Using a Medigap plan comparison chart to help make decisions
Medicare Supplement (Medigap) comparison charts provide a convenient way to compare the benefits these health care plans provide. However, many Americans don’t know how to use them correctly. This step-by-step guide will help you compare Medicare Supplement plans correctly and find the best plan for your needs.
Understand the Layout of Medicare Supplement Comparison Charts
You will notice that some of the benefits listed on the left side of Medicare Supplement comparison charts are shared by all Medigap plans. That’s because all Medigap policies must legally provide some basic benefits. However, some policies offer additional benefits that are also listed on any Medicare Supplemental Insurance comparison chart.
Most states have 10 standardized Medicare Supplement plans. Medicare supplement plans are standardized in a different way in Massachusetts, Minnesota, and Wisconsin. Regardless of the state, you’ll usually see the plans referred to by letters of the alphabet (Plan A, Plan B etc.).
|Medigap Plans||A||B||C *||D||F * 1||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 3|
|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||Yes||Yes||Yes||Yes||50%||75%||Yes||Yes|
|Part A deductible||Yes||Yes||Yes||Yes||Yes||50%||75%||50%||Yes|
|Part B deductible||Yes||Yes|
|Part B excess charge||Yes||Yes|
|Foreign travel exchange (up to plan limits)||80%||80%||80%||80%||80%||80%|
|Out-of-pocket limit 2||$5,880||$2,940|
* As of Jan. 1, 2020 Medicare Supplement plan types C and F will no longer be made available to beneficiaries who become Medicare-eligible after Dec. 31, 2019. For those who became Medicare-eligible prior to Jan. 1, 2020, Medicare Supplement plan types C and F will remain active and available for future enrollment.
1 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 $2,300 in 2019 ($2,340 in 2020) before your Medigap plan pays anything.
2 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.
3 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.
Understand Basic Medicare Supplement Plan Benefits
Medicare Supplement comparison charts briefly list the benefits that various plans offer. These brief descriptions can be confusing for people unfamiliar with the healthcare industry. Some of the most basic benefits that all Medicare Supplement plans offer include:
- Medicare Part A coinsurance and hospital costs: Medicare usually covers the first 60 days of any hospital stay minus a deductible, all but $329 a day for the next 61 to 90 days in the hospital, and all but $658 a day for the next 91 to 151 days. There is nothing to pay after the 151st day of your hospital stay. All Medicare Supplement plans pay for the copays and all fees for an extra 365 days in hospital.
- Medicare Part B coinsurance or copayment: Medicare pays for 80% of these costs. All Medicare Supplement plans pay some or all of the remaining 20%, but benefit amounts vary.
- Blood, first three pints: Medicare Supplement plans pay some or all of the first three pints of a blood transfusion. The percent each plan pays is shown on the Medigap chart. Medicare covers the entire cost of any blood transfusion after the first three pints.
Part A hospice care coinsurance or copayments:
All Medicare Supplement Plans pay some or all of the Medicare copayment or coinsurance. Medicare Supplement charts list the exact percentage each plan covers. Medicare pays 100% of remaining approved hospice care costs.
Understand Optional Medicare Supplement Plan Benefits
In addition, there are benefits that some Medicare Supplement plans cover. These benefits can really help Americans differentiate one Medicare Supplement plan from another.
- Skilled nursing facility care coinsurance: This benefit covers procedures in health care facilities with skilled nursing or rehabilitation staff. These procedures might include physical therapy or intravenous injections. Medicare covers the first 20 days of treatment via these services in its entirety, then all but $164.50 of the next 21 to 100 days. Medicare supplement plans may pay all, some, or none of the deductibles or copays for your first 100 days of treatment.
- Part A deductible: This benefit refers to the deductible on a hospital stay. In 2020, this amounts to $1,408 per hospital stay. A Medicare Supplement plan may pay for all, some, or none of this amount.
- Part B deductible: This is the annual deductible payable before you receive Part B benefits, such as doctor’s visits and other outpatient medical services. In 2020, this amounts to $198. Medicare Supplement plans typically pay for all or none of this amount.
- Part B excess charges: This is an additional amount that a health care provider can charge for Part B services above the Medicare approved amount.
Foreign travel emergency:
This optional benefit covers policyholders for essential emergency medical care not covered by Medicare while traveling overseas. Plans offering this benefit typically pay 80% of foreign medical fees up to a lifetime cap of $50,000 with a deductible of $250.
Understand the Marks Used to Compare Benefits Side-by-Side
Medicare Supplement charts let you easily see each policy’s benefits side by side. As you read across the horizontal row, you’ll see whether each benefit listed on the left is covered or not and to what degree.
Medicare Supplement charts typically use the following words or symbols:
- Yes or a tick: the plan covers this benefit entirely
- XX %: the plan covers the listed percentage of the benefit
- No, a cross, or a blank space: the plan doesn’t cover that benefit
- N/A: the benefit is not applicable to the plan
To make the best choice, decide which benefits are important to you and look for a plan that provides most of them.