Medicare Supplement (Medigap) Coverage

Medicare Supplement Plans, also known as Medigap policies, are designed to help cover some of the healthcare costs that Original Medicare (Part A and Part B) doesn’t cover. These plans are offered by private insurance companies and can help pay for out-of-pocket costs such as copayments, coinsurance, and deductibles. The coverage provided by Medicare Supplement Plans can vary significantly depending on the specific plan.

Types of Medicare Supplement Plans

There are 10 standardized Medicare Supplement Plans available in most states, labeled A through N. Each plan offers a different combination of coverage, but all must follow federal and state laws designed to protect you. The most popular plans are F, G, and N, due to their comprehensive coverage.

Common Benefits Covered

• Medicare Part A coinsurance and hospital costs: Most Medigap plans cover these costs up to an additional 365 days after Medicare benefits are used up.
• Medicare Part B coinsurance or copayment: Most plans help cover the Part B costs.
• Blood (first 3 pints): Medigap plans usually cover the cost of the first three pints of blood needed for a medical procedure.
• Part A hospice care coinsurance or copayment: This helps cover hospice care costs under Part A.
• Skilled nursing facility care coinsurance: Plans like C, F, G, and N offer this coverage.

Additional Benefits Depending on the Plan

• Medicare Part A deductible: Covered by Plans B, C, D, F, G, and N.
• Medicare Part B deductible: Only covered by Plans C and F.
• Medicare Part B excess charges: Covered by Plans F and G.
• Foreign travel emergency (up to plan limits): Plans C, D, F, G, M, and N may cover certain types of emergency care outside the U.S.
• Out-of-pocket limit: Plan K and L include this feature, which sets a yearly limit on your out-of-pocket expenses.

Choosing the Right Plan

Choosing the right Medicare Supplement Plan depends on your health care needs and budget. Factors to consider include:

• Coverage Level: Decide which benefits are most important to you.
• Cost: Premiums can vary widely even for the same level of coverage.
• Future Coverage: Some benefits might be more important as you age.

Plan Availability

Not all plans are available in every state, and Massachusetts, Minnesota, and Wisconsin have their own standardized Medigap plans.

Enrollment

The best time to enroll in a Medigap policy is during your 6-month Medigap Open Enrollment Period, which starts the first month you have Medicare Part B and are 65 or older.