Standardized Medigap Plans and Benefits

There are 12 Medigaps plans designed to help fill the gaps in Medicare coverage. The plans are standardized to offer the same benefits regardless of what company offers them. The only difference between companies is cost. The most popular Medigap plans are C and F. Note: The numbers listed below are for 2008.

Your State Department of Insurance can give you a list of companies that sell Medigap plans in your state. You can also call your State Health Insurance Assistance Program or the National Medicare Hotline (1-800-MEDICARE) for free Medicare help. In addition, the Medicare.gov web site let's you compare Medigap plans in your area.

A

B

C

D

E

F**

G

H

I

J**

K

L

Hospital Coinsurance Coinsurance for days 61-90 ($256) and days 91-150 ($512) in hospital; Payment in full for 365 additional lifetime days.

Part B coinsurance Coinsurance for Part B services such as doctor's services, laboratory and x-ray services, durable medical equipment, and hospital outpatioent services.

50%*

75%*

First three pints of blood

50%*

75%*

Hospital Deductible Covers $1,024 in each benefit period.

50%*

75%*

Skilled Nursing Facility (SNF) Daily Coinsurance Covers $128 a day for days 21-100 each benefit period.

50%*

75%*

Part B Annual Deductible Covers $135 per calendar year.

Part B Excess Charges Benefits 80% or 100% of Part B excess charges. (Under Federal law, the excess limit is 15% more than Medicare's approved charge when provider does not take assignment; Under New York State law, the excess limit is 5% for most services.)

100%

80%

100%

100%

Emergency Care Outside the US Covers 80% of emergency care costs during the first 60 days of each trip, after an annual deductible of $250, up to a maximum lifetime benefit of $50,000.

At-Home Recovery Benefit Up to $40 each visit for custodial care after an illness, injury, or surgery, up to a maximum benefit of $1,600 a year.

Preventive Medical Care Up to $120 a year for non-Medicare covered physicals, preventive tests and services. 100% of coinsurance for Part B-covered preventive care services after the Part B deductible has been paid.

Hospice Care Coinsurance for respite care and other Part A-covered services.

50%*

75%*

Outpatient Prescription Drugs

*Out-of-Pocket Maximum Pays 100% of Part A and Part B coinsurance after annual maximum has been spent.

$4,440

$2,220

Medigap plans are standardized by the federal government. Not all plans may be available in your area. Consider the benefits offered by each plan and look for one that best meets your individual needs. **Plans F and J also offer high-deductible options. You pay $1,900 in 2008 before your coverage begins.

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