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What is first-dollar Medigap coverage?

First-dollar Medigap coverage is when a Medicare Supplement insurance plan covers both the Medicare Part A and Medicare Part B deductible. With first-dollar Medigap plans, policyholders don’t have to pay these deductibles before their Medicare health insurance benefits kick in.

Medigap Plan C and Plan F are the only plans with first-dollar Medigap coverage in the states that offer standardized plans. These two Medigap policies cover other Medicare out-of-pocket costs as well including co-insurance and co-payments.

The chart below shows which benefits Medigap covers under Plan C and Plan F. 

Medicare Supplement benefits C F
Part A hospital care co-insurance & costs
Part A hospice care co-insurance or co-payment
Part B co-insurance or co-payment
First 3 pints of blood
Part A deductible
Part A skilled nursing care co-insurance
Part B deductible
Part B excess charges  
Foreign travel emergency

First-dollar Medigap plans are popular

First-dollar plans are the most popular Medigap policies available.

About 11.2 million people were enrolled in Medigap coverage in 2014, according to a report from America’s Health Insurance Plans (AHIP). More than 6 out of every 10 Medigap policyholders had either Plan F or Plan C.

Plan F had 5.1 million enrollees in 2012, according to AHIP. Plan C had 1.2 million enrollees during the same period.

Proposals to limit first-dollar Medigap plans

The Affordable Care Act (ACA) — also called Obamacare — required that the National Association of Insurance Commissioners (NAIC) review Medigap Plan C and Plan F to ensure that physicians’ services are not being abused.

The NAIC responded that it did not find evidence for this claim, and no changes were made to first-dollar Medigap coverage for Plans C or F. Learn more about how Obamacare affects Medicare Supplement Insurance.

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