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Medigap Insurance Plans

Medigap Insurance Plans

A Medigap policy is a health insurance policy sold by private insurance companies to fill “gaps” in Original Medicare Plan coverage. Medigap policies must follow federal and state laws. These laws protect you. The front of the Medigap policy must clearly identify it as “Medicare Supplement Insurance.”

Each policy has a different set of benefits. Two of the standardized policies may have a high deductible option. In addition, any standardized policy may be sold as a “Medicare SELECT” policy. Medicare SELECT policies usually cost less because you must use specific hospitals and, in some cases, specific doctors to get full insurance benefits from the policy. In an emergency, you may use any doctor or hospital.

Outline of Medicare Supplement Coverage

Click here or click image to view guide to Medigap Policies
(Benefit Plans A-N)

A B C D F* G K L M N
Medicare Part A Coinsurance hospital costs up to an additional 365 days after Medicare benefits are used up YES YES YES YES YES YES YES YES YES YES
Medicare Part B Coinsurance or Copayment YES YES YES YES YES YES 50% 75% YES YES***
Blood (First 3 pints) YES YES YES YES YES YES 50% 75% YES YES
Part A Hospice Care Coinsurance or Copayment YES YES YES YES YES YES 50% 75% YES YES
Skilled Nursing Facility Care Coinsurance NO NO YES YES YES YES 50% 75% YES YES
Medicare Part A Deductible NO YES YES YES YES YES 50% 75% 50% YES
Medicare Part B Deductible NO NO YES NO YES NO NO NO NO NO
Medicare Part B Excess Charges NO NO NO NO YES YES NO NO NO NO
Foreign Travel Emergency (Up to Plan Limits) NO NO YES YES YES YES NO NO YES YES
 **Out-of-Pocket Limit  N/A  N/A  N/A  N/A  N/A  N/A  $4,800**  $2,400**  N/A  N/A

Clients receive expert consulting, administration and technology solutions from our benefit consultants. We can also provide valuable HR assistance, employee training, compliance review and COBRA health insurance management services.

***Plan N Pays 100% of the Part B coinsurance except up to $20 copayment for office visits and up to $50 for emergency department visits

*Medigap Plan F also offers a high-deductible plan. This means you must pay for Medicare-covered costs up to the deductible amount ($2,000 in 2010) before your Medigap plan pays anything.

**After you meet your out-of-pocket yearly limit and your yearly Part B deductible ($155 in 2010), the plan pays 100% of covered services for the rest of the calendar year. Out-of-pocket limit is the maximum amount you would pay for coinsurance and copayments.

Eliminate the burden of handling employee benefits and compliance