Medicare Gap Programs

MediGap policies are designed to cover what Medicare does not.

Medicare supplement insurance policies, also known as Medigap policies, are sold by private companies in order to cover costs not covered by traditional Medicare. These costs include copayments, coinsurance and deductibles. There are 10 plans that are available as a supplement to Medicare as of June 1, 2010, each covering a different mix of sections of the "gap."

Plan A

This plan covers the following as of June 1, 2010: Medicare Part A coinsurance for hospital stays up to 365 days after Medicare runs out, Medicare Part B coinsurance or copayment (except for preventive treatments), blood (first three pints), hospice care coinsurance or copayment and Medicare Preventive Care Part B coinsurance.

Plan B

This plan covers the following as of June 1, 2010: Medicare Part A coinsurance for hospital stays up to 365 days after Medicare runs out, Medicare Part B coinsurance or copayment (except for preventive treatments), blood (first three pints), hospice care coinsurance or copayment, skilled nursing facility care coinsurance, Medicare Part A deductible and Medicare Preventive Care Part B coinsurance.

Plan C

This plan covers the following as of June 1, 2010: Medicare Part A coinsurance for hospital stays up to 365 days after Medicare runs out, Medicare Part B coinsurance or copayment (except for preventive treatments), blood (first three pints), hospice care coinsurance or copayment, skilled nursing facility care coinsurance, Medicare Part A deductible, Medicare Part B deductible, foreign travel emergency (up to plan limits) and Medicare Preventive Care Part B coinsurance.

Plan D

This plan covers the following as of June 1, 2010: Medicare Part A coinsurance for hospital stays up to 365 days after Medicare runs out, Medicare Part B coinsurance or copayment (except for preventive treatments), blood (first three pints), hospice care coinsurance or copayment, skilled nursing facility care coinsurance, Medicare Part A deductible, foreign travel emergency (up to plan limits) and Medicare Preventive Care Part B coinsurance.

Plan F

This plan covers the following as of June 1, 2010: Medicare Part A coinsurance for hospital stays up to 365 days after Medicare runs out, Medicare Part B coinsurance or copayment (except for preventive treatments), blood (first three pints), hospice care coinsurance or copayment, skilled nursing facility care coinsurance, Medicare Part A deductible, Medicare Part B deductible, Medicare Part B excess charge, foreign travel emergency (up to plan limits) and Medicare Preventive Care Part B coinsurance. This plan covers the most services outside of Medicare. Plan F also offers a high deductible plan that requires that a recipient pay the full deductible up to $2,000 before Medicare kicks in.

Plan G

This plan covers the following as of June 1, 2010: Medicare Part A coinsurance for hospital stays up to 365 days after Medicare runs out, Medicare Part B coinsurance or copayment (except for preventive treatments), blood (first three pints), hospice care coinsurance or copayment, skilled nursing facility care coinsurance, Medicare Part A deductible, Medicare Part B excess charge, foreign travel emergency (up to plan limits) and Medicare Preventive Care Part B coinsurance.

Plan K

This plan covers the following as of June 1, 2010: Medicare Part A coinsurance for hospital stays up to 365 days after Medicare runs out, 50 percent of Medicare Part B coinsurance or copayment (except for preventive treatments), 50 percent of blood (first three pints), 50 percent of hospice care coinsurance or copayment, 50 percent of skilled nursing facility care coinsurance, 50 percent of Medicare Part A deductible and Medicare Preventive Care Part B coinsurance. The out-of-pocket limit (maximum amount you would have to pay before coverage kicks in) for this plan is $4,620.

Plan L

This plan covers the following as of June 1, 2010: Medicare Part A coinsurance for hospital stays up to 365 days after Medicare runs out, 75 percent of Medicare Part B coinsurance or copayment (except for preventive treatments), 75 percent of blood (first three pints), 75 percent of hospice care coinsurance or copayment, 75 percent of skilled nursing facility care coinsurance, 75 percent of Medicare Part A deductible and Medicare Preventive Care Part B coinsurance. The out-of-pocket limit (maximum amount you would have to pay before coverage kicks in) for this plan is $2,310.

Plan M

This new plan, introduced June 1, 2010 covers: Medicare Part A coinsurance for hospital stays up to 365 days after Medicare runs out, Medicare Part B coinsurance or copayment (except for preventive treatments), blood (first three pints), hospice care coinsurance or copayment, skilled nursing facility care coinsurance, 50 percent of Medicare Part A deductible, foreign travel emergency (up to plan limits) and Medicare Preventive Care Part B coinsurance.

Plan N

This new plan, introduced June 1, 2010 covers: Medicare Part A coinsurance for hospital stays up to 365 days after Medicare runs out, Medicare Part B coinsurance or copayment (except for preventive treatments), blood (first three pints), hospice care coinsurance or copayment, skilled nursing facility care coinsurance, Medicare Part A deductible, foreign travel emergency (up to plan limits) and Medicare Preventive Care Part B coinsurance. This plan pays 100 percent of the Part B coinsurance except up to $20 copay for office visits and up to $50 for emergency visits.

Plan E, H, I

These three plans, which covered the same services as the plans above, have been phased out and will no longer be offered after June 1, 2010. If you have any of these plans before June 1, 2010, they will still be considered legitimate.

References

• Medicare: Medicare & You 2010
• Medicare: 2010 Choosing a Medigap Policy: A Guide to Health Insurance for People On Medicare