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Medigap Plans: Is It Covered?

Posted on April 13, 2023 By Jeff Snyder

This table lays out what each Medicare Supplement plan covers. The state and federal governments set the minimum benefits that each plan must cover. The only states that don’t follow this are Massachusetts, Minnesota, and Wisconsin.

Standard Medicare Supplement Plans & Benefits

Standard Medicare Supplement Plans & Benefits

BenefitsABDG1KLMNC4F4,5
Part A coinsurance and hospital costs up to an additional 365 days after Medicare insurance benefits are used upYesYesYesYesYesYesYesYesYesYes
Part B coinsurance or copaymentYesYesYesYes50%75%YesYes2YesYes
Blood (first 3 pints)YesYesYesYes50%75%YesYesYesYes
Part A hospice care coinsurance or copaymentYesYesYesYes50%75%YesYesYesYes
Skilled nursing facility care coinsuranceNoNoYesYes50%75%YesYesYesYes
Part A deductibleNoYesYesYes50%75%50%YesYesYes
Part B deductibleNoNoNoNoNoNoNoNoYesYes
Part B excess chargeNoNoNoYesNoNoNoNoNoYes
Foreign travel exchange (up to plan limits)NoNo80%80%NoNo80%80%80%80%
Out-of-pocket limit3N/AN/AN/AN/A$7,060$3,530N/AN/AN/AN/A

1Enrollees in high-deductible Plan G must pay for their Medicare insurance-covered costs up to the deductible amount before the Med Supp begins to pay.
2Med Supp pays 100% of the Part B coinsurance, excluding copayments of up to $20 for some office visits and up to $50 for ER visits that don’t lead to inpatient admission.
3Upon meeting your annual out-of-pocket (OOP) limit and annual Part B deductible, the Med Supp pays 100% of all covered services for the remainder of the calendar year. OOP limits are for CY 2024.
4Plan only available to those eligible for the Medicare program before January 1, 2020.
5Enrollees in high-deductible F must pay for their Medicare insurance-covered costs up to the deductible amount before the Med Supp begins to pay. Only available to those eligible for the Medicare program before January 1, 2020.
Note: Med Supp plans are standardized differently in MA, MN, and WI.

Yes means the benefit is covered 100% by your plan. No means it’s not. Percentages are the amount of the plan covers, not how much you owe.

Only Plans K and L have out-of-pocket limits. In these plans, once you hit the yearly limit, your gap plan picks up 100 percent of the covered services. In 2024, the limit for Plan K is $7,060 and $3,530 for Plan L.

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Each plan offers different layers of coverage and cost. You can learn more about Medicare Supplements from our post What Are Medicare Supplements? You can also see what plans are available by contacting Chastain Agency LLC.

This entry was posted in Medicare Insurance and Tagged Chastain Agency LLC, Gainesville GA

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