Medigap Benefits Chart

Medigap Benefits Medigap Plans
A B C D F* G K L M N
Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes
Part B coinsurance or copayment Yes Yes Yes Yes Yes Yes 50% 75% Yes Yes***
Blood (first 3 pints) Yes Yes Yes Yes Yes Yes 50% 75% Yes Yes
Part A hospice care coinsurance or copayment Yes Yes Yes Yes Yes Yes 50% 75% Yes Yes
Skilled nursing facility care coinsurance No No Yes Yes Yes Yes 50% 75% Yes Yes
Part A deductible No Yes Yes Yes Yes Yes 50% 75% 50% Yes
Part B deductible No No Yes No Yes No No No No No
Part B excess charge No No No No Yes Yes No No No No
Foreign travel exchange (up to plan limits) No No 80% 80% 80% 80% No No 80% 80%
Out-of-pocket limit** N/A N/A N/A N/A N/A N/A  $4,940 ($4,960 in 2016)  $2,470 ($2,480 in 2016) N/A N/A

 

* Plan F also offers a high-deductible plan. If you choose this option, this means you must pay for Medicare-covered costs up to the deductible amount of $2,180 in 2016 before your Medigap plan pays anything.

** After you meet your out-of-pocket yearly limit and your yearly Part B deductible, the Medigap plan pays 100% of covered services for the rest of the calendar year.

*** 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 inpatient admission.

How insurance companies set Medigap premiums
There are three ways an insurance company can set Medigap premium rates:

– “Community-rated” (or “no-age-rated”) premiums are the same for everyone, regardless of age.

– “Issue-age-rated” (or “entry-age-rated”) premiums are based on your age when you first buy the policy. The sooner you enroll, the less you will pay.

– “Attained-age-rated” premiums are based on your current age, meaning it goes up as you grow older.

Other factors impacting the premium rates can include inflation, geography, medical underwriting (if you did not enroll when first eligible), and other discounts. You should check with each specific health insurer to see how it sets Medigap prices before you buy.