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Last Updated:
10/8/08
| What is
a MEDIGAP policy and what does it cover?
Are the benefits and costs the same within each of the standard plans? |
|
CHART OF 12 STANDARDIZED MEDICARE SUPPLEMENT PLANS
(Click on the letter for a more detailed explanation of the plan's benefits)
| B | D | E | F* | ||
| Basic Benefit | Basic Benefit | Basic Benefit | Basic Benefit | Basic Benefit | Basic Benefit |
| Skilled Nursing Coinsurance | Skilled Nursing Coinsurance | Skilled Nursing Coinsurance | Skilled Nursing Coinsurance | ||
| Part A Deductible | Part A Deductible | Part A Deductible | Part A Deductible | Part A Deductible | |
| Part B Deductible | Part B Deductible | ||||
| Part B Excess (100%) | |||||
| Foreign Travel Emergency | Foreign Travel Emergency | Foreign Travel Emergency | Foreign Travel Emergency | ||
| At Home Recovery | |||||
| Preventive Care |
| G | H | I | J* | K** | L** |
| Basic Benefit | Basic Benefit | Basic Benefit | Basic Benefit |
100% Part A Coinsurance plus coverage for 365 days after Medicare Benefits end. 50% Hospice cost-sharing. 50% Medicare-eligible expenses for the first three pints of blood. 50% Part B Coinsurance, except 100% Coinsurance for Part B Preventive Services. |
100% Part A Coinsurance plus coverage for 365 days after Medicare Benefits end. 75% Hospice cost-sharing. 75% Medicare-eligible expenses for the first three pints of blood. 75% Part B Coinsurance, except 100% Coinsurance for Part B Preventive Services. |
| Skilled Nursing Coinsurance | Skilled Nursing Coinsurance | Skilled Nursing Coinsurance | Skilled Nursing Coinsurance | 50% Skilled Nursing Facility Coinsurance | 75% Skilled Nursing Facility Coinsurance |
| Part A Deductible | Part A Deductible | Part A Deductible | Part A Deductible | 50% Part A Deductible | 75% Part A Deductible |
| Part B Deductible | |||||
| Part B Excess (80%) | Part B Excess (100%) | Part B Excess (100%) | |||
| Foreign Travel Emergency | Foreign Travel Emergency | Foreign Travel Emergency | Foreign Travel Emergency | ||
| At Home Recovery | At Home Recovery | At Home Recovery | |||
| Preventive Care | |||||
| Out of Pocket Annual Limit *** | Out of Pocket Annual Limit *** |
* Plans F and J also have an option called a high deductible plan F and high deductible Plan J. These high deductible plans pay the same or offer the same benefits as plans F and J after the insured individual has paid a calendar year deductible. Benefits from high deductible plans F and J will not begin until out-of-pocket expenses are equal to the calendar year deductible amount. Out-of-pocket expenses for this high deductible are expenses that would ordinarily be paid by the policy. These expenses include the Medicare deductibles for Part A and Part B, but do not include in plans F and J the plan’s separate foreign travel emergency deductible.
Currently, some insurance companies offer high deductible Plan F in Maryland, however, there are no insurance companies that offer high deductible Plan J in Maryland.
** Plans K and L provide for different cost-sharing for items and services than plans A-J. Once you reach the annual limit, the plan pays 100% of the Medicare co-payments, coinsurance, and deductibles for the rest of the calendar year. The out-of-pocket annual limit does NOT include charges from your provider that exceed Medicare-approved amounts, called "Excess Charges". You will be responsible for paying excess charges.
*** The out-of-pocket annual limit will increase each year for inflation.
Go to a list of insurance companies offering MEDIGAP policies in the State of Maryland. (This information is provided by the Maryland Insurance Administration in a table. It serves as a guideline and does not cover the full range of age groups. The rates are also subject to change. Please verify the current rates for your age by phoning the company of your choice.) |