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Medigap Insurance Policies

We  hope this information from the official Medicare website helps you understand Medigap insurance, the supplemental insurance that helps pay for many things Medicare does not.   There are monthly premiums for this private insurance.

 

What Medicare Covers

Medicare Part A is for partial payment for inpatient hospitalization, skilled nursing facility, hospice and home health care.  

Medicare Part B is for partial payment for doctors services, outpatient hospital services, and home health care. 

Medicare Part C is for HMOs and PPOs and usually includes Parts A, B, D. These are called Medicare Advantage Plans.

Medicare Part D is for partial payment for prescriptions.   

What Medigap Insurance Plans Cover

To fill in the gaps where Medicare leaves off are the highly regulated Medigap policies.  Medicare determines what is offered in each of the plans available through private insurance companies across the U.S.  That means, for example, the basic benefits of Plan A, listed below, are the same no matter what company you buy this insurance from.  They may add other bells and whistles--for example health club benefits or vision care--but Plan A is Plan A is Plan A.  Massachusetts, Minnesota and Wisconsin have different policies.  This information does not include all details, but should give you a better idea of your choices.  Prices vary according to the coverage offered.  Not all companies offer all plans.

Plan A:   These are the Basic Benefits of Medigap insurance plans.  They are also included in the policies listed below: 
    - Part A coinsurance and certain hospital costs for up to 365 days longer 
             than Medicare coverage
    - Part B coinsurance or co-payment 
    - 3 pints blood 
    - Part A Hospice care

Plan B:   Basic Benefits, plus 
   - Medicare Part A deductible

Plan C:   Basic Benefits, plus   
   - Medicare Part A deductible 
   - Skilled nursing facility coinsurance 
   - Medicare Part B deductible 
   - Foreign travel emergency

Plan D:   Basic Benefits, plus 
    - Medicare Part A deductible 
    - Skilled nursing facility coinsurance  
    - Foreign travel emergency

Plan E:   (No longer sold, but if you have this plan you may continue it.)

Plan F:   Basic Benefits, plus 
    - Medicare Part A deductible  
    - Skilled nursing facility coinsurance 
    - Medicare Part B deductible   
    - Medicare Part B excess charges (100%), 
    - Foreign travel emergency

Plan G:   Basic Benefits, plus 
    - Medicare Part A deductible 
    - Skilled nursing facility coinsurance  
    - Medicare Part B excess charges (80%)   
    - Foreign travel emergency

Plan H:  (No longer sold, but if you have this plan you may continue it.)

Plan I:   (No longer sold, but if you have this plan you may continue it.)

Plan J:   (No longer sold, but if you have this plan you may continue it.)

Plan K:  Medicare Part A coinsurance and hospital costs for 365 
               additional days plus
    - 50% of the following: Medicare Part B coinsurance or copayments, Part A hospice care coinsurance or copayment, skilled nursing facility co-insurance, Medicare Part A deductible.  Out of pocket limit of $4,640.

Plan L:  Medicare Part A coinsurance and hospital costs for 365 
               additional days plus
   - 75% of the following: Medicare Part B coinsurance or copayments, Part A hospice care coinsurance or copayment, skilled nursing facility co-insurance, Medicare Part A deductible.  Out of  pocket limit of $2,320.

Plan M:  Basic Benefits, plus
    - Skilled nursing facility co-insurance 
    - 50% of Medicare Part A deductible
    - Foreign travel emergency

Plan N:  Basic benefits, plus  the following: 
    - Medicare Part B coinsurance or copayments with some copayments required 
    - Skilled nursing facility co-insurance  
    - Medicare Part A deductible  
    - Foreign travel emergency   

We strongly urge you to contact several private insurance companies and ask to receive printed information about the plans they offer before you make a decision.  Read everything.  Ask questions.  Compare many plans and prices. 

NOTE:  All names on this site have been changed to protect individual privacy.  
The stories are real, the names are not. 

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