Medicare Supplement Insurance (also called Medigap) is a type of private insurance plan that can work alongside your Original Medicare coverage to help cover some out-of-pocket Medicare costs such as copayments, coinsurance and deductibles.
You can compare different types of Medicare plans, including Medicare Supplement Insurance, to find the type of coverage that's the best fit for your needs.
For example, you have to meet the Medicare Part B deductible ($203 in 2021) before Part B will start covering some of the costs of your care. And once it does, you are still typically responsible for a 20 percent Part B coinsurance for approved services.
A Medicare Supplement Insurance plan can help provide coverage for some of these out-of-pocket Medicare costs.
You typically pay a monthly premium to belong to a Medigap plan.
|Medicare Supplement Benefits||A||B||C1||D||F1||G||K||L||M||N|
|Part A coinsurance and hospital costs||✓||✓||✓||✓||✓||✓||✓||✓||✓||✓|
|Part B coinsurance or copayment||✓||✓||✓||✓||✓||✓||50%||75%||✓||✓|
|First 3 pints of blood||✓||✓||✓||✓||✓||✓||50%||75%||✓||✓|
|Part A hospice care co-insurance or co-payment||✓||✓||✓||✓||✓||✓||50%||75%||✓||✓|
|Co-insurance for skilled nursing facility||✓||✓||✓||✓||50%||75%||✓||✓|
|Medicare Part A deductible||✓||✓||✓||✓||✓||50%||75%||50%||✓|
|Medicare Part B deductible||✓||✓|
|Medicare Part B excess charges||✓||✓|
|Foreign travel emergency||80%||80%||80%||80%||80%||80%|
|1. Plans C and F are not available to new beneficiaries who became eligible for Medicare on or after January 1, 2020.
2. Plans F and G also offer a high deductible plan which has an annual deductible of $2,370 in 2021. Once the annual deductible is met, the plan pays 100% of covered services for the rest of the year. The high deductible Plan F is not available to new beneficiaries who became eligible for Medicare on or after January 1, 2020.
3. Plan K has an out-of-pocket yearly limit of $6,220 in 2021. Plan L has an out-of-pocket yearly limit of $3,110 in 2021.
4. Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to $50 for emergency room visits that don’t result in an inpatient admission.
View an image version of this table.
Medicare Supplement Insurance can provide coverage for some or all of the following costs:
There are 10 Medicare Supplement Insurance plans available in most states. They are designated a plan letter (Medigap Plan A, B, C, D, F, G, K, L, M and N), and each type of plan offers a different combination of some or all of the above coverage.
Not every plan will be available in every state.
Medicare Supplement Insurance is sold by private insurance companies, so the cost of a plan can differ between one carrier or location and another.
There are a few other things that may affect the cost of a Medigap plan:
In order to be eligible for a Medicare Supplement Insurance plan, you must be at least 65 years old, enrolled in Medicare Part A and Part B and reside in the area that is serviced by the plan.
Some states – but not all – allow Medicare Supplement Insurance enrollment for Medicare beneficiaries under the age of 65.
The following states require insurance companies to offer at least one Medicare Supplement plan to Medicare beneficiaries under 65:
If you are currently enrolled in a Medicare Advantage (Part C) plan, you will not be eligible to sign up for a Medicare Supplement Insurance plan. You must disenroll from your Medicare Advantage plan before you can join a Medigap plan.
Your six-month Medigap Open Enrollment Period begins when you are 65 years old and enrolled in Part A and Part B.
During your Medigap Open Enrollment Period, insurance companies are not allowed to use medical underwriting to determine your premium rates when you apply for a policy. This means that if you apply for a plan during this period, you cannot be charged more due to your age or health history.
Once your six-month open enrollment window ends, you may be subject to underwriting and may pay higher plan premiums. Insurance companies also reserve the right to deny you a policy based on the results of the underwriting. That’s why it’s highly advisable to take advantage of your Medigap open enrollment period.
There are some special enrollment periods for Medicare Supplement Insurance that give you guaranteed issue rights, which means insurance companies can't use underwriting in your application process. You have to meet specific criteria to qualify for one of these special enrollment periods.
If one of the following situations applies to you, you may qualify for a Medigap special enrollment period:
Medicare Supplement plans and Medicare Advantage plans work very differently, and you can't have both at the same time.
Medicare Supplement plans work alongside your Original Medicare coverage to help cover out-of-pocket Medicare costs like deductibles and coinsurance.
Medicare Advantage plans replace your Original Medicare coverage. Many plans also offer other benefits such as prescription drug coverage or dental care, which Original Medicare doesn't typically cover.
Medicare Supplement plan premiums can vary based on where you live, the insurance companies offering plans, the pricing structure those companies use and the type of plan you apply for.
For example, the average monthly premium rate for Medigap Plan G in New York was $304 in 2018. The average monthly premium for the same plan in Iowa in 2018 was only $102.1
With 10 different types of standardized Medigap plans and a range of benefits they can offer (not to mention the range of monthly premiums for each plan), it can be helpful to take the time to compare the Medigap options available where you live.
You can usually change your Medicare Supplement plan at any time during the year. You should consider switching Medigap plans during certain times of the year, however.
Changing Medicare Supplement plans during the right time can help protect you from having to pay higher premiums or being denied coverage due to your health or preexisting conditions.
There are a number of different Medicare Supplement Insurance companies across the nation. The companies that sell Medigap plans in your area may vary. You can learn more about them by comparing company ratings and reading customer reviews.
Medigap Plan F covers more out-of-pocket Medicare costs than any other standardized type of Medigap plan. In exchange for their monthly premium, Plan F beneficiaries know that all of their Medicare deductibles, coinsurance, copays and other out-of-pocket costs will be covered.
For many Medicare Supplement beneficiaries, this piece of mind and ease of use are the reasons they chose to enroll in Plan F.
New Medicare beneficiaries who first became eligible for Medicare on or after January 1, 2020 will no longer be able to enroll in Medigap Plan F or Plan C.
If you already had Plan F or Plan C, you can keep your plan. If you became eligible for Medicare before Jan. 1, 2020, you can apply for Plan F or Plan C after this date if either plan is available where you live.
Also new in 2020 is high-deductible Plan G, which offers comparatively lower monthly premiums in exchange for having to meet an annual deductible before Plan G benefits kick in.
1 TZ Insurance Solutions LLC internal sales data, 2019. This data is based on the Medicare Supplement Insurance policies TZ Insurance Solutions LLC has sold. It is not a comprehensive national average of all available Medicare Supplement Insurance plan premiums.