Private insurance companies contract with Medicare to offer health insurance to cover a variety of out-of-pocket expenses not covered by Original Medicare, Part A and Part B. Called Medicare Supplement plans, these plans are also known by other names, including Medigap and MedSupp.
Medicare Supplement plan types
MedSupp plans can help pay Original Medicare’s copayments and deductibles. Each type of plan offers a different level of coverage, and is named with a different letter (such as Plan A). The plans are standardized, so that all plans of the same letter offer the same benefits. In other words, the benefits for a Medicare Supplement Plan D enrollee in Rhode Island are the same for a Medicare Supplement Plan D enrollee in Tennessee. However, the premiums can differ among these private insurance companies.
The table below shows a summary of benefits offered by each of the 10 standard Medicare Supplement plans. In this chart, X indicates that the service (or item) is 100% covered; a percentage indicates what percent of the service/item is covered; and a blank cell indicates it is not covered.
|Medicare Supplement Plans|
|Medicare Supplement 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 exhausted
|Medicare Part B copayment or coinsurance||X||X||X||X||X||X||50%||75%||X||X***|
|First three pints of blood||X||X||X||X||X||X||50%||75%||X||X|
|Medicare Part A hospice care coinsurance or copayment||X||X||X||X||X||X||50%||75%||X||X|
|Skilled nursing facility (SNF) care coinsurance||X||X||X||X||50%||75%||X||X|
|Medicare Part A deductible||X||X||X||X||X||50%||75%||50%||X|
|Medicare Part B deductible||X||X|
|Medicare Part B ‘excess charges’||X||X|
|Foreign travel emergency coverage (up to plan limits)||80%||80%||80%||80%||80%||80%|
|Medicare Part B preventive care coinsurance||X||X||X||X||X||X||X||X||X||X|
|Out-of-pocket limits apply**|
*Medicare Supplement Plan F offers a high-deductible version in which beneficiaries pay a certain deductible amount before the plan begins coverage. This amount may change from year to year.
**Once you reach the out-of-pocket limits (including the Part B deductible), both Medicare Supplement Plans K and L pay 100% of covered services in the above chart for the remainder of the calendar year.
***Plan N pays 100% of the Part B coinsurance costs, except up to $20 copayment for some office visits and up to $50 for emergency room visits.
More facts about Medicare Supplement plans
- Although Medicare Supplement plans are standardized by letter, prices may vary across different carriers, so you may want to comparison-shop before enrolling.
- Beneficiaries with Medigap plans often buy Medicare prescription drug plans, since Medigap plans don’t offer this coverage (Medigap plans sold before 2006 did include prescription drug coverage).
- Medicare SELECT is a Medigap plan that requires beneficiaries to use hospitals or physicians within its network of healthcare providers to be eligible for full plan benefits. Any of the ten Medigap plan types can be offered in a Medicare SELECT version by an insurance company.
- Insurance companies offering Medicare Supplement insurance don’t necessarily offer all ten plan types. An insurer may choose to offer only some of the plans.