Medicare 101

What Is a Medigap Plan?

Christian Worstell

by Christian Worstell | Published February 18, 2021 | Reviewed by John Krahnert

If you are enrolled in Original Medicare (Part A and Part B), you may have heard of something called Medicare Supplement Insurance (also known as Medigap).

Medigap plans are sold by private insurance companies and can help pay for some of the out-of-pocket costs associated with Original Medicare, such as deductibles, copays, coinsurance and other fees.

10 Things Every Medicare Beneficiary Should Know About Medigap

Before enrolling in a Medigap policy, it helps to do your research to find a plan that will give you the most bang for your buck.

Below, we list the top 10 things you should know about Medigap before you enroll.

1. Medigap does not replace Original Medicare.

Rather than replace Original Medicare health insurance benefits, Medigap helps cover the gaps that it leaves. If you are enrolled in Original Medicare, you likely pay a monthly premium for Medicare Part B (medical insurance).

In some cases, you may have to pay a Part A premium, too. With a Medigap plan, you still receive your Medicare Part A and Medicare Part B benefits and are still responsible for paying your Medicare Part B premium each month — and a Part A premium, if applicable.

2. You must be enrolled in Medicare Part B to be eligible for a Medigap plan.

Similarly, you cannot enroll in a Medigap plan if you are already enrolled in a Medicare Advantage plan (Medicare Part C). If you have Medicare Advantage and wish to enroll in Medicare Supplement Insurance, you must leave your Medicare Advantage plan before your Medigap policy takes effect.

Contact your Medicare Advantage plan provider for more information on disenrolling in your plan.

3. Medigap premiums vary widely, even for plans with the same benefits.

There are 10 standardized Medigap plans to choose from in most states, labeled Plan A, B, C, D, F, G, K, L, M and N. Each of these different Medigap plans provide a different combination of benefits that cover a wide range of expenses — from deductibles to copayments and coinsurance.

Important: Plan F and Plan C are not available to beneficiaries who became eligible for Medicare on or after January 1, 2020.

Because Medicare Supplement Insurance plans are sold through private insurance companies that determine how each of their Medigap plans are priced, a person enrolled in Medigap Plan N from one insurance company could pay more than a person enrolled in the same plan from a different insurer.

To get an affordable rate, it is recommended that you compare Medigap plans to find the plan you want at a price you can afford.

4. Insurance companies don't have to offer Medigap plans.

It is up to an insurance company whether or not they sell Medigap plans.

If they do sell Medigap plans, however, they must at least offer Medigap plan A and either Medigap plan C or Plan F.

5. Different Medigap plans are available in different states.

Every Medigap plan may not be available where you live. In fact, in Massachusetts, Minnesota and Wisconsin, Medigap policies are standardized in a different way altogether.

To find out which Medigap plans are available in your state, speak with a licensed insurance agent.

6. You must be enrolled in Medicare Part B to be eligible for a Medigap plan.

Similarly, you cannot enroll in a Medigap plan if you are already enrolled in a Medicare Advantage plan (Medicare Part C). If you have Medicare Advantage and wish to enroll in Medicare Supplement Insurance, you must leave your Medicare Advantage plan before your Medigap policy takes effect.

Contact your Medicare Advantage plan provider for more information on disenrolling in your plan.

7. If you have a Medicare Medical Savings Account plan, it is illegal for an insurance company to sell you a Medigap policy.

A Medical Savings Account (MSA) plan is a type of Medicare Advantage plan that combines a high-deductible health plan with a medical savings account.

8. Medicare Supplement Insurance plan is guaranteed renewable.

This means that as long as you are paying your Medigap monthly premium, an insurance company cannot cancel your Medigap policy — even if you have medical problems.

9. Medigap policies do not cover prescription medication.

Medicare Supplement Insurance policies sold after January 1, 2006, are not allowed to cover prescription drug benefits.

If you are enrolled in Original Medicare and a Medigap plan and would like prescription drug coverage, you must join a Medicare Prescription Drug Plan (Medicare Part D) separately.

You can compare Part D plans available where you live and enroll in a Medicare prescription drug plan online when you visit MyRxPlans.com.

10. Medigap Plan F offers the most comprehensive coverage.

Medigap Plan F is the only Medigap policy that covers all nine standardized Medigap benefits.

Because of its robust coverage, however, Medigap Plan F may cost more than other plans. Medigap plans that offer similar coverage include Plans C, D and G.

You can use the 2020 Medigap plan chart below to compare the benefits that are offered by each type of plan. Use the scroll bar at the bottom of the chart to view all plans and information.

Click here to view enlarged chart

Scroll to the right to continue reading the chart

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Medicare Supplement Benefits

Part A coinsurance and hospital coverage

Part B coinsurance or copayment

Part A hospice care coinsurance or copayment

First 3 pints of blood

Skilled nursing facility coinsurance

Part A deductible

Part B deductible

Part B excess charges

Foreign travel emergency

A B C* D F1* G1 K2 L3 M N4
50% 75%
50% 75%
50% 75%
50% 75%
50% 75% 50%
80% 80% 80% 80% 80% 80%

* Plan F and Plan C are not available to Medicare beneficiaries who became eligible for Medicare on or after January 1, 2020. If you became eligible for Medicare before 2020, you may still be able to enroll in Plan F or Plan C as long as they are available in your area.

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1 Plans F and G offer high-deductible plans that each have an annual deductible of $2,370 in 2021. Once the annual deductible is met, the plan pays 100% of covered services for the rest of the year. The high-deductible Plan F is not available to new beneficiaries who became eligible for Medicare on or after January 1, 2020.

2 Plan K has an out-of-pocket yearly limit of $6,220 in 2021. After you pay the out-of-pocket yearly limit and yearly Part B deductible, it pays 100% of covered services for the rest of the calendar year.

3 Plan L has an out-of-pocket yearly limit of $3,110 in 2021. After you pay the out-of-pocket yearly limit and yearly Part B deductible, it pays 100% of covered services for the rest of the calendar year.

4 Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to $50 copayment for emergency room visits that don’t result in an inpatient admission.

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Now that you have a better understanding of what Medigap plans are and the types of benefits they provide, you can make an informed decision regarding your services and coverage. 

Call to speak with a licensed agent today to compare plans in your area and get a quote.

Find Medigap plans in your area.

Compare Plans
Or call 1-800-995-4219 to speak with a licensed insurance agent.

 

Christian Worstell is a health care and policy writer for MedicareSupplement.com. He has written hundreds of articles helping people better understand their Medicare coverage options.

Resource Center

Compare Medigap Plans 2021

See how the 10 Medigap plans differ. Review our chart for a detailed comparison of Medicare Supplement insurance benefits and compare Medigap options where you live. Read more
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