Medicare Supplement (Medigap) Basics
Federal law lets states allow an insurer to add “new and innovative benefits” to the benefits in a standardized policy. Check with your insurance company to find out if these benefits are available.
This chart shows basic information about the different benefits that Medigap policies cover. If a percentage appears, the Medigap plan covers that percentage of the benefit, and you must pay the rest. (This is only intended as a summary, contact us for specific information or www.medicare.gov)
Medicare Supplement Insurance (Medigap) Plans | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|
Benefits | A | B | C | D | F | G | K | L | M | N |
Medicare Part A coinsurance and hospital costs (up to an additional 365 days after Medicare benefits are used) | 100% | 100% | 100% | 100% | 100% | 100% | 100% | 100% | 100% | 100% |
Medicare Part B coinsurance or co-payment | 100% | 100% | 100% | 100% | 100% | 100% | 50% | 75% | 100% | 100% *** |
Blood (first 3 pints) | 100% | 100% | 100% | 100% | 100% | 100% | 50% | 75% | 100% | 100% |
Part A hospice care coinsurance or co-payment | 100% | 100% | 100% | 100% | 100% | 100% | 50% | 75% | 100% | 100% |
Skilled nursing facility care coinsurance | 100% | 100% | 100% | 100% | 50% | 75% | 100% | 100% | ||
Part A deductible | 100% | 100% | 100% | 100% | 100% | 50% | 75% | 50% | 100% | |
Part B deductible | 100% | 100% | ||||||||
Part B excess charges | 100% | 100% | ||||||||
Foreign travel emergency (up to plan limits) | 80% | 80% | 80% | 80% | 80% | 80% | ||||
Part A deductible- $1316 for 2017 | Out-of-Pocket Limit in 2017** | |||||||||
Part B deductible- $183 for 2017 | $5,120 | $2,560 |
* Plan F is also offered as a high‑deductible plan by some insurance companies in some states. If you choose this option, this means you must pay for Medicare‑covered costs (coinsurance, copayments, deductibles) up to the deductible amount of $2,200 in 2017 before your policy pays anything.
**For Plans K and L, after you meet your out‑of‑pocket yearly limit and your yearly Part B deductible ($183 in 2017), the Medigap plan pays 100% of covered services for the rest of the calendar year.
*** Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don’t result in an inpatient admission.
If you do not use a Medicare SELECT provider for non-emergency services, you will have to pay what Medicare doesn’t pay. Medicare will pay its share of approved charges no matter what provider you choose. Medicare SELECT might not be offered in your state.