Medigap Benefits Chart - Medigap Chart - Health Exchange Agency
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Medigap Benefits Chart

We encourage you to take a look at the Medigap benefits chart on this page. All benefits associated with Medicare Supplemental Plans are listed in the Medigap chart below.

 

Medigap Benefits

Medigap Plans

A

B

C

D

F*

G*

K

L

M

N

Part A coinsurance
and hospital costs up to an additional 365 days after Medicare benefits are
used up

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Part B coinsurance or
copayment

Yes

Yes

Yes

Yes

Yes

Yes

50%

75%

Yes

Yes***

Blood (first 3 pints)

Yes

Yes

Yes

Yes

Yes

Yes

50%

75%

Yes

Yes

Part A hospice care
coinsurance or copayment

Yes

Yes

Yes

Yes

Yes

Yes

50%

75%

Yes

Yes

Skilled nursing
facility care coinsurance

No

No

Yes

Yes

Yes

Yes

50%

75%

Yes

Yes

Part A deductible

No

Yes

Yes

Yes

Yes

Yes

50%

75%

50%

Yes

Part B deductible

No

No

Yes

No

Yes

No

No

No

No

No

Part B 

excess charge

No

No

No

No

Yes

Yes

No

No

No

No

Foreign travel
exchange (up to plan limits)

No

No

80%

80%

80%

80%

No

No

80%

80%

Out-of-pocket limit**

N/A

N/A

N/A

N/A

N/A

N/A

$5,880 in 2020 ($6,220 in 2021)

$2,940 in 2020 ($3,110 in 2021)

N/A

N/A

 

 

*Additionally, Plan F offers a high deductible plan. Should you pick this option, then you are required to pay for costs covered by Medicare up to the deductible amount of $2,180 in 2016 before your Medigap plan covers anything.

**Once you’ve met your out of pocket annual limit and Part B deductible, Medigap covers 100-percent of covered services for the remainder of the calendar year.

***Plan N pays 100-percent of Part B co-insurance, excluding a co-payment of up to $20 for certain office visits and up to a $50 co-payment for ER visits not resulting in inpatient admission.

How insurance companies set Medigap premiums

There are 3 ways that insurance companies set Medigap premium rates:

–          “Community-rated” (aka “no-age-rated”) premiums are the same for everyone, regardless of age.

–          “Issue-age-rated” (aka “entry-age-rated”) premiums are based on one’s age when they first purchase the policy. The sooner one enrolls, the less they pay.

–          “Attained-age-rated” premiums are based on one’s current age. In other words, it increases as one grows older.

Additional factors that impact the premium rates may include inflation, geography, medical underwriting (in the event that you didn’t enroll upon first being eligible), in addition to other discounts. We recommend that you check with each specific health insurer to find out how they set Medigap prices prior to purchasing.

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