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Medigap Plans A - N

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How to compare Medigap policies

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Medigap policies are standardized.

Every Medigap policy must follow federal and state laws designed to protect you, and it must be clearly identified as "Medicare Supplement Insurance."

Insurance companies can sell you only a "modernized" policy identified in most states by letters.

(Prior to 2010 they were called "Standardized", after 2010 they were changed to "Modernized)

All policies offer the same basic benefits but some offer additional benefits, so you can choose which one meets your needs.

In Massachusetts, Minnesota, and Wisconsin, Medigap policies are standardized in a different way.

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Compare Medigap plans side-by-side

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The chart below shows basic information about the different benefits Medigap policies cover.

Yes = the plan covers 100% of this benefit
No = the policy doesn't cover that benefit

                                                                                                     % = the plan covers that percentage of this benefit
                                                                                                     N/A = not applicable

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Note: You’ll need more details than this chart provides to compare and choose a policy.

If you have any questions you are always welcome to call us at the Toll Free phone number listed above.

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* Plan F also offers a high-deductible plan in some states. If you choose this option, this means you must pay for Medicare-covered costs

(coinsurance, copayments, deductibles) up to the deductible amount of $2,140 in 2014 before your policy pays anything.

** For Plans K and L, after you meet your

out-of-pocket yearly limit and your yearly Part B deductible ($147 in 2014), 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.

What types of Medigap policies can insurance companies sell?

In most cases, Medigap insurance companies can sell you only a "Modernized" Medigap policy.

All Medigap policies must have specific benefits so you can compare them easily.

Insurance companies that sell Medigap policies don’t have to offer every Medigap plan. However, they must offer Medigap Plan A if they offer any Medigap policy. If they offer any plan in addition to Plan A, they must also offer Plan C or Plan F.

Each insurance company decides which Medigap policies it wants to sell, although state laws might affect which ones they offer.

In some cases, an insurance company must sell you a Medigap policy, even if you have health problems.

Listed below are certain times that you’re guaranteed the right to buy a Medigap policy:

When you’re in your Medigap:

  1. Open Enrollment Period.
  2. If you have a Guaranteed Issue right.

You may be able to buy a Medigap policy at other times, but the insurance company can deny you a Medigap policy based on your health. Also, in some cases it may be illegal for the insurance company to sell you a Medigap policy (like if you already have Medicaid or a Medicare Advantage Plan).

Information for people under 65 (Medicare.gov)

Medigap policies for people under 65 and eligible for Medicare because of a disability or End-Stage Renal Disease (ESRD)

You may have Medicare before 65 due to a disability or ESRD (permanent kidney failure requiring dialysis or a kidney transplant).

If you’re a person with Medicare under 65 and have a disability or ESRD, you might not be able to buy the Medigap policy you want, or any Medigap policy, until you turn 65. Federal law doesn’t require insurance companies to sell Medigap policies to people under 65. However, some states require Medigap insurance companies to sell you a Medigap policy, even if you’re under 65.

Texans with Disabilities (Texas Department of Insurance)

People under age 65 who receive Medicare because of disabilities have a six-month open enrollment period beginning the day they enroll in Medicare Part B. This open enrollment right only applies to Medicare supplement Plan A.

Companies that sell Medicare supplement plans in Texas may not deny you a Plan A policy because you have preexisting conditions. Companies may offer the other plans to Texans with disabilities, but they are not required.

Note:During the first six months after you turn 65 and are enrolled in Medicare Part B, you will have a right to buy any of the 10 plans.

Below is a short video from CMS about people under 65 on Medicare Disability and Medigap Plans