Insurance Read Time: 4 min

Which Medigap Option Is Right for You?

Insurance companies may offer up to 10 different Medigap policies labeled A, B, C, D, F, G, K, L, M and N. Each lettered policy is standardized. This means that all policies labeled with the same letter have the same benefits, no matter which company provides them or their price. For example, Medigap policy A offered by company 1 provides exactly the same benefits as Medigap policy A offered by company 2. Companies are not required to offer all 10 standardized Medigap policies, meaning some may be unavailable in your state.

Note that Minnesota, Massachusetts, and Wisconsin have different ways of standardizing Medigap policies. If you live in one of these states, please contact your, State Health Insurance Assistance Program (SHIP) or State Department of Insurance for more information on purchasing a Medigap policy.

Medigaps help pay certain Medicare costs, including deductibles, coinsurance, and copays. Medigaps do not help pay for Medicare premiums. All policies must offer the following basic benefits:

  • Hospital coinsurance coverage
  • 365 additional days of full hospital coverage
  • Full or partial coverage for the 20% coinsurance for provider charges and other Part B services
  • Full or partial coverage for the first three pints of blood you need each year
  • Hospice coinsurance for drugs and respite care

Beyond these basic benefits, each standardized Medigap covers a different amount of your Medicare cost-sharing. Depending on which Medigap policy you choose, you can get coverage for additional expenses, including:

  • Hospital deductible
  • Skilled nursing facility coinsurance
  • Part B deductible (Note: People eligible for Medicare on or after January 1, 2020 cannot purchase Medigaps that pay for the Part B deductible. See below for more information.)
  • Emergency care outside the U.S.
  • At-home recovery
  • Preventive care that Medicare does not cover
  • Excess physician’s charges (some Medigaps will pay the limiting charge, which is the amount above the Medicare-approved amount that non-participating doctors can charge).

Medigap policy A is often the least expensive, but it only covers the basic benefits listed above. Policies C and F are the most comprehensive, but they generally cost more.

Medigap Plans C and F

Medigap Plans C and F are only available to you if you became eligible for Medicare before January 1, 2020. This is because people eligible for Medicare on or after January 1, 2020 cannot purchase Medigaps that pay the Part B deductible.

If you became Medicare-eligible before this date, you will still be able to purchase Plan C or Plan F. If you were eligible for Medicare before this time but did not enroll, you will be able to purchase Plan C or Plan F as long as you are within your Medigap open enrollment period or have a guaranteed issue right once you enroll in Original Medicare. If you currently have Medigap Plan C or Plan F, you can continue to renew it from insurers in your state.

Policies sold before June 1, 2010

Keep in mind that policies sold today have slightly different benefits from those offered before June 1, 2010. Also, policies E, H, I, and J are no longer sold. If you bought your Medigap before June 1, 2010, and have a discontinued policy, you can keep it as long as you like. The insurance company must continue to renew the discontinued Medigap policy each year you wish to keep it.

See the Medigap Plan Benefits Chart for plans purchased between July 31, 1992, and May 31, 2010 for more information on your Medigap policy’s coverage.

© 2020 Medicare Rights Center. Used with permission.

The content is developed from sources believed to be providing accurate information. The information in this material is not intended as tax or legal advice. It may not be used for the purpose of avoiding any federal tax penalties. Please consult legal or tax professionals for specific information regarding your individual situation. This material was developed and produced by FMG Suite to provide information on a topic that may be of interest. FMG, LLC, is not affiliated with the named broker-dealer, state- or SEC-registered investment advisory firm. The opinions expressed and material provided are for general information, and should not be considered a solicitation for the purchase or sale of any security. Copyright 2020 FMG Suite.

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