| Tue, Nov 19, 2019 @ 09:03 AM

What Do Medigap Plans Cover?

Posted by Medicare Made Clear

Learn more about Medigap and Medicare supplement insurance.Medigap plans, also called Medicare supplement insurance plans, cover some of the costs not paid by Original Medicare (Parts A & B). For example, Medicare Part B typically pays 80 percent of the cost for a covered service, such as a doctor visit. You would be responsible for the other 20 percent of the cost, which a Medigap plan may cover.

Depending on the specific Medigap plan, some or all of the following out-of-pocket Medicare costs may be covered:

What Are the Different Types of Medigap Plans?

There are ten different types of Medigap plans. In most states, the plan types are known by letters, such as Plan A, Plan G, Plan M, etc. However, Massachusetts, Minnesota and Wisconsin have their own Medigap plan types and name them differently.

What Does Each Type of Medigap Plan Cover?

The federal government sets the standard benefits for each type of Medigap plan. So, every Medigap plan of the same type provides the exact same coverage.

Medigap Plan A and Plan M benefits are listed below as examples. You can see a chart showing every plan type and what it covers here.

Medigap Plan A Covers:

  • Coinsurance or copayments for medical services covered by Part B
  • Coinsurance for additional hospital days beyond what Medicare pays for
  • Coinsurance or copayment for hospice care
  • Cost of the first three pints of blood

Medigap Plan M Covers:

  • Everything Medigap Plan A covers (see list above)
  • Coinsurance for care in a skilled nursing facility
  • 50 percent of the Part A deductible
  • 80 percent of care received while traveling internationally

Does Medigap Cover Drugs?

No, Medigap plans do not cover drugs. Medigap plans help pay only for services that are covered by Original Medicare. Since neither Medicare Part A nor Part B cover prescription drugs, Medigap plans do not help with drug costs – or with costs for other services not covered by Original Medicare.

You can get drug coverage through a standalone Medicare Part D plan or a Medicare Advantage plan (Part C) that includes it. Please note that Medigap plans work only with Original Medicare. You can’t use and don’t need a Medigap plan if you have a Medicare Advantage plan.

How Much Do Medigap Plans Cost?

Medigap plans charge a monthly premium. The amount varies depending on the specific plan and on the insurance company offering it.

While the federal government standardizes Medigap plan benefits, insurance companies set the cost for plans they sell. You may have a few Medigap plans of the same type to choose from. Since you get the same benefits no matter which plan you choose, it’s a good idea to compare costs.

For more information about Medicare, explore MedicareMadeClear.com or contact the Medicare helpline 24 hours a day, seven days a week at 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048.

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