You have guaranteed issue rights to buy a Medigap policy, but the policies are different.
Basic benefits
- Inpatient hospital care: covers the Part A coinsurance
- Medical costs: covers the Part B coinsurance (generally 20% of the Medicare-approved amount)
- Blood: covers the first 3 pints of blood each year
- Part A hospice and respite care cost sharing
- Parts A and B home health services and supplies cost sharing
Medigap plans
The Basic and Extended Basic benefits are available when you enroll in Part B, regardless of your age or health problems. If you return to work and drop Part B to elect your employer's health plan, you’ll get another 6-month Medigap Open Enrollment Period after you retire from that employer when you can elect Part B again.
Basic Plan
Covers:
- Basic benefits
- Part A: skilled nursing facility (SNF) coinsurance (provides 100 days of SNF care)
- 80% of foreign travel emergency
- 50% of outpatient mental health
- Medicare-covered preventive care
- 20% of physical therapy
- State-mandated benefits (diabetic equipment and supplies, routine cancer screening, reconstructive surgery, and immunizations)
Doesn't Cover:
- Part A: inpatient hospital deductible
- Part B: deductible
- Usual and customary fees
- Coverage while in a foreign country
Extended Basic Plan
Basic benefits:
- Part A: inpatient hospital deductible
- Part A: skilled nursing facility (SNF) coinsurance (provides 120 days of SNF care)
- Part B: deductible
- 80%* of foreign travel emergency
- 50% of outpatient mental health
- 80%* of usual and customary fees
- Medicare-covered preventive care
- 20% of physical therapy
- 80%* of coverage while in a foreign country
- State-mandated benefits (diabetic equipment and supplies, routine cancer screening, reconstructive surgery, and immunizations)
* The plan pays 100% after you spend $1,000 in out-of-pocket costs for a calendar year.
Compare these plans side-by-side
If a "yes" appears, the plan covers the described benefit 100%. If a row lists a percentage, the policy covers that percentage of the described benefit. If a "no" appears, the policy doesn't cover that benefit.
Medigap Benefits | Medigap Plans | |
---|---|---|
Basic Plan | Extended Basic Plan | |
Basic benefits | Yes | Yes |
Part A: inpatient hospital deductible | No | Yes |
Part A: skilled nursing facility coinsurance | Yes (Provides 100 days of SNF care) | Yes (Provides 120 days of SNF care) |
Part B: deductible | No | Yes |
Foreign travel emergency | 80% | 80%* |
Outpatient mental health | 50% | 50% |
Usual and customary fees | No | 80%* |
Medicare-cover preventative care | Yes | Yes |
Physical therapy | 20% | 20% |
Coverage while in a foreign country | No | 80%* |
State-mandated benefits (diabetic equipment and supplies, routine cancer screening, reconstructive surgery, and immunizations) | Yes | Yes |
* The plan pays 100% after you spend $1,000 in out-of-pocket costs for a calendar year.
Important plan information
Minnesota versions of Medigap Plans K, L, M, N, and high deductible F are available.
Insurance companies can offer 4 additional riders that can be added to a Basic Plan. You may choose any or all of these riders to design a Medigap policy that meets your needs:
- Part A: inpatient hospital deductible
- Part B: deductible
- Usual and customary fees
- Non-Medicare preventive care