Medigap Benefits

This chart shows basic information about the different benefits that Medigap policies cover. If a percentage appears, the Medigap plan covers that percentage of the benefit.

The remaining percentage is your obligation.

Benefits Medicare Supplement Insurance (Medigap) Plans
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) 100% 100% 100% 100% 100% 100% 100% 100% 100% 100%
Part B coinsurance or copayment 100% 100% 100% 100% 100% 100% 50% 75% 100% **100%
Blood (first 3 pints) 100% 100% 100% 100% 100% 100% 50% 75% 100% 100%
Part A hospice care coinsurance /copayment 100% 100% 100% 100% 100% 100% 50% 75% 100% 100%
Skilled nursing facility coinsurance - - 100% 100% 100% 100% 50% 75% 100% 100%
Part A deductible 100% 100% 100% 100% 100% 100% 50% 75% 100% 100%
Part B deductible - - 100% - 100% - - - - -
Part B excess charge - - - - 100% 100% - - - -
Foreign travel (up to plan limits) - - 80% 80% 80% 80% - - 80% 80%
Out-of-pocket max limit NA NA ## ## ## ## $6,620 $3,310 NA ##

NA – Not Applicable

* Plans F and G also offer a high-deductible plan in some states. With this option, you must pay for  Medicare-covered costs (coinsurance, copayments, and deductibles) up to the deductible amount of
$2,490 in 2022 before your policy pays benefits. (Plans C and F are not available to people who were newly eligible for Medicare on or after January 1, 2020.)

For Plans K and L, 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.

## The Plan G maximum out-of-pocket (MOOP) is equal to the Medicare Part B deductible. The Plan N MOOP is equal to the Part B deductible plus office visit copays when you avoid excess charges. The High Deductible Plans G-HD and F-HD  MOOP is equal to the Medigap deductible. That is $2,490 for 2022.

*** Plan N pays 100% of the Part B coinsurance. However,  there may be a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that do not result in inpatient admission.

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