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% | 50% | 75% | 50% | 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.
For a review of all the benefits offered by Original Medicare, please see my post detailing all that Medicare covers.
Matthew Claassen
Matthew Claassen, CMT and CEO of Medigap Seminars Insurance Agency. Medigap Seminars is an award winning premier national Medicare Insurance Brokerage, ranked among the top in the U.S.A. Matthew is considered a leading national expert on Medicare and Social Security. Mr. Claassen is a distinguished member of the Forbes Business council, an invitation only organization of business leaders and entrepreneurs. He and his team have received awards from many of the countries largest insurance companies including Mutual of Omaha, Aetna, Humana, Cigna, United American, United Healthcare and others. His videos have become the most popular Medicare educational videos on YouTube with millions of views. As a financial analyst Matthew lead a team of researchers to win the 2009 Best Equity Research & Strategy Award from The Technical analysis magazine.