Description of Basic Medigap Supplemental Insurance Plans

Part 3, Chapter 10: Medicare and Medicare Related Programs: Medigap and Secondary Health Insurance Policies Page 2

Continued from Previous Page

Each of the ten standardized plans has significant differences, and each plan offers a different level of coverage. Medigap plans may not necessarily cover pre-existing conditions for the first six months. Aside from that, however, all of the plans (A through J) provide at least some coverage for co-insurance in terms of hospital stays and doctors bills that are covered by Medicare.

Medigap Plans A and B are considered basic plans and offer very limited coverage. Plans H, I, and J provide the widest degree of coverage. Plan A primarily provides coverage for the co-insurance amount for hospitalization and the co-insurance amount for outpatient treatment under Medicare: Part B, amounts that are not generally covered by the traditional Medicare program. Plan B also provides some coverage for the hospital deductible amount.

Plan C includes coverage for the co-insurance amount for treatment in a skilled nursing facility, for the Medicare: Part B deductible, and for some emergency care outside of the United States, once a special deductible has been met. Plans D and C provide some coverage for home health care under certain conditions following an illness, accident, or surgery. That may include coverage for a brief period of time for home-based health care related to such activities of daily living as getting dressed and bathing.

Continued on Next Page