About Medicare Supplement (Medigap) Plans F, G, and N
This article was updated on: 07/06/2017
Are you considering Medicare Supplement insurance? Medicare Supplement plans, also called Medigap plans, can help pay for out-of-pocket costs for services covered by Original Medicare (Part A and B). It’s important to select a Medigap plan option that fits your health-care needs now and in the future because, depending on the timing of when you enroll, you might not be able to switch plans later.
There are 10 standardized Medigap plans available in every state (excluding Massachusetts, Minnesota, and Wisconsin, which all have their own versions). Each plan has a letter designation (Plan F, for example) and is sold by private insurance companies across the country. While the prices may vary across different insurers, the benefits of each Medigap plan are standardized across plans of the same letter. This means that coverage for Medigap Plan F, for example, will be the same regardless of the insurance provider.
Medicare Supplement Plans F, G, and N offer many of the same benefits, with a few differences, which this article will share.
Medicare Supplement Plan F
Medigap Plan F is a popular choice that offers more coverage than any other Medicare Supplement plan. There is also a high-deductible Plan F that offers the same benefits as the standard Plan F, but requires you to pay a certain amount out of pocket before coverage starts.
Plan F benefits include:
- Medicare Part A coinsurance and hospital costs (up to an additional 365 days after Medicare benefits are used up)
- Medicare Part A hospice care coinsurance or copayment
- Medicare Part A deductible
- Medicare Part B coinsurance or copayment
- Medicare Part B deductible
- Medicare Part B excess charges
- First three pints of blood
- Skilled nursing facility (SNF) care coinsurance
- Foreign travel emergency coverage (up to plan limits)
If you choose the high-deductible Plan F, you’ll need to pay for all out-of-pocket Original Medicare costs until you reach a designated amount ($2,180 in 2016), before your policy pays anything. However, because of the high deductible amount, you may have a lower monthly premium than the standard Plan F.
Because Medigap Plan F offers the most benefits, it is usually the most expensive; however, this may not always be the case, and you should shop around to find the best plan option for you.
You may be able to find other Medigap plans with lower premiums than Plan F. But if you see your doctor a lot or face high out-of-pocket costs, Plan F generally gives you the most help with Original Medicare costs.
Medicare Supplement Plan G
Medigap Plan G offers all of the benefits of Plan F, with the exception of the Part B deductible. If you choose Plan G, you’ll need to pay the standard annual Medicare Part B deductible ($166 in 2016) out of pocket.
It’s worth noting that both Plan F and Plan G cover Medicare Part B excess charges, and they are the only Medicare Supplement plans to do so. Excess charges are the difference in cost between what a non-participating doctor or health-care provider charges for a medical service and the Medicare-approved amount. If you see a non-participating provider, he or she is allowed to charge up to 15% above what Medicare has approved for a covered service, which you’ll normally be responsible for paying.
Medicare Supplement Plan N
Medigap Plan N covers all the same benefits as Plan F with the exceptions of the:
- Medicare Part B deductible
- Medicare Part B excess charges
You would need to pay these cost differences out of pocket. Plan N is also a little different from Plan F because although it pays for 100% of the Part B coinsurance in most cases, there are exceptions: You’ll need to pay up to $20 for certain office visits and up to a $50 copayment for emergency room visits that do not result in an inpatient admission.
What else do I need to know about Medigap Plan F, Plan G, and Plan N?
If you’re thinking of signing up for Medigap insurance, a good time to enroll is during the Medicare Supplement Open Enrollment Period, which starts when you have Part B and are 65 or older. During this six-month period, you have a special right to join any Medigap plan offered by any insurance company in your service area with “guaranteed issue“; in other words, you can’t be turned down for health reasons or charged a higher premium if you have pre-existing conditions. After your Medigap Open Enrollment Period is over, it may be harder to enroll in a plan or switch plans if you don’t have guaranteed-issue rights. Medigap insurance companies can require medical underwriting or deny you coverage, especially if you have health problems.
Please note that a Medigap plan won’t work with a Medicare Advantage plan and can’t be used to pay for Medicare Part C costs. In most cases, you can’t be enrolled in both a Medicare Advantage plan and a Medigap plan, and it’s illegal for anyone to sell you a Medigap policy if they know you have a Medicare Advantage plan (unless you’re switching back to Original Medicare coverage). Also, Medigap plans don’t include prescription drug coverage, and if you’d like prescription drug benefits in addition to your Original Medicare coverage, you’ll need to enroll in a stand-alone Medicare Prescription Drug Plan.
If you’d like to find a Medigap plan option to supplement your Original Medicare coverage, or if you have questions about other Medicare plan options, you can:
- Feel free to set up a phone appointment or have me email you more information; the links for requesting those are below.
- Click the Compare Plans or Find Plans buttons on this page.
- Learn more about me in my profile below; just click the “View profile” link below.If you need immediate assistance from a licensed insurance agent, we welcome your call.
Call Medicare.com’s licensed insurance agents at 1-844-847-2660, TTY users 711; Monday through Friday, 8AM to 8PM ET.
- The purpose of this communication is the solicitation of insurance. Contact will be made by an insurance agent/producer or insurance company.
- Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program.
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