Original Medicare pays for many, but not all, health care services and supplies. A Medigap policy, sold by private insurance companies, can help pay some of the health care costs (“gaps”) that Original Medicare doesn’t cover, like copayments, coinsurance, and deductibles. Some Medigap policies also offer coverage for services that Original Medicare doesn’t cover, like medical care when you travel outside the U.S. If you have Original Medicare and you buy a Medigap policy, Medicare will pay its share of the Medicare-approved amount for covered health care costs. Then your Medigap policy pays its share. Medicare doesn’t pay any of the premiums for a Medigap policy.
Every Medigap policy must follow Federal and state laws designed to protect you, and it must be clearly identified as “Medicare Supplement Insurance.” Medigap insurance companies can sell you only a “standardized” Medigap policy identified in most states by letters. All plans offer the same basic benefits but some offer additional benefits, so you can choose which one meets your needs.Note: In Massachusetts, Minnesota, and Wisconsin, Medigap policies are standardized in a different way.
How to read the chart: If a check mark appears in a column of this chart, the Medigap policy covers 100% of the described benefit. If a row lists a percentage, the policy covers that percentage of the described benefit. If a row is blank, the policy doesn’t cover that benefit. Note: The Medigap policy covers coinsurance only after you have paid the deductible (unless the Medigap policy also covers the deductible).
|Medicare Part A Coinsurance and hospital costs
up to an additional 365 days after Medicare benefits are used up
|Medicare Part B Coinsurance of Copayment||50%||75%||***|
|Blood (First 3 Pints)||50%||75%|
|Part A Hospice Care Coinsurance or Copayment||50%||75%|
|Skilled Nursing Facility Care Coinsurance||50%||75%|
|Medicare Part A Deductible||50%||75%||50%|
|Medicare Part B Deductible|
|Medicare Part B Excess Charges|
|Foreign Travel Emergency (Up to Plan Limits)||80%||80%||80%||80%||80%||80%|
|Out Of Pocket Limit **||$4,800||$2,400|
Insurance companies may charge different premiums for exactly the same Medigap coverage. As you shop for a Medigap policy, be sure you’re comparing the same Medigap policy (for example, compare Plan A from one company with Plan A from another company).
In some states, you may be able to buy another type of Medigap policy called Medicare SELECT (a Medigap policy that requires you to use specific hospitals and, in some cases, specific doctors to get full coverage). If you buy a Medicare SELECT policy, you also have rights to change your mind within 12 months and switch to a standard Medigap policy.
More About Medigap Policies