Medigap

Medigap is secondary insurance offered by private companies that is specifically meant to fill the gaps in traditional Medicare. Medigap includes coverage for things such as copayments or co-insurance, deductibles and more.

 

Medigap plans at each level are required by law to offer the same basic benefits regardless of which private insurance company is selling it. The main difference between each level of the plans is the degree of coverage they provide and how much the plan costs. For example, all Medigap A plans offer the same coverage; all Medigap B plans offer the same coverage, etc.

 

These standard Medigap plans are available nationwide, except for in Massachusetts, Minnesota or Wisconsin, where Medigap plans are standardized in a different way. Click on each state to learn more about its specific Medigap plans. 

The chart below (effective June 2010) lists all the Medigap plans coverage for Plans A, B, C, D, F, G, K, L, M and N. All Medigap plans are required to offer Medicare Part A co-insurance, Medicare Part B co-insurance, hospice care and up to three pints of blood per year.

 

As you can see, some plans fill in the gaps in traditional Medicare more completely than others. You’ll note, too, that none of the Medigap plans cover prescription drugs. This is because most drugs that Medigap would have covered are covered under a Medicare Part D plan.

 

 

Medigap Policy	Skilled Nursing Facility	Part A Deductible	Part B Deductible	Part B Excess Charges	Foreign Travel Emergency
A
B
C
D
F				(100%)
G
K	(50%)	(50%)
L	(75%)	(75%)
M		(50%)
N

All Medigap plans will still be required by law to offer the same benefits regardless of which private insurance company is selling them. But because Medicare Part B is expanding to cover more services, “core” Medigap benefits will change. All Medigap policies will still need to include Part A and Part B coinsurance and up to three pints of blood per year, however, because Medicare Part B will now cover Medicare-approved preventive services, Medigap policies will no longer cover those same services or at-home recovery. 

 

Companies offering Medigap policies also will be able to offer Medigap Plans M and N, which provide similar coverage to other Medigap policies, but with higher out-of-pocket costs and lower premiums. These plans may work best for people who want a Medigap plan but don’t necessarily have the money to pay for one of the richer plans. Companies offering Medigap policies in 2010 will no longer be able to offer Medigap Plans E, H, I or J.

 

With the expansion of Medicare Part B, some of the Medigap plans will be duplicative. Additionally, because Medicare Part D now provides Medicare-eligible individuals a way to get prescription drug coverage, Medigap Plans H, I and J are no longer needed. If you need drug coverage, you can get it through Medicare Part D.

 

If you already have Medigap Plan E, H, I or J, don’t worry – your plan will not be taken away from you or changed without your knowledge. For more details on how these changes affect you if you have a Medigap policy, call your plan provider.

 

If you don’t have one of the plans being eliminated and are looking for a Medigap plan, contact the plan of your choice for information on how to enroll or choose Allsup Medicare Advisor to help you understand your options. You also can use the chart below for information about each plan.

 

Please Note: The information provided below is applicable to plans nationwide except those located in Minnesota, Massachusetts and Wisconsin, where plans are standardized differently. For information on plans in those states, click on the links or contact your local State Heath Insurance Assistance Program (SHIP).