicare Supplement Insurance plan that is still available for new enrollees in 2019.
|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.
Learn more about the Medicare Supplement Insurance plan options that are available in your state.
Prior to 2003, Medicare did not cover certain home health care services and certain durable Medicare equipment (DME). At the time, certain Medigap plans – such as Medigap Plan E – covered some of these services and devices for people who joined those plans.
But in 2003, Congress passed the Medicare Prescription Drug, Improvement and Modernization Act, which expanded certain Original Medicare benefits. This included adding coverage for at-home recovery care and preventive care, which were previously covered by Medigap Plan E.
The 2003 law also introduced Medicare Part D plans, which are standalone Medicare prescription drug plans (PDP) sold by private insurance companies. Due to this law, Medicare Advantage plans (Medicare Part C) can also offer prescription drug coverage.
These additions – and later changes to Medicare in 2010 – made the benefits offered by Medicare Supplement Insurance Plan E redundant. Therefore, Medicare Supplement Insurance companies were no longer allowed to sell Medigap Plan E to new enrollees as of June 1, 2010.
Medigap plan costs may vary based on factors such as age, gender, health, how your insurance company rates (prices) its plans, and where you live.
Remember, Plan E is no longer available for purchase for new enrollees. Less than 1 percent of all Medigap beneficiaries were still enrolled in Medigap Plan E in 2016. This is a decrease of close to 30,000 beneficiaries since 2013.1
Medigap Plan E does not cover prescription drugs. Medigap plans can only help cover certain out-of-pocket Medicare costs, such as deductibles and copayments.
If you want to get Medicare prescription drug coverage, you have two options:
Please note that Medigap plans and Medicare Advantage plans are very different things. You cannot have a Medicare Supplement Insurance plan and a Medicare Advantage plan at the same time.
As previously mentioned, beneficiaries who are currently enrolled in Medigap Plan E are allowed to remain in the plan.
So if you currently have Plan E, should you keep it?
The first thing to consider is the plan cost. Because no new members are being accepted into Plan E, the overall plan risk pool can only increase in age and claim frequency. This may cause Plan E premiums to rise at a faster rate than other Medigap plan premiums.
The second factor to consider is benefits. Several Medigap plans offer similar benefits to Plan E, and several plans actually cover more.
Plan F is the most popular Medigap plan currently available. 55 percent of all Medicare Supplement Insurance beneficiaries are enrolled in Plan F as of 2016.1
Plan G is the second-most popular Medigap plan currently available. 10 percent of all Medigap beneficiaries are enrolled in Plan G as of 2016, which was a 41 percent growth rate from 2015.
Plan G and Medigap Plan F are nearly identical except for the fact that Plan F covers the Medicare Part B deductible, while Plan G does not.
The Medicare Part B deductible is $185 per year in 2019. If you can find a Plan G option that only costs $184 more per year (or less) than Plan F, you could save money in the long run by choosing Plan G.
Medicare Supplement Insurance Plan F offers more standardized benefits than the other current Medicare Supplement plans.
Because of a new federal law, Plan F and Plan C won’t be available for Medicare beneficiaries who became eligible on or after January 1, 2020.
If you already have Plan C or Plan F before 2020, you will be able to keep your plan.
If you become eligible for Medicare before 2020, you may still be able to buy either Plan C or Plan F after January 1, 2020, if either is available where you live.
While you can’t enroll in Plan E unless you currently have Plan E, there are several Medigap options that can provide you with similar – if not more – benefits.
A licensed insurance agent can help you learn about plans in your area and what they cover and cost.
Learn more about Medigap plans in your areaVisit MedicareSupplement.com
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1 AHIP. State of Medigap 2018. (June, 2018). Retrieved from www.ahip.org/wp-content/uploads/2018/06/State_of_Medigap18_FINAL.pdf.
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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