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What Medigap Policies Cover and Don't Cover

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What Medigap Policies Cover

The chart below gives a quick look at the standardized Medigap Plans, it's benefits, and the percentage of benefit coverage.

Note:

  • All plan benefits are standardized. No company can offer more or less benefits. The only difference is the premium you pay.
  • Insurance companies that sell Medigap policies are required to offer Plan A. If they offer any other plans, they must also offer either Plan C or Plan F. Not all types of Medigap policies may be available in your state.

 

 * There is also a high-deductible version of Plan F where beneficiaries pay a deductible of $2,180 in 2016 before the Medigap plan begins to cover costs.

** After the out-of-pocket limit (including the Medicare Part B deductible) is reached for Plans K or L, the Medigap plan pays 100% of covered services for the remainder of the calendar year.

***Plan N pays 100% of the Medicare Part B coinsurance costs, with the exception of a copayment of up to $20 for some office visits and up to $50 for emergency room visits that don't result in the beneficiary being admitted as an inpatient.

 

What Medigap policies don’t cover

Typically, Medigap policies don't cover:

  1. Long term care
  2. Vision
  3. Dental
  4. Hearing aids
  5. Eyeglasses
  6. Private-duty nursing.
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