What are the medigap plans and what do they cover?
- By law, companies can offer only 12 standard medigap insurance plans -- plans labeled A to L -- though a company doesn't have to offer all 12.
- Each plan has its own standardized set of benefits or payment options, regardless of which company sells it. However, premiums for the same plan vary among companies and geographic areas. You'll want to study the benefits offered by each of the 12 plans, as well as the premiums charged by each company and the terms under which those premiums may be raised over time, before deciding whether a policy makes good sense for you or the person in your care.
- If you regularly spend time in more than one state, you'll also want to make sure the policy provides coverage in either place.
- All 12 medigap policies cover certain basic benefits -- including copayments for Medicare Parts A and B -- but each plan has different additional benefits. Plan A is the most basic. Plan B offers everything in Plan A, and also covers the deductible for Medicare hospitalization. Plan C covers everything in Plans A and B, as well as the deductible for outpatient care and some healthcare outside the United States. And so it goes up to Plan J, which covers all Medicare deductibles and much preventive care.
- Plans K and L work a little differently from the others. They cover most gaps in Medicare coverage but pay only a percentage of those costs. They make up for these reduced payments by placing a cap on an insured's total out-of-pocket costs. After the cap is reached, these policies pay 100 percent of all covered costs.
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