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Last Updated:
6/30/2010
| What is
a MEDIGAP policy and what does it cover?
Are the benefits and costs the same within each of the standard plans? |
|
INDIVIDUAL MEDICARE SUPPLEMENT PLAN CHOICES
(These charts show the benefits included in each of the standard Medicare supplement plans. Every company must make available Plan "A". If a company offers any other Medicare supplement plan, it must also offer either Plan C or Plan F.)
Basic Benefits for Plans A, B, C, D, F, F*, G, K, L, M and N
Hospitalization: Part A coinsurance plus coverage for 365 additional days after Medicare benefits end.
Medical Expenses: Part B coinsurance (generally 20% of Medicare-approved expenses) or copayments for hospital outpatient services. Plans K, L, and N require insureds to pay a portion of the Part B coinsurance or copayments.
Blood: First three pints of blood each year
Hospice: Part A coinsurance
| B | D | F* | G | ||
| Basic Benefit, including 100% Part B Coinsurance | Basic Benefit, including 100% Part B Coinsurance | Basic Benefit, including 100% Part B Coinsurance | Basic Benefit, including 100% Part B Coinsurance | Basic Benefit, including 100% Part B Coinsurance | Basic Benefit, including 100% Part B Coinsurance |
| Skilled Nursing Facility Coinsurance | Skilled Nursing Facility Coinsurance | Skilled Nursing Facility Coinsurance | Skilled Nursing Facility 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%) | Part B Excess (100%) | ||||
| Foreign Travel Emergency | Foreign Travel Emergency | Foreign Travel Emergency | Foreign Travel Emergency | ||
* Plan F also has an option called a high deductible plan F. The high deductible plan pays the same benefits as plan F after one has paid a calendar year deductible. Benefits from high deductible plan F will not begin until out-of-pocket expenses exceed this deductible. 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 the plan's separate Foreign Travel Emergency deductible.
Calendar year deductibles, beneficiary coinsurances and out-of-pocket annual limits for Medicare are subject to change. Please contact SHIP at 301-590-2819 for any updates.
Basic Benefits for Plans K, L and N include similar services as Plans A, B, C, D, E, F*, G and M but cost-sharing for the basic benefits is at different levels
| K** | L** | M | N |
|
100% Part A Hospitalization and preventive care paid at 100%; other basic benefits paid at 50% |
100% Part A Hospitalization and preventive care paid at 100%; other basic benefits paid at 75% | Basic Benefit, including 100% of Part B Coinsurance | Basic Benefit, including 100% of Part B Hospitalization Coinsurance except up to the copayment for office visit, and up the payment for emergency room visits |
| 50% Skilled Nursing Facility Coinsurance | 75% Skilled Nursing Facility Coinsurance | Skilled Nursing Coinsurance | Skilled Nursing Coinsurance |
| 50% Part A Deductible | 75% Part A Deductible | 50% Part A Deductible | Part A Deductible |
| Foreign Travel Emergency | Foreign Travel Emergency | ||
| Out of Pocket Annual Limit *** | Out of Pocket Annual Limit *** |
** Plans K and L provide for different cost-sharing for items and services than plans A, B, C, D, F, F*, G, M and N. Once you reach the annual limit, the plan pays 100% of the Medicare copayments, 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.) |