Medicare Outline

Medigap Policies

     A Medigap policy is a health insurance policy sold by private insurance companies to fill "gaps" in Original Medicare Plan coverage. Medigap policies must follow federal and state laws. These laws protect you. The front of the Medigap policy must clearly identify it as "Medicare Supplement Insurance."

     In all states, except Massachusetts, Minnesota, and Wisconsin, a Medigap policy must be one of twelve standardized policies so you can compare them easily. Each policy has a different set of benefits. Two of the standardized policies may have a high deductible option. In addition, any standardized policy may be sold as a "Medicare SELECT" policy. Medicare SELECT policies usually cost less because you must use specific hospitals and, in some cases, specific doctors to get full insurance benefits from the policy. In an emergency, you may use any doctor or hospital.

Click image to view guide to Medigap Policies

 

Outline of Medicare
Supplement Coverage

(Benefit Plans A-L)
Medicare Supplement Insurance can be sold in only twelve standard plans. This chart shows the benefits included in each plan. Every company must make available Plan "A". Some plans may not be available in your state as indicated below.
  A  
B  
C  
D  
E  
F* 
G H  
I   
J*  K L
Medicare Part A Coinsurance and Medigap Coverage for Hospital Benefits
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    Medicare Part B Coinsurance or Copayment

     

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    		•  50%* 75%*
    Blood (First 3 pints)
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    		•  50%* 75%*
    Hospice Care Coinsurance or Copayment
    		                     50%* 75%*
    Medicare Part A Deductible
    		  
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    		•  50%* 75%*
    Skilled Nursing Facility Care Coinsurance
    		    
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    Medicare Part B Deductible
    		    
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    Medicare Part B Excess Charges
    		          
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    		•  80%  
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    Foreign Travel Emergency (Up to Plan Limits)**
    		    
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    At Home Recovery (Up to Plan Limits)
    		      
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    Preventive Care Coinsurance (Included in the Part B Coinsurance)
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    Preventive Care not Covered by Medicare (up to $120)        
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    *Out-of-Pocket Maximum (2009)
    		                     $4,620*** $2,310***
    Plans A-L are standardized by the federal government. Not all plans may be available in your area. Consider the benefits offered by each plan and look for one that best meets your individual needs.
    *Medigap Plans F and J also offer a high-deductible option. You must pay the high-deductible ($2,000 in 2009) amount before your Medigap-covered costs before pays anything..
    **You must also pay a separate deductible for foreign travel emergency ($250 per year).
    ***After you meet your out-of-pocket yearly limit and your yearly Part B deductible ($135 in 2009), the plan pays 100% of covered services for the rest of the calendar year.