If you’re considering enrolling in a Medigap plan, you might be feeling a bit overwhelmed by the number of options available. There are 10 standardized Medigap plans labeled from A to N, each offering different levels of coverage to help fill in the gaps left by Original Medicare (Part A and Part B). In this blog, we’ll break down each option in simple terms, so you can make an informed decision about which one might be the best fit for your healthcare needs.
What is Medigap Insurance?
Medigap plans are private insurance policies designed to work alongside Original Medicare. While Medicare Part A and Part B cover a lot of your healthcare needs, there are certain out-of-pocket costs, like copayments, coinsurance, and deductibles, that you’ll still be responsible for. Medigap insurance helps cover these extra costs, which can significantly reduce your out-of-pocket expenses.
Now, let’s dive into the different plans:
Plan A – The Basic Plan
Coverage:
Plan A is the most basic Medicare Supplement plan. It covers the essential gaps that Original Medicare leaves behind, including:
- Part A coinsurance and hospital costs (up to an additional 365 days after Medicare benefits are used up)
- Part B coinsurance or copayments
- First three pints of blood used in a medical procedure
What it doesn’t cover:
Plan A does not cover the Medicare Part A deductible, skilled nursing facility care coinsurance, or foreign travel emergency care.
Best for:
Those looking for the most affordable option and willing to cover certain gaps themselves.
Plan B – Extra Coverage for the Part A Deductible
Coverage:
Plan B is like Plan A but with one key addition: it covers the Part A deductible. That’s the amount you must pay before Medicare starts covering hospital costs.
- All the same coverage as Plan A, plus the Part A deductible.
Best for:
Those who want a bit more coverage but don’t mind paying a little extra each month for it.
Plan C – Comprehensive Coverage
Coverage:
Plan C is one of the most comprehensive options available. It includes everything from Plan A and Plan B, plus more:
- Part A deductible
- Part B deductible
- Skilled nursing facility care coinsurance
- Foreign travel emergency care (up to 80% of costs)
- Part B excess charges (the difference between what Medicare pays and what a provider charges)
What it doesn’t cover:
Plan C is no longer available for new enrollees as of January 2020, but those who were already enrolled can keep it.
Best for:
Anyone who wants extensive coverage and is eligible for a plan that includes the Part B deductible.
Plan D – Similar to Plan C, But Without the Part B Deductible
Coverage:
Plan D offers most of the same coverage as Plan C, but it doesn’t cover the Part B deductible. Here’s what’s covered:
- Part A deductible
- Skilled nursing facility care coinsurance
- Foreign travel emergency care
- Part B coinsurance/copayments
- First three pints of blood
What it doesn’t cover:
The Part B deductible, which Plan C covers.
Best for:
Those who want a comprehensive plan but can manage the Part B deductible themselves.
Plan F – The Cadillac of Plans (but only available to those eligible before 2020)
Coverage:
Plan F is the most comprehensive Medigap plan available, and it covers everything. This includes:
- Part A and Part B deductibles
- Part A and Part B coinsurance/copayments
- Skilled nursing facility care coinsurance
- Foreign travel emergency care
- Part B excess charges
What it doesn’t cover:
Nothing! Plan F is the gold standard.
Best for:
Those who want the most complete coverage possible and who were eligible for Medicare before 2020. (Note: You can no longer enroll in Plan F if you became eligible for Medicare after January 1, 2020.)
Plan G – Close Second to Plan F
Coverage:
Plan G is nearly identical to Plan F, but it doesn’t cover the Part B deductible. Here’s what it covers:
- Part A deductible
- Part B coinsurance/copayments
- Skilled nursing facility care coinsurance
- Foreign travel emergency care
- Part B excess charges
What it doesn’t cover:
The Part B deductible.
Best for:
Those who want nearly the same benefits as Plan F but are okay with paying the Part B deductible.
Plan K – Lower Monthly Premium, Higher Out-of-Pocket Costs
Coverage:
Plan K offers more limited coverage, but with much lower premiums. It covers:
- 50% of the Part A deductible
- 50% of Part A coinsurance
- 50% of skilled nursing facility care coinsurance
- First three pints of blood
What it doesn’t cover:
Plan K leaves out a lot of the extra coverage found in the more comprehensive plans, including the Part B deductible and Part B excess charges.
Best for:
People who want lower monthly premiums and are okay with higher out-of-pocket costs.
Plan L – Similar to Plan K, but with 75% Coverage
Coverage:
Plan L is similar to Plan K, but it covers a higher percentage of the costs:
- 75% of the Part A deductible
- 75% of Part A coinsurance
- 75% of skilled nursing facility care coinsurance
- First three pints of blood
What it doesn’t cover:
Plan L doesn’t cover the Part B deductible or Part B excess charges.
Best for:
Those looking for moderate premiums and who are comfortable with some out-of-pocket costs.
Plan M – A Balanced Approach
Coverage:
Plan M covers most gaps, but it has a catch: it only covers 50% of the Part A deductible. Here’s what it covers:
- Part A coinsurance and hospital costs
- Part B coinsurance/copayments
- First three pints of blood
- Skilled nursing facility care coinsurance
- Foreign travel emergency care
What it doesn’t cover:
Plan M doesn’t cover the Part A deductible in full and also doesn’t cover Part B excess charges.
Best for:
People who want a balance between coverage and cost.
Plan N – Affordable with Some Limitations
Coverage:
Plan N is a good option for those who want affordable coverage with some out-of-pocket responsibilities. It covers:
- Part A coinsurance and hospital costs
- Part B coinsurance/copayments (except for copays for office visits and ER visits)
- Skilled nursing facility care coinsurance
- Foreign travel emergency care
- First three pints of blood
What it doesn’t cover:
Plan N doesn’t cover the Part B deductible, Part B excess charges, and has small copayments for doctor visits and emergency room visits.
Best for:
Those who are okay with some out-of-pocket costs and want lower premiums.
Final Thoughts: Choosing the Right Plan
When selecting a Medigap plan, the best option for you will depend on your healthcare needs, budget, and preferences.
- Plan A is best for those who want the most basic coverage.
- Plan F and Plan G offer the most extensive coverage, with Plan G being more accessible for those who became eligible for Medicare after 2020.
- Plan K and Plan L are good choices for those who prefer lower premiums but can handle higher out-of-pocket costs.
- Plan N is a great middle ground, offering reasonable premiums with some small copayments.
Each plan is designed to meet different needs, so take time to consider what makes the most sense for you. If you’re unsure, consult with an independent licensed insurance broker who can help guide you through the process based on your unique healthcare needs.
