MEDIGAP
STANDARD MEDICARE SUPPLEMENT PLANS

 

CORE BENEFITS

A

B

C

D

E

F

G

H*

I*

J*

K**

L***

Hospital coinsurance:
Days 61 to 91

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Hospital coinsurance:
Days 91 to 150

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Hospital Payment in full:
365 additional days

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Part A and Part B blood deductible:
First three pints of blood

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50%

75%

Part B 20% coinsurance:
Physician and other services

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50%

75%

 

ADDITIONAL BENEFITS

A

B

C

D

E

F

G

H*

I*

J*

K**

L***

SNF coinsurance:
Days 21 to 100 - $119 per day in 2006

 

 

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50%

75%

Part A Hospital Deductible:
$952 in 2006

 

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50%

75%

Part B Annual Deductible:
$124 in 2006

 

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Part B Excess Charges:
Coverage for up to 115% percent of Medicare's approved charge (Medigap policy will either pay 80% or 100% of excess charge)

 

 

 

 

 

 

 

 

 

 

100%

80%

 

100%

100%

    

Foreign Travel Emergency:
$250 deductible, 80% of the cost of emergency care during the first two months of the trip, $50,000 lifetime limit

 

 

 

 

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At-Home Recovery:
Maximum benefit of $1,600 annually

 

 

 

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*Effective 1/1/06, plans H, I, and J can no longer be sold with prescription drug benefits.  Beneficiaries who purchased these plans before 1/1/06 are allowed to renew them and to retain the plans’ prescription drug benefits.

** Plan K covers 100% of cost sharing for Medicare Part B preventive services and 100% of all cost sharing under Medicare Parts A and B for the balance of the calendar year once an individual has reached the out-of-pocket limit on annual expenditures of $4,000 in 2006.

** Plan L covers 100% of cost sharing for Medicare Part B preventive services and 100% of all cost sharing under Medicare Parts A and B for the balance of the calendar year once an individual has reached the out-of-pocket limit on annual expenditures of $2,000 in 2006.

2008 MEDIGAP DEDUCTIBLE AMOUNT
FOR HIGH DEDUCTIBLE POLICY OPTIONS

CMS released the 2008 deductible amount for Medigap high deductible plans F & J; effective January 1, 2008, the annual deductible amount for those two plans is $1,900. The high deductible amount for Medigap plans F and J is updated each year and is based on the August CPI-U figures released by the Bureau of Labor Statistics. The full text of the announcement is available on the CMS website at: http://www.cms.hhs.gov/Medigap/.  This figure represents the out-of-pocket expense, excluding premiums, that a beneficiary must incur before the policy begins paying any benefits.   Under the high deductible option, policies pay 100% of covered out-of-pocket expenses once the deductible has been satisfied in a year.  Note, the high deductible option for benefit packages F or J was added by Section 4032 of the Balanced Budget Act of 1997, Sec. 1882(p) of the Social Security Act, 42 U.S.C. 1395ss(p).