Original Medicare & Medigap
Medicare Part A (2021)
|Hospital Inpatient Stay||Deductible: $1,484 per benefit period||First 60 Days Cost: You pay $0. Medicare pays.|
|Days 61-100 Cost: You pay $371 a day. Medicare pays the rest.|
|Days 101-150 Cost: You pay $742 a day. Medicare pays the rest.|
|Days 150+ Cost: You pay 100%|
|Skilled Nursing Facility Care Stay||Only after a 3-day inpatient stay at a hospital. Skilled Nursing Care is a technical term and does not include solely custodial care||First 20 days Cost: You pay $0. Medicare pays.
Days 21-100 Cost: You pay the first $185.50 a day. Medicare pays the rest.
Days 101+: You pay 100%
|Inpatient Psychiatric Care||190 days lifetime benefit, Medicare pays 100%|
Medicare Part B (2021): Part B Deductible = $203.00 Annually
|$88,000 or less||$176,000 or less||$148.50|
|$88,000 – $111,000||$176,000 – $222,000||$207.90|
|$111,000 – $138,000||$222,000 -$276,000||$297.00|
|$138,000 – $165,000||$276,000 – $330,000||$386.10|
|$165,000 – $500,000||$330,000 – $750,000||$475.20|
|Greater than $500,000||Greater than $750,000||$504.90|
Medicare Part D (2021)
|$88,000 or less||$174,000 or less||Plan Premium|
|$88,000 – $111,000||$176,000 – $222,000||$12.30 + Plan Premium|
|$111,000 – $138,000||$222,000 -$276,000||$31.80 + Plan Premium|
|$138,000 – $165,000||$276,000 – $330,000||$51.20 + Plan Premium|
|$165,000 – $500,000||$330,000 – $750,000||$70.70 + Plan Premium|
|Greater than $500,000||Greater than $750,000||$77.10 + Plan Premium|
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||X||X||X||X||X||X||X||X||X||X|
|Medicare Part B Coinsurance or Copayment||X||X||X||X||X||X||50%||75%||X||X***|
|Blood (First 3 Pints)||X||X||X||X||X||X||50%||75%||X||X|
|Part A Hospice Care Coinsurance or Copayment||X||X||X||X||X||X||50%||75%||X||X|
|Skilled Nursing Facility 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 (Up to Plan Limits)||X||X||X||X||X|
|Out-of Pocket Limit**|
* Plan F and Plan G (beginning in January, 2020) also offers a high-deductible plan. lf you choose this option, this means you must pay for Medicare-covered costs up to the high deductible amount before your Medigap plan pays anything.
** After you meet your out-of-pocket yearly limit and your yearly Part B deductible, the Medigap plan pays 100% of covered services for the rest of the calendar year.
*** Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don’t result in an inpatient admission.
Enrollment in any plan on this page may provide compensation (in the form of commission), that we do not control. I will always, always fulfill my fiduciary responsibility to you.
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