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Medigap Plans Benefits Grid

The chart below shows the benefits of the standard Medigap plans:

In Massachusetts, Minnesota and Wisconsin, Medigap Plans are standardized in a different way.

Medigap Plans Benefits
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
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Part B coinsurance or copayment
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50%
75%
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Blood (first 3 pints)
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50%
75%
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Part A hospice care coinsurance or copayment
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50%
75%
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Skilled nursing facility care coinsurance
-
-
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50%
75%
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Part A deductible
-
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50%
75%
50%
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Part B deductible
-
-
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-
Medigap Check Mark
-
-
-
-
-
Part B excess charge
-
-
-
-
Medigap Check Mark
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-
-
-
-
Foreign travel exchange (up to plan limits)
-
-
80%
80%
80%
80%
-
-
80%
80%
Out-of-pocket limit**
-
-
-
-
-
-
 $4,960
 $2,480
-
-
   

* Plan F also offers a high-deductible plan. If you choose this option, this means you must pay for Medicare-covered costs up to the deductible amount of $2,200 in 2017 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 inpatient admission.

  1. Plan F comes with either a standard or a higher $2,180 deductible. With the $2,180-deductible plan, you pay for $2,180 worth of Medicare-covered costs, such as co-insurance, co-payments and deductibles, before Plan F coverage begins. In exchange, premiums are lower on the high-deductible plan than on the standard-deductible plan. After the deductible has been met, the high-deductible Plan F pays the same benefits as the standard-deductible version.
  2. Once you reach the annual out-of-pocket limit on either Plan K or Plan L, that plan will pay 100% of the Medicare co-payment, co-insurance and deductibles for the rest of the calendar year.  The out-of-pocket limit does not include charges for any provider that exceeds Medicare-approved amounts, known as excess charges.

  3. With Plan M, you pay 50% of the Part A deductible ($1,288 per benefit period), as well as the entire Part B deductible for the calendar year ($166).

  4. Plan N pays all of the Part A deductible, and you pay the Part B deductible plus a $20 co-payment for some doctor appointments and a $50 co-payment for trips to the Emergency Room.

  5. Part B Excess Charges can occur if a doctor doesn’t accept Medicare’s approved amount.  Medicare will pay 80% of the amount it sets for specific doctor services.  If Medicare pays 80% on a service it says should cost $100 and a doctor charges you $100, Medicare pays $80 and you owe $20.  If the doctor charges you $120, however, Medicare will still pay $80 and you owe $40.  Medigap Plan F and Plan G will take care of those excess charges for you.

Some plans may not be available in every state.  Run an instant quote to see the plans in your area, or contact us to learn more about your available options.


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1281 E. Magnolia St., Unit D #233
Fort Collins, CO 80524
800-913-3416
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Disclaimer: Medigap Advisors is not connected with or endorsed by the U.S. Government or the federal Medicare program. Medicare has neither reviewed nor endorsed the information contained on this website. This is not a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE or consult www.medicare.gov (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week.