Medigap Plans and Coverage

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.

 

 

Medigap Plans
Medigap Benefits ABCDF*G*KLMN
Medicare Part A Coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used upXXXXXXXXXX
Medicare Part B Coinsurance or CopaymentXXXXXX50%75%XX***
Blood (First 3 Pints)XXXXXX50%75%XX
Part A Hospice Care Coinsurance or CopaymentXXXXXX50%75%XX
Skilled Nursing Facility Care CoinsuranceXXXX50%75%XX
Medicare Part A DeductibleXXXXX50%75%50%X
Medicare Part B DeductibleXX
Medicare Part B Excess ChargesXX
Foreign Travel Emergency (Up to Plan Limits)XXXXX
Out-of Pocket Limit**
$4,660$2,330

 

* 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.