Medigap Plans by Avera Health Plans
There are 7 different Medigap Plans offered by Avera Health Plans available to residents in South Dakota. This page outlines the Medicare Supplement insurance plans and benefits from Avera Health Plans, as well as information to help you get an accurate quote.
|Plan Type||Under 65||Community||Issued
|Medigap Policy A||Yes||No||No||Yes||Jun 27 2016||Enroll|
|Medigap Policy B||Yes||No||No||Yes||Jun 27 2016||Enroll|
|Medigap Policy C||Yes||No||No||Yes||Jun 27 2016||Enroll|
|Medigap Policy F||Yes||No||No||Yes||Jun 27 2016||Enroll|
|Medigap Policy G||Yes||No||No||Yes||Jun 27 2016||Enroll|
|Medigap Policy K||Yes||No||No||Yes||Jun 27 2016||Enroll|
|Medigap Policy L||Yes||No||No||Yes||Jun 27 2016||Enroll|
*Under 65 -- If this plan is avaiable to people under the age of 65.
*Community Rated Pricing -- The base premium is the same for everyone in the area, regardless of age.
*Issue Age -- The premium is based on your age at issue. And the premium will only increase with the carriers state-wide increase.
*Attained Age -- The carrier will price the policy based on your age at issue and the premium will increase over time with your age. This is the most common pricing method that carriers use.
Medigap Plan A
All insurance companies including Avera Health Plans that sell Medicare Supplement Plans Medicare Supplement Plans must offer Plan A. This is the most basic policy covering your expenses for Medicare Part A (Hospital Coverage) and Part B (Medical Insurance) and hospice care that the government doesn’t pay in SD.
Medigap Plan B
Medicare Supplement Plan B is available from Avera Health Plans in South Dakota. Medigap Plan B offers all the benefits of Plan A with additional coverage on your Part A (Hospital Coverage) Deductible.
Medigap Plan C
Avera Health Plans offers Medigap Plan C in South Dakota. Medicare Supplement Plan C offers additional benefits covering you for foreign travel emergencies up to 80% of the cost, Skilled Nursing Facility care coinsurance and covers 100% of your Part B deductible.
Medigap Plan F
Plan F is the most popular Medigap Plan in South Dakota. Medicare supplement Plan F offers the most comprehensive coverage of any plans by Avera Health Plans. It includes all the coverage of plan C with help paying your Plan B excess charges. Plan F with a high dedudictible you must pay for Medicare-covered costs (coinsurance, copayments, deductibles) up to the deductible amount of $2,300 in 2019 before your policy pays anything. There are No Co Pays, No Deductibles and No Out of Pocket Costs with Plan F. That means if your Medicare Part A or Part B pay a penny on any doctor or hospital charges, this policy will cover the gap.
Medigap Plan G
Medicare supplement Plan G covers your share of any medical benefit that Original Medicare covers, except for the outpatient deductible. Avera Health Plans helps to pay for inpatient hospital costs, such as blood transfusions, skilled nursing, and hospice care.
Medigap Plan K
Medigap Plan K results in lower premiums because it does not offer extensive coverage for many healthcare expenses. Plan K still offers 100% coverage on Medicare Part A coinsurance and hospital costs. But only pays 50% coverage on Medicare Part B, blood, hospice care, skilled nursing facility care and Part A deductible. Medicare Supplement by Avera Health Plans Plan K does not cover the Medicare Part B Deductible, Part B excess charges, or foreign travel emergencies. The 2020 out-of-pocket (OOP) limits for Medigap plans K are $5,880.
Medigap Plan L
Medigap Plan L policies sometimes have lower premiums than more comprehensive Medicare Supplement plans. Medigap Plan L covers 100% of the costs of Medicare Part A coinsurance and hospital costs. Medigap Plan L covers 75% of the costs of: Medicare Part A ( hospice care coinsurance or copayment), Medicare Part A deductible, Medicare Part B coinsurance or copayment, Skilled Nursing Facility care coinsuranc and First three pints of blood used in a medical procedure. The 2020 out-of-pocket (OOP) limits for Medigap plans L is $2,940 in South Dakota.
|Medicare Part A Coinsurance and Hospital Costs||100%||100%||100%||100%||100%||100%||100%||100%||100%||100%|
|Medicare 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 or Copayment||100%||100%||100%||100%||100%||100%||50%||75%||100%||100%|
|Skilled Nursing Facility Care Coinsurance||100%||100%||100%||100%||50%||75%||100%||100%|
|Part A Deductible||100%||100%||100%||100%||100%||50%||75%||100%||100%|
|Part B Deductible||100%||100%|
|Part B Excess Charges||100%||100%|
|Foreign Travel Emergency||80%||80%||80%||80%||80%||80%|
* Plan K and L have a deductible. The 2020 out-of-pocket (OOP) limits for Medigap plans K & L are $5,880 and $2,940, respectively.
*Plan F is also offered as a high-deductible plan by some insurance companies. If you choose this option, you must pay for Medicare-covered costs (coinsurance, copayments, deductibles) up to the deductible amount of $2,300 in 2019 before your policy pays anything.
*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.
*Excess Charges - If you see a provider that doesn’t participate in Medicare, the provider can charge up to 15% more than the standard Medicare rate. You will have to pay it out-of-pocket unless you have a Medigap plan that includes benefits for Part B excess charges.
|Plan A||$63 - $222|
|Plan B||$100 - $252|
|Plan C||$118 - $287|
|Plan D||$112 - $173|
|Plan F||$118 - $241|
|Plan F High Deductible||$34 - $94|
|Plan G||$104 - $183|
|Plan K||$47 - $102|
|Plan L||$79 - $151|
|Plan M||$106 - $119|
|Plan N||$82 - $156|
Starting January 1, 2020, Medigap plans sold to new people with Medicare won’t be allowed to cover the Part B deductible. Because of this, Plans C and F will no longer be available to people new to Medicare starting on January 1, 2020. If you already have either of these 2 plans (or the high deductible version of Plan F) or are covered by one of these plans before January 1, 2020, you’ll be able to keep your plan. If you were eligible for Medicare before January 1, 2020, but not yet enrolled, you may be able to buy one of these plans.