Compare Medigap Plans
Medicare supplemental insurance, also called Medigap, is extra insurance you buy from a private insurer to pay for health care costs Medicare doesn’t cover. There are 10 standardized Medigap plans. Comparing plans for coverage and costs can help you find the right plan for your needs and budget.
How to Compare Medigap Plans
There are 10 standardized Medicare Supplement insurance plans, each given a letter name. You shouldn’t confuse Medicare Parts A, B, C or D with Medigap policies that have the same letter in the plan name.
Many different companies sell Medigap policies, but every Medigap plan is standardized across all companies and each offers the same basic benefits. But some companies may offer additional benefits with their version of a plan. This gives you a wider variety of choices.
If you live in Massachusetts, Minnesota or Wisconsin, Medigap plans are standardized differently from those in other states and territories.
Each plan provides different coverage. You should look for a plan that meets your needs.
- Coverage for blood transfusions
- Coverage for health care during foreign travel
- Coverage for hospital stays beyond the limit in Medicare Part A
- Hospice care coinsurance or copayment coverage
- Amount of coinsurance or copayment the plan covers
- How much of your Medicare Part A deductible is covered
- How much of your Medicare Part B deductible is covered
- How much of your Medicare Part B excess charge is covered
- Skilled nursing care coinsurance coverage
- The plan’s out-of-pocket limit
Comparing the 10 Medicare Supplement Plans
While there are 10 possible, standardized Medigap plans, insurance companies can choose which plans they want to sell.
But if they sell any Medicare supplemental insurance plan, they must also offer Medigap Plan A. State laws may require insurers to sell other plans, too.
- Medigap Plan A
- This is the most basic plan. It covers 20 percent of what Medicare does not for outpatient services. All companies must carry Medigap Plan A but don’t have to sell it to people on Medicare disability if they’re under 65.
- Medigap Plan B
- In addition to having all Plan A coverage, Plan B covers part of the Medicare Part A deductible.
- Medigap Plan C
- This plan covers everything except Medicare excess charges. It covers your deductibles and your 20 percent coinsurance or copayment for outpatient services. Plan C is being phased out. It is no longer available to anyone who qualified for Medicare on or after Jan. 1, 2020.
- Medigap Plan D
- Do not confuse this plan with Medicare Part D prescription drug coverage. Medigap Plan D does not cover Medicare excess charges or your Medicare Part B deductible. It covers most other out-of-pocket expenses.
- Medicare Plan F
- Generally, this has been the most popular Medigap plan. Plan F covers all of your out-of-pocket costs with Medicare. It can be expensive, but there is a high deductible version of Plan F that may have lower premiums. Plan F is being phased out. It is not available to anyone who qualified for Medicare on or after Jan. 1, 2020.
- Medigap Plan G
- Plan G covers everything Plan F covers except for the Medicare Part B deductible. This may be an alternative to consider if you were considering Plan C or Plan F but are no longer eligible for those.
- Medigap Plans K, L and M
- These plans are not offered by all insurers. They offer only partial coverage. Plan K covers 50 percent of most out-of-pocket costs, Plan L covers 75 percent of most costs and Plan M covers most costs, but only 50 percent of your Medicare Part A deductible.
- Medigap Plan N
- The newest Medigap plan offers lower premiums if you agree to copayments for doctor visits, emergency room visits and other medical services. It also does not cover Medicare excess charges.
Comparing Benefits of Medigap Plans
Each standardized Medicare Supplement plan has different coverage for different out-of-pocket costs. You should compare their coverage to your needs to find the plan that’s right for your wants and needs.
|Part A coinsurance and hospital costs*|
|Part B coinsurance or copayment||50%||75%|
|Blood (first three pints)||50%||75%|
|Part A hospice care coinsurance or copayment||50%||75%|
|Skilled nursing facility care coinsurance||50%||75%|
|Part A deductible||50%||75%||50%|
|Part B excess charge**|
|Foreign travel exchange (up to plan limits)||80%||80%||80%||80%|
|Out-of-pocket limit in 2021||N/A||N/A||N/A||N/A||$6,220||$3,110||N/A||N/A|
Medigap Coverage in Massachusetts, Minnesota and Wisconsin
If you live in Massachusetts, Minnesota or Wisconsin, you are guaranteed the right to buy a Medigap policy, but the policies are different from other Medigap plans in the United States.
All three states require Medigap plans to offer the same basic benefits.
- Medicare Part A coinsurance
- Part B coinsurance (generally 20 percent of cost)
- Part A hospice coinsurance or copayment
- First three pints of blood needed each year
In addition, Wisconsin requires coverage of 40 home health care visits in addition to those covered by Original Medicare. Massachusetts also includes an additional 365 days of hospitalization costs after Medicare coverage ends.
Beyond that, the offerings can vary from state to state.
Massachusetts offers three plans: Core Plan, Supplement 1 Plan and Supplement 1A Plan. The supplement plans notably include mental health coverage.
Minnesota offers a Basic Plan and Extended Basic Plan. The Extended Basic Plan notably includes coverage for the Part A inpatient hospital deductible and the Medicare Part B deductible which the Basic Plan does not cover. Both do provide 80 percent coverage for emergency care during foreign travel.
Wisconsin offers only a Basic Plan, but there are versions known as “50 percent and 25 Percent Cost-Sharing Plans” similar to standardized Plans K and L. There is also a plan with a high deductible available. The deductible is $2,340 per year.
3 Cited Research Articles
- U.S. Centers for Medicare & Medicaid Services. (2020, February). 2020; Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare. Retrieved from https://www.medicare.gov/Pubs/pdf/02110-medicare-medigap-guide.pdf
- U.S. Centers for Medicare & Medicaid Services. (n.d.). How to Compare Medigap Policies. Retrieved from https://www.medicare.gov/supplements-other-insurance/how-to-compare-medigap-policies
- Cigna. (n.d.). Compare Plans. Retrieved from https://www.cigna.com/medicare/supplemental/compare-plans?campaign_ID=CSBORG