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What Is A Medigap Policy?

 

A Medigap (sometimes called "Medicare Supplement Insurance) policy is health insurance designed to supplement the Original Medicare Plan.  If you have Original Medicare (Parts A and B), and you buy a Medigap Policy, then both plans will pay their share of Medicare-approved amounts for covered health care costs.  Medigap policies are designated by different letters (A through L).  Usually, the only difference between Medigap Policies sold by different companies is the cost. 

 

A Medigap Policy covers only one person.  Therefore, if you and your spouse both want Medigap coverage, you each must buy separate Medigap policies.

 

What You Might Pay If You Had Original Medicare, but No Medigap or Medicare Advantage Plans:

 

 

 

 Cost Sharing

What YOU PAY in 2009

(these amounts can change each year)

Medigap Policies that may

help pay all or some of

these costs

Medicare Part A Coinsurance

& Hospital Benefits

For each benefit period, YOU PAY:

  • $256/day for days 61-90
  • $534/day for days 91-150

(while using your 60 lifetime reserve days)

Medigap Plans: A, B, C, D,

E, F, G, H, I, J, K or L

Medicare Part B Coinsurance

or Copayment

 YOU PAY all coinsurance, generally 20% of

Medicare approved amounts for most covered

services and any copayment after you meet

the $135 yearly Part B deductible

Medigap Plans: A, B, C, D,

E, F, G, H, I, J, K or L

 

Blood Generally, YOU PAY for the first 3 pints of blood

Medigap Plans: A, B, C, D,

E, F, G, H, I, J, K or L

 

Hospice Care Coinsurance

or Copayment

 YOU PAY a coinsurance or copayment, up to $5

for inpatient drugs and 5% of the Medicare-approved

amount for inpatient respite care.

Medigap Plans: K or L

Skilled Nursing Facility Care

Coinsurance

 For each benefit period, YOU PAY:

  • nothing for the first 20 days
  • up to $133.50/day for days 21-100

Medigap Plans: C, D, E,

F, G, H, I, J, K or L

Medicare Part A Deductible

For each benefit period, YOU PAY:

  • $1068 for days 1-60 in a hospital stay

Medigap Plans: B, C, D,

E, F, G, H, I, J, K or L

Medicare Part B Deductible

 YOU PAY the $135 yearly deductible

 Medigap Plans: C, F or J

Medicare Part B Excess Charges

 YOU PAY the difference between the Medicare-

approved amounts and the limiting charge (115%)

 Medigap Plans: F, G, I, J

Foreign Travel Emergency

Generally, YOU PAY all costs

Medigap Plans: C, D, E, F

G, H, I, J

At-Home Recovery

YOU PAY:

  • $0 for Medicare-approved home health services
  • 100% for services not covered by Medicare

Medigap Plans: D, G, I, J

Preventive Care Coinsurance

Generally, YOU PAY all costs

 

Medigap Plans: A, B, C, D,

E, F, G, H, I, J, K or L

 

Preventive Care not covered by

Medicare

YOU PAY all costs

Medigap Plans: E or J