Original Medicare (Parts A & B): Medicare Supplement (Medigap)
With Original Medicare, your loved one pays 20% of the costs for services. Medicare Supplement (Medigap) is extra insurance that helps cover those costs.
How To Receive
Details on how to apply
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Things to know
A Medigap policy is different from a Medicare Advantage Plan, and policies don’t cover prescription drugs.
Medigap only works with Original Medicare.
Your loved one needs both Medicare Part A and Part B to buy and keep a policy.
The best time to get a policy is during the Medigap Open Enrollment Period.
This is the 6-month period that starts the month your loved one turns 65 and they first have both Medicare Part A and Part B. During this time, they can buy any Medigap policy sold in their state, even if they have health problems.
After the Medigap Open Enrollment Period ends, they may not be able to buy a policy, as they can be denied for not meeting the policy criteria based on existing health problems.
There are 10 standardized plans.
Once purchased, they will keep their policy, even if they have health problems, as long as they faithfully pay the Medigap policy and Part B premiums.
Plan F
Plan F is not available to anyone born after January 1, 1955. Plan F is the most comprehensive plan and pays all out-of-pocket costs associated with Original Medicare. The only cost to the member is the monthly premium. No matter what the medical costs are, there are no copays, coinsurance, or deductibles.
Plan F - High deductible (HD-F)
Plan F also has a high-deductible version, wherein the deductible must be met before 100% coverage kicks in (this plan keeps the monthly premiums lower).
Plan C
Plan C is not available to anyone who became eligible for Medicare after 2020. Plan C provides all the same coverage as Plan F, with the exception of Medicare Part B excess charges.
Plan D
Plan D is a lower premium plan and there are no copayments for office visits or the emergency room; however, like Plan N - it does not cover the Part B deductible or excess charges.
Plan G
Plan G is the only other plan that does cover Medicare Part B excess charges, though it does not cover the Medicare Part B deductible like Plans F and C do. Otherwise, Plan G offers all the same coverage as Plan F.
Plan G - High deductible (HD-G)
Plan G also has a high-deductible version, wherein the deductible must be met before 100% coverage kicks in (this plan keeps the monthly premiums lower). HD-G offers all the same coverage as Plan G (and subsequently, Plan F).
Plan N
Plan N is similar to Plan D but with copays. In exchange for a lower premium, members pay some of the costs, which include the Medicare Part B deductible, excess charges, and copayments for office visits and the emergency room.
Plans K, L, and M
Plan K. Plan K is the lowest cost plan with the least amount of coverage. It does not cover the Part B deductible, or excess charges, and pays half (50%) of the remaining Part A and Part B costs.
Plan L. Plan L is a low-cost plan with a moderate amount of coverage, more than Plan K. It does not cover the Part B deductible, or excess charges, and pays 75% of remaining Part A and Part B costs.
Plan M. Plan M is a deductible-sharing plan. It provides the same coverage as Plan N, but with greater out-of-pocket medical costs since it only covers half (50%) of the Part A deductible.
Plans A and B
Plan A. Plan A only covers basic benefits. It does not cover Part A or Part B deductibles, excess charges, or skilled nursing facility (SNF) coinsurance.
Plan B. Plan B provides the same basic coverage as Plan A, plus covers the Part A deductible.
About us
Helpful is an app to make caregiving easier. We integrate your loved one’s insurance benefits, medical records and caregiving guides into an immediate, accessible and user-friendly experience. Helpful supports your care needs by eliminating administrative tasks and providing technology to support your caregiving experience.
