A Brief Guide to Help Compare Medigap Plans


In order to compare Medigap plans, it is important to understand what Medigap plans are. A Medigap plan, also known as Medicare Supplement plan, are insurance plans or policies sold by private companies. Medicare Supplemental Insurance, another term frequently used for Medigap, helps in paying some of the healthcare costs that are not covered by the original Medicare. These costs include coinsurance, copayments, and deductibles as well. Some of the Medigap plans cover services like medical care while traveling outside the US and other costs which are not covered in the original Medicare plan. Thus, it can be said that Medigap plans supplement the original Medicare benefits.

Before we compare Medigap plans, it is useful to note that if you buy any Medigap plan, the original Medicare facility will be liable to cover or pay its share or percentage of the Medicare-approved amount for the covered healthcare.

The first thing to remember when comparing Medigap plans is that a monthly premium is required to be paid for a Medigap policy. These plans or policies are only available to those who already hold a Medicare Part A and Medicare Part B. While Medicare Part A comprises payment for hospital services, Medicare Part B, however, covers the cost for medic services.

Typical Medigap plans are branded A through N and include different health coverage levels. Plans E, H, I, and J, however, are no more available to the new subscribers.

Usually, the premium required to be paid by the plan holder of Medigap varies, the benefits usually remain the same. For example, the Medigap Plan C policy provides predefined benefits that remain true irrespective of the insurance company that is offering them. However, when one would compare Medigap plans, they should know that the standard Medigap policies would differ in states such as Minnesota, Massachusetts, and Wisconsin among what is offered by Medigap plans across the country.

The open enrollment period while buying a Medigap plan is six months starting from the first day of the month of an individual’s 65th birthday. The cost of a Medigap policy depends on different criteria, including the plan type, the insurance company from which the plan has been purchased, an individual’s age, location, etc. All medical policies are renewable, irrespective of the health problems.

A comparison chart to compare Medigap plans
Medicare Part A coinsurance and hospital costs – Medicare plans, for most hospital stays, normally covers the first 60 days minus the deductibles, i.e., $329 per day till the 90th day, and $658 per day of statement from the 91st till the 151st day; however, the costs are not covered after this period. All Medigap plans are liable to pay for these copays along with 100% of an additional 365 days.

Medicare Part B coinsurance or copayment – This normally covers 80% of the costs. All medical plans usually pay for some or all of the remaining 20%.

First three packets of blood – All plans are required to pay for a certain or all of the first three packets of blood. Medicare is required to pay 100% of any additional blood needed.

Part A hospice care coinsurance or copayments – All plans pay for some or all of the Medicare copayment or coinsurance. Medicare covers all remaining approved hospice care costs.

Skilled Nursing Facility Care Coinsurance – This facility helps in handling or managing the required daily association or contribution of trained nursing or experienced rehabilitation staff. For instance, Skilled Nursing Facility Care Coinsurance includes intravenous injections and physical therapy. Medicare is liable to pay all of the first 20 days, i.e., $164.50 per day starting from the 21st until the 100th day of agreed costs. After the 100th day, Medicare has no liability to pay for further costs involved in the treatment.

Part A deductibles – The Medicare Part A deductible comprises hospital stay. For 2017, the amount has been fixed at $1316 per stay.

Part B deductibles – To be able to reap the benefits offered by Part B, Part B deductible has to be paid. The benefits include doctor visits and other outpatient services. As of 2017, the deductible amount is $183. However, only Plans C and F allow its beneficiaries to benefit from this plan.

Part B excess charges – Part B excess charges refer to the amount that can be charged by a health care provider. This price is usually more than the Medicare-approved amount. However, only Plans F and G cover such costs.

Foreign travel emergency – This type of medical urgency is usually not covered by Medicare. The advantage of having this plan is that it covers 80% to a lifetime with a maximum of $50,000 (with $250 as deductible).

It is well observed that although the Medigap plans are standardized across the providers, Medigap costs can vary at large. Therefore, it is recommended to shop around and compare Medigap plans before zeroing in on the one that offers best competitive price.