NOTE: This article contains outdated figures, as some of the Medicare premiums and benefits change each year. For updated information, please refer to other pages on our site like this: Medicare Part B – The Bottom Line | 65Medicare.org and our Medicare Blog.
Several factors should be considered when doing a Medigap comparison. One factor is whether you are in relatively good health or not. Do you have an extensive list of medications you are presently taking? How many times per year do you anticipate seeing a health care provider? Are your finances limited, or do you not have any restrictions on how much you pay for your monthly premium? Do you lead a healthy lifestyle, i.e. exercising and eating healthy? Or do you lead a sedentary life and/or are a smoker? These are some of the important questions that you should ask yourself, before making your final decision.
All Medigap plans are standardized. In other words, they must abide by federal and state rules and regulations governing those plans. This means that “like” plans provide the same coverage (one Plan G from Company X is the same as another Plan G from Company Y). That said, Massachusetts, Minnesota and Wisconsin have their own standardized plans. If you’re doing a Medigap comparison, an overview of the ten nationally-standardized Medigap plans is outlined below:
Plan F, Plan G and Plan N – A Medigap Comparison
- Covers the Medicare Part A hospitalization deductible of $1,340 for each benefit period
- Has a $0 copay/$0 deductible Medicare Part B
- If you are in a “guaranteed issue” period (When is a Medigap Guaranteed Issue?), this plan is available without underwriting (i.e. no health questions required)
**This plan will be closed as of 2020 to new Medicare beneficiaries. As a result, it is probable that the rates of existing policyholders will be increased at a higher percentage than normal since the pool of subscribers will be smaller and older.
- Covers the Medicare Part A hospitalization deductible of $1,340 for each benefit period
- Covers skilled nursing facility care, blood, hospice care, and foreign travel
- Has a $0 copay and a $183 Medicare Part B deductible
- Application must go through medical underwriting unless you are enrolling during Medigap open enrollment (when you are first eligible for Medicare).
- Covers the Medicare Part A hospitalization deductible of $1,340 for each benefit period (Find out about Part A coverage)
- Covers skilled nursing facility care, blood, hospice care, and foreign travel
- Does not cover the $183 Medicare Part B deductible
- Does not cover the full Part B coinsurance – you are responsible for $20 doctor’s office co-pay
- Emergency room copay of up to $50, if not admitted to the hospital (otherwise it is waived)
- You may have to pay Part B excess charges of 15% (the difference in cost between the Medicare-approved payment amount for services and the amount your health care provider charges). Many providers accept the payment schedule, but if they do not, they may charge these Part B Excess charges.
- Application must go through medical underwriting unless you are enrolling during open enrollment (when you are first eligible for Medicare).
Plan F, Plan G and Plan N List, by email, for your zip code
Plan F, G and N Rates for your Zip Code
We will send, via email, the list of the rates and company ratings for Plan F, G and N for your zip code.
Other Plans to Consider for a Medigap Comparison
Although Plans F, G and N make up about 75% of the market share of Medigap plans, there are some other options that you can consider if you are doing a Medigap comparison.
Plan A:
Covers 100% of:
- Medicare Part A coinsurance and hospital costs (up to an additional 365 days after Medicare Benefits are used up.
- Medicare Part A hospice care
- Medicare Part B coinsurance or copayment
- First 3 pints of blood
Plan B:
Covers 100% of:
- Medicare Part A coinsurance and hospital costs (up to an additional 365 days after Medicare Benefits are used up.
- Medicare Part A hospice care
- Medicare Part B coinsurance or copayment
- First 3 pints of blood
- Medicare Part A deductible ($1,340 for each benefit period)
Plan C:
Covers 100% of:
- Medicare Part A coinsurance and hospital costs (up to an additional 365 days after Medicare Benefits are used up.
- Medicare Part A hospice care
- Medicare Part B coinsurance or copayment
- First 3 pints of blood
- Skilled nursing facility care coinsurance
- Medicare Part A deductible ($1,340 for each benefit period)
- Medicare Part B deductible ($183 per year)
- Covers 80% of foreign travel emergency (up to plan limits)
**This plan will be closed to new subscribers as of 2020.
Plan D:
Covers 100% of
- Medicare Part A coinsurance and hospital costs (up to an additional 365 days after Medicare Benefits are used up.
- Medicare Part A hospice care
- Medicare Part B coinsurance or copayment
- First 3 pints of blood
- Skilled nursing facility care coinsurance
- Medicare Part A deductible ($1,340 for each benefit period)
- Covers 80% of foreign travel emergency (up to plan limits)
Plan F – High Deductible:
There is a $2,240 deductible per year. Once this deductible is met, plan pays the same as Plan F.
Plan K:
- Covers 100% of Medicare Part A coinsurance and hospital costs (up to an additional 365 days after Medicare Benefits are used up.
Covers 50% of:
- Medicare Part A hospice care
- Medicare Part B coinsurance or copayment
- First 3 pints of blood
- Skilled nursing facility care coinsurance
- Medicare Part A deductible ($1,340 for each benefit period)
Plan L:
- Covers 100% of Medicare Part A coinsurance and hospital costs (up to an additional 365 days after Medicare Benefits are used up.
Covers 75% of:
- Medicare Part A hospice care
- Medicare Part B coinsurance or copayment
- First 3 pints of blood
- Skilled nursing facility care coinsurance
- Medicare Part A deductible ($1,340 for each benefit period)
Plan M:
Covers 100% of:
- Medicare Part A coinsurance and hospital costs (up to an additional 365 days after Medicare Benefits are used up.
- Medicare Part A hospice care
- Medicare Part B coinsurance or copayment
- First 3 pints of blood
- Skilled nursing facility care coinsurance
- Covers 50% of Medicare Part A deductible ($1,340 for each benefit period)
- Covers 80% of foreign travel emergency (up to plan limits)
Plan F, Plan G and Plan N List, by email, for your zip code We will send, via email, the list of the rates and company ratings for Plan F, G and N for your zip code. Plan F, G and N Rates for your Zip Code
Under certain circumstances, if you have a guaranteed issue right, you may be able to buy a policy for Plans A, B, C, F, K and L, without having to answer any medical questions (medical underwriting is avoided). Examples of guaranteed issue rights include: losing group coverage, moving out of your plan’s service area, or wanting to disenroll from an Advantage plan after being in the plan less than a year after turning 65. In those cases, a Medigap comparison can help you determine which plans works best for you.
All plans are available without underwriting/health questions if you are turning 65 and in open enrollment. If you have additional questions about what the plans cover, which plan is right for you, or want the rates for certain plans, you can contact us online or call us at 877.506.3378.
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