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 plans also provide extensive coverage for other Medicare out-of-pocket costs including co-insurance and co-payments.
The Medigap benefits chart below shows which benefits are covered by Medicare Supplement Insurance 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 plans 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.
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.