What is Medicare Supplement Plan J?

What Happened to Medicare Supplement Plan J?

Medicare experienced a change in 2003, when the Medicare Prescription Drug, Improvement and Modernization Act was passed. This benefits change introduced prescription drug coverage to Medicare (Medicare Part D), something that was previously only available through Medigap Plan J.¹ Because Medigap plans can no longer offer prescription drug coverage, Plan J was eventually retired in June of 2010.

This piece of legislation also added updates to Original Medicare, expanding its coverage of benefits that previously would only be covered with Medicare Plan J, such as at-home recovery care and preventive care. Without these benefits, Medigap Plan J’s coverage became too similar to Plan F to warrant keeping both options.

While no new Medicare beneficiaries may enroll for Medicare Supplement Insurance Plan J benefits, the plan remains in place for enrollees who purchased the plan prior to it being removed from the Medigap plan lineup. Enrollees who cancel their existing Medicare Supplement Insurance Plan J coverage may not re-enroll in the plan.

What Did Medigap Plan J Cover?

What Happened to Medicare Supplement Plan J?

Medicare experienced a change in 2003, when the Medicare Prescription Drug, Improvement and Modernization Act was passed. This benefits change introduced prescription drug coverage to Medicare (Medicare Part D), something that was previously only available through Medigap Plan J.¹ Because Medigap plans can no longer offer prescription drug coverage, Plan J was eventually retired in June of 2010.

This piece of legislation also added updates to Original Medicare, expanding its coverage of benefits that previously would only be covered with Medicare Plan J, such as at-home recovery care and preventive care. Without these benefits, Medigap Plan J’s coverage became too similar to Plan F to warrant keeping both options.

While no new Medicare beneficiaries may enroll for Medicare Supplement Insurance Plan J benefits, the plan remains in place for enrollees who purchased the plan prior to it being removed from the Medigap plan lineup. Enrollees who cancel their existing Medicare Supplement Insurance Plan J coverage may not re-enroll in the plan.

Comparing Medigap Plan J Coverage to Plan F

Medigap Plan J benefits were popular among Medicare beneficiaries because of the comprehensive coverage of Medicare’s out-of-pocket costs. The option for a wide range of health care cost coverage still exists in the form of Medigap Plan F.

IMPORTANT: Plan F is not available to beneficiaries who became eligible for Medicare on or after January 1, 2020. 

If you are not eligible for Plan F, you may consider Medigap Plan G.

Both Medicare Supplement Insurance Plan J and Plan F each provide coverage for: 

• Medicare Part A coinsurance and hospital costs
• Medicare Part B coinsurance and copayments
• First three pints of blood
• Medicare Part A hospice care coinsurance and copayments
• Skilled nursing facility care coinsurance
• Medicare Part A deductible
• Medicare Part B deductible
• Medicare Part B excess charges 

Plan J and Plan F each provide coverage for foreign travel emergency care as well. While Plan F allots for coverage of 80% of costs, Plan J provides 100% coverage. 

Medicare Supplement Insurance Plan J coverage also provides two additional benefits that are not found in Plan F:

• At-home recovery care (up to $1,600 a year)
• Preventive care (up to $120 a year)

Medicare has since expanded its coverage of at-home recovery and preventive care, making these differences no longer necessary.

Keeping Medigap Plan J vs. Switching to Plan F

Medicare beneficiaries who enrolled in Medicare Supplement Insurance Plan J prior to its discontinuation may remain enrolled in the plan. However, it would be wise for any enrollees still receiving Medigap Plan J benefits to shop around and compare their premiums with those of a Plan F policy.

Because new enrollees are no longer accepted into Plan J, there are only older beneficiaries participating in the plan. As these beneficiaries continue to age, the insurance companies may have to pay out more claims, which can lead to an increase in rates. On the other hand, Plan F has newer Medicare beneficiaries that are not requiring as many claims, and thus lower rates may be maintained for a period. 

The only real difference in the two Medigap plans today is a slight variation in foreign travel emergency coverage. Any Medigap Plan J enrollees who do not plan on doing any further foreign travel could potentially benefit from seeking out and comparing free Medigap quotes for Plan F and consider switching Medigap plans.

Refer to the chart below for a side-by-side comparison of all 10 standardized Medigap plans.

Find Medigap Plans Near You

Ready to compare Medicare Supplement plans and find a plan that fits your needs? Call to speak with a licensed insurance agent today who can help you compare your options.

¹ https://www.congress.gov/bill/108th-congress/house-bill/1