Medigap Plans and Coverage
How to read the chart: If a check mark appears in a column of this chart, the Medigap policy covers 100% of the described benefit. If a row lists a percentage, the policy covers that percentage of the described benefit. If a row is blank, the policy doesn’t cover that benefit.
Note: The Medigap policy covers coinsurance only after you have paid the deductible (unless the Medigap policy also covers the deductible.
|Medicare Part A Coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up||X||X||X||X||X||X||X||X||X||X|
|Medicare Part B Coinsurance or Copayment||X||X||X||X||X||X||50%||75%||X||X***|
|Blood (First 3 Pints)||X||X||X||X||X||X||50%||75%||X||X|
|Part A Hospice Care Coinsurance or Copayment||X||X||X||X||X||X||50%||75%||X||X|
|Skilled Nursing Facility Care Coinsurance||X||X||X||X||50%||75%||X||X|
|Medicare Part A Deductible||X||X||X||X||X||50%||75%||50%||X|
|Medicare Part B Deductible||X||X|
|Medicare Part B Excess Charges||X||X|
|Foreign Travel Emergency (Up to Plan Limits)||X||X||X||X||X|
|Out-of Pocket Limit**|
* Plan F also offers a high-deductible plan. lf you choose this option, this means you must pay for Medicare-covered costs up to the deductible amount of $2,070 in 2012 before your Medigap plan pays anything.
** After you meet your out-of-pocket yearly limit and your yearly Part B deductible ($140 in 2012), the Medigap plan pays 100% of covered services for the rest of the calendar year.
*** Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don’t result in an inpatient admission.