What Does Medigap Cover?
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Medicare Supplement (Medigap) plans cover many of the costs Original Medicare doesn't, such as your deductible, copay and coinsurance. Some plans also offer foreign emergency travel coverage.
The level of coverage is set by which Medigap plan you pick. In most of the U.S., you can choose from 10 different Medigap plans.
What Medigap covers
Medigap coverage pays for some of the costs that Original Medicare (Parts A and B) won't cover. There are different levels of Medigap plans because Original Medicare requires you to pay a wide range of smaller costs for different kinds of care.
For example, under Medicare rules, you have to pay for the first three pints of blood when you get a transfusion. All 10 Medigap plans cover the so-called "vampire deductible" to some degree.
Medigap coverage areas
- Part A and B coinsurance
- First three pints of blood
- Hospice care daily coinsurance
- Skilled nursing facility daily coinsurance
- Part A and B deductibles
- Part B excess charges
- Foreign travel emergency
Plan F provides the most coverage. You cannot buy Plan F if you became eligible for Medicare after Jan. 1, 2020. However, you can get a Plan G policy, which provides the same coverage except it won't pay the $226 for your Part B deductible.
Plans F, G and N account for over 80% of all Medicare Supplement policies sold. These plans all provide high levels of coverage.
What does Medigap not pay for?
Your Medigap policy does not pay for dental, vision, hearing or most of your medical costs.
Medigap plans are not a form of traditional medical insurance. Instead, Medicare Supplement policies are a type of supplemental insurance designed to help you pay for the costs not covered by Original Medicare.
Medigap plans also do not include coverage for vision or dental. Although Medicare covers some vision and dental procedures, you're best off buying a separate plan for each to get the best coverage.
Not covered by Medicare Supplement plans
- Dental
- Vision
- Hearing
- Prescription drugs
- Transportation
If you want dental or vision coverage with your Medigap policy, you can buy "innovative" Medicare Supplement plans in some states. These plans bundle extra benefits onto your regular Medigap plan. For example, in California, Nevada and Kentucky, you can buy an Innovative Plan F or G policy that comes with vision and hearing insurance alongside traditional Medigap coverage.
However, these plans are not common or widespread.
Many Medigap providers sell separate supplemental insurance like vision, dental and hearing policies. You may qualify for a discount if you buy more than one policy from the same insurance company.
What is a Medicare Supplement plan?
A Medicare Supplement plan, also called a Medigap plan, is a type of insurance that pays for costs not covered by Original Medicare (Parts A and B). Medigap plans help you cover your Medicare out-of-pocket costs like your deductible, copay and coinsurance. Some plans also offer emergency foreign medical coverage.
Private insurance companies sell Medigap policies, but the government sets coverage levels for each plan. That means you get the same coverage for a Plan G policy regardless of which company you buy it from.
When shopping for a Medicare Supplement plan, keep in mind that coverage is standardized by plan letter. Once you choose a plan letter, you can compare companies based on price and customer service reputation.
Major Medigap providers
Medigap Plans F, G, N, C, D and M all cover up to 80% of your emergency medical costs (up to a $50,000 lifetime limit) when you're traveling outside the U.S. These plans do not pay for routine procedures and checkups.
If you need more robust health coverage while traveling abroad, consider buying a travel health insurance policy.
You cannot buy a Medicare Supplement plan if you have Medicare Advantage.
Medicare Supplement plan cost
The cost of a Medicare Supplement plan depends on the amount of coverage it has. Plans with more coverage typically have higher prices. For example, Plan F policies typically cost more than Plan K policies since Plan F offers significantly more coverage than Plan K. Other factors like your age, health status and when you buy your Medigap plan also affect how much you pay.
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Medigap plan costs
Plan letter | Monthly rate |
|---|---|
| High-deductible Plan G | $48 |
| High-deductible Plan F | $50 |
| Plan K | $85 |
| Plan N | $118 |
| Plan L | $136 |
| Plan A | $147 |
| Plan G | $152 |
| Plan D | $167 |
| Plan M | $169 |
| Plan F | $186 |
Prices are for a 65-year-old woman who doesn't smoke.
You should buy your Medigap plan when you become eligible for Medicare during your initial enrollment period to get the best price on your Medigap policy.
Insurance companies set prices for Medicare Supplement policies in three different ways. Some states require Medigap providers to set prices in one of those ways, while other states let companies choose.
- Community-rated: Age doesn't impact your price.
- Issue-age-rated: Your age when you enroll influences your price, but you don't pay more just because you get older.
- Attained-age-rated: You pay more for your Medigap policy as you get older.
Each option has certain advantages and disadvantages. For example, plans that take age into account may be cheaper when you first enroll, but they can grow unaffordable over time.
Frequently asked questions
What does Medigap cover?
Medigap plans cover your Medicare Part A and B out-of-pocket costs. Some plans also pay for up to 80% of your foreign emergency medical care costs.
What is Medigap insurance?
Medigap insurance is an extra type of health insurance that helps you pay for the roughly 20% of medical costs that you're responsible for under Original Medicare. Private companies sell Medicare Supplement insurance policies, but the government has strict requirements for what has to be covered.
What are the disadvantages of a Medigap plan?
You cannot buy a Medigap policy if you have a Medicare Advantage plan. In addition, most Medicare Supplement plans do not have an out-of-pocket maximum. {"content":"The most you will pay in out-of-pocket costs in a single year.","icon":"","label":"","triggerText":"out-of-pocket maximum."}
Sources
Medicare Supplement coverage information and plan limits were taken from the Centers for Medicare & Medicaid Services (CMS) and Medicare.gov.
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These numbers provided are not specific to your area, but rather represent the number of organizations and the number of products available on a national basis. We will connect you with licensed insurance agents who can provide information about the number of organizations they represent and the number of products they offer in your service area. Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
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Medicare supplement insurance is available to people age 65 or older enrolled in Medicare Parts A and B, and in some states to those under age 65 eligible for Medicare due to disability or end stage renal disease.
Medicare Advantage and Part D plans and benefits are offered by these carriers: Aetna Medicare, Anthem Blue Cross Blue Shield, Anthem Blue Cross, Aspire Health Plan, Cigna Healthcare, Dean Health Plan, Devoted Health, Florida Blue Medicare, GlobalHealth, Health Care Service Corporation, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Premera Blue Cross, Medica Central Health Plan, SCAN Health Plan, Baylor Scott & White Health Plan, Simply, UnitedHealthcare, Wellcare and WellPoint.
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