What Does Medigap Insurance Cover?
Some expenses that Medigap insurance may cover include Medicare deductibles, copayments and coinsurance. In most states, there are 10 standardized Medigap plans to choose from, each providing a different variation of basic benefits to help cover certain Medicare out-of-pocket costs.
What Medigap Insurance May Cover
The nine benefit areas that Medigap insurance may cover include: coinsurance, copayments, deductibles, and excess charges.
- Medicare Part A coinsurance and hospital costs
Potential savings in 2024 = Up to $408 per day for days 61-90 of a hospital stay and up to $816 per day thereafter.
- Medicare Part B coinsurance or copayment
Potential savings in 2024 = Up to 20 percent of the cost of services and products.
- First three pints of blood
Potential savings in 2024 = Up to $150 per pint.
- Medicare Part A hospice care coinsurance or copayments
Potential savings in 2024 = Up to $5 for each prescription drug and 5 percent of the Medicare-approved amount for inpatient respite care.
- Medicare Part A deductible
Potential savings in 2024 = Up to $1,632 per benefit period.
- Medicare Part B deductible
Potential savings in 2024 = Up to $240 per year.
- Medicare Part B excess charges
Potential savings in 2024 = Up to 15 percent of the Medicare approved amount.
- Skilled nursing facility care coinsurance
Potential savings in 2024 = Up to $204 per day for days 21-100 of a stay.
- Emergency care outside of the U.S.
The first four benefits listed above are covered (at least in part) by all 10 Medigap plans. The other benefits may or may not be included, depending on which Medigap plan option you choose.
Before purchasing a Medigap plan, make sure you understand which benefits are included. The following chart shows the basic benefits of all 10 standardized plans.
Scroll to the right to continue reading the chart
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
|Medicare Supplement Benefits||A||B||C*||D||F1*||G1||K2||L3||M||N4|
|Part A coinsurance and hospital coverage|
|Part B coinsurance or copayment||50%||75%|
|Part A hospice care coinsurance or copayment||50%||75%|
|First 3 pints of blood||50%||75%|
|Skilled nursing facility coinsurance||50%||75%|
|Part A deductible||50%||75%||50%|
|Part B deductible|
|Part B excess charges|
|Foreign travel emergency||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.+ Read more
NOTE: In Massachusetts, Minnesota and Wisconsin, Medigap insurance plans are standardized differently.
Signing Up For Medigap Insurance
To be eligible for a Medigap policy, you must be at least 65 years old and enrolled in Medicare Part B. The best time to enroll in a Medigap policy is during your six-month Medigap open enrollment period.
- Failing to enroll in a Medigap plan during this time may result in higher monthly premiums or refusal of coverage.
- If you enroll in a Medigap insurance policy during your open enrollment period, insurance companies cannot use medical underwriting to determine the cost of your plan, regardless of your current health or health history.
- You cannot be enrolled in Medicare Advantage (Medicare Part C) and a Medigap plan. If you enroll in a Medigap plan while you are enrolled in Medicare Part C, you will lose your Medicare Part C coverage and be automatically enrolled in Original Medicare.
Have questions about what Medigap covers? Ready to start comparing quotes in your area? Connect with a licensed insurance agent to speak with someone who can help. Based in the United States, our agents are trained to help you find the right plan for your needs.