3 things to know about Medigap benefits:
- Medigap plans help pay for certain Medicare out-of-pocket costs like deductibles, coinsurance and copayments.
- Each of the standardized Medigap plans include a different combination of benefits.
- 2 popular plans (Plan F and Plan C) are not available to Medicare beneficiaries who became eligible for Medicare on or after January 1, 2020.
Below are the specific types of Medicare-related expenses that Medicare Supplement insurance policies may cover:
- Part A hospital care coinsurance
- Part A hospice care coinsurance or copayment
- Part B coinsurance or copayment
- First 3 pints of blood
- Part A deductible
- Part B deductible*
- Part B excess charges
- Skilled nursing care
- Foreign travel emergency care
The bold items in the list are the expenses covered by all Medicare Supplement insurance plans. The other items may or may not be covered, depending on which Medigap plan option you choose.
* The only plans that cover the Part B deductible are Plan F and Plan C. If you became eligible for Medicare on or after January 1, 2020, neither of these plans are available to you.
Since each plan is different, it’s important to understand which benefits are included in the Medigap policy you plan to buy.
The following chart shows which plan options cover which expenses. Use the scroll bar at the bottom of the chart to view all plans and information
- If a box contains a check mark, it means that plan covers the expense 100%.
- If a box contains a percentage, it means that plan option will pay only that portion of the expense.
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.
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What Do Medigap Policies Cover?
Medigap policies have 4 required benefits that must be included and 5 optional benefits that are only included with some plan options.
Required health care benefits
The following 4 benefits are included, at least in part, in every Medigap policy:
- Part A hospital care coinsurance
- Part A hospice care coinsurance or copayment
- Part B coinsurance or copayment
- First 3 pints of blood
No matter which Medigap plan option you choose, these costs will be covered.
The following explains each of the benefits in detail.
Part A hospital care coinsurance
Medicare Part A covers inpatient hospital stays. But if your stay lasts longer than 60 days, you have to make a coinsurance payment for each day you’re still in the hospital.
After a certain point, Medicare stops covering your inpatient hospital costs altogether.
If you have a Medicare Supplement insurance policy, it will cover your Part A coinsurance costs.
- The coinsurance is $408 per day in 2024 for days 61 to 90 of your hospital stay.
- Beyond 90 days, there’s a $816 per day coinsurance cost in 2024.
If you have a Medigap policy, it also will cover any inpatient hospital costs after Medicare stops covering them. It will do so for up to 365 days after you use up your Medicare benefits.
Part A hospice care coinsurance or copayment
Medicare Part A hospice care covers respite care and prescription drugs for pain relief.
However, there is a 5% coinsurance for respite care and a $5 copayment for each prescription drug.
If you have Medicare Supplement insurance, it will pay for these coinsurance and copayment costs.
Note: Plans K and L cover only a portion of the coinsurance and copayments.
Part B coinsurance or copayment
Medicare Part B covers preventative services and necessary supplies to diagnose and treat medical conditions.
Part B only pays 80% of the Medicare-approved amount for a particular service. So if the Medicare-approved cost for a service is $1,000, Medicare only pays for $800 of it.
After you meet your Part B deductible, you are typically responsible for a 20% Part B coinsurance.
If you have a Medigap policy, it will cover the remaining 20% Part B coinsurance costs.
Note: Plans K and L cover only a portion of the coinsurance or copayment.
First 3 pints of blood
Medicare only covers the cost of blood for the 4th pint and beyond for a blood transfusion. It doesn’t cover pints 1 through 3.
If you have a Medigap policy, it will cover the first 3 pints of blood.
Other Medicare Supplement Insurance benefits offered by some plans
The following 5 benefits are covered, at least in part, by some Medicare Supplement insurance plans. However, some Medigap plan options do not cover them.
- Part A deductible
- Part B deductible
- Part B excess charges
- Part A skilled nursing care coinsurance
- Foreign travel emergency care
The following explains each of the benefits in detail.
Part A deductible
Medicare Part A covers a range of hospital costs. But before your Part A coverage kicks in, you need to pay a deductible.
In 2024, the Part A deductible is $1,632 per benefit period.
9 out of the 10 Medicare Supplement insurance plan options cover the Part A deductible. The only plan option that doesn’t cover it is Plan A.
Note: Plans K, L, and M cover only part of the Part A deductible. Plans K and M cover 50% of it, and Plan L covers 75% of it.
Part B deductible
Medicare Part B covers a range of preventative and diagnostic services. Before your Part B coverage kicks in, you need to meet your Part B deductible.
In 2024, the Part B deductible is $240 per year.
If you have Medicare Supplement Plan F or Plan C, your policy will cover the Part B deductible. No other plan options include this coverage.
Part B excess charges
In some cases, a health care facility will charge up to 15% more than the Medicare-approved amount for a service. These extra costs are called Medicare Part B excess charges.
If you have Medicare Supplement Plan F or Plan G, your policy will pay for the extra charges. No other plan options include this coverage.
Part A skilled nursing care coinsurance
Medicare Part A covers some skilled nursing facility services. But after 20 days of inpatient skilled nursing facility care, you need to start paying daily coinsurance to keep your coverage going.
For days 21 through 100 in a skilled nursing facility, the daily c-insurance is $204 per day in 2024.
Medicare Supplement plans will cover this cost unless you have Plan A or Plan B. If you have any other plan, it will be covered at least partially.
Note: Plan K covers only 50% of the coinsurance and Plan L only covers 75% of it.
Foreign travel emergency care
Medicare only covers foreign emergency health care in a small set of rare situations.
If you have Medicare Supplement Plans C, D, F, G, M, or N, your insurance company will pay 80% of the billed charges for certain medically necessary emergency care received outside of the United States.
Find Medicare Supplement Plans Where You Live
A licensed insurance agent can help you find Medigap plans that are available where you live.
Call to speak with a licensed agent today to get help comparing plan benefits and costs so you can find a plan that fits your coverage needs.
Compare Medigap plans in your area.
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