Medicare Supplements

What is a Medicare Supplement?

A Medicare Supplement policy, also known as a “Medigap” policy, is private health insurance designed to supplement Original Medicare, covering costs such as, copayments, deductibles, and coinsurance.

Important Facts about Medicare Supplements

  • You must have Original Medicare (Medicare Part A and Part B)
  • Plans are standardized and can be purchased with varying coverage options
  • You pay a monthly premium for your Medicare Supplement Policy in addition to your monthly Part B premium
  • A Medicare Supplement Policy only covers one person. Spouses must buy a separate policy
  • Medicare Supplement plans have no provider networks
  • You can’t have prescription drug coverage in both your Medicare Supplement policy and a Medicare drug plan–you must have one or the other
  • You cannot buy a Medicare Supplement policy if you have a Medicare Advantage Plan. If you want to switch to a Medicare Supplement Policy you will need to disenroll from your Medicare Advantage Plan

Medicare Supplements generally cover:

  • Medicare Part A coinsurance and hospital costs up to an additional 365 days after Original Medicare benefits expire
  • Medicare Part B Copayment or Coinsurance
  • Blood (First 3 pints)
  • Part A Hospice Care Copayment or Coinsurance

The chart below gives an overview of standardized Medicare Supplement Plans available in most states (Exceptions: Minnesota, Wisconsin, Massachusetts)

Medicare Supplement Plans

How to read the chart:

If a check mark appears in a column of this chart, the Medicare Supplement policy covers 100% of the described benefit. If a row lists a percentage, the policy covers that percentage of the described benefit. If a row is blank, the policy doesn’t cover that benefit. Note: The Medicare Supplement policy covers coinsurance only after you have paid the deductible (unless your Medicare Supplement plan also covers the deductible).

Medicare Supplement Plans

Medicare Supplement Benefits

A

B

C

D

F*

G

K

L

M

N

Medicare Part A Coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up

Medicare Part B Coinsurance or Copayment

50%

75%

✓***

Blood (first 3 pints)

50%

75%

Part A Hospice Care Coinsurance or Copayment

50%

75%

Skilled Nursing Facility Care Coinsurance

50%

75%

Medicare Part A Deductible

50%

75%

50%

Medicare Part B Deductible

Medicare Part B Excess Charge

Foreign Travel Emergency (Up to Plan Limits)

Out-of-pocket Limit**

$4,660

$2,330

*Plan F also offers a high-deductible plan. If you choose this option, you must pay for Medicare-covered costs up to the deductible amount of $2,070 in 2012 before your Medicare Supplement plan pays anything.

**After you meet your out-of-pocket yearly limit and your yearly Part B deductible ($140 in 2012), the Medicare Supplement 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 an inpatient admission.

Minnesota, Wisconsin and Massachusetts have different standardized Medicare Supplement Plans.