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The standardized policies allow you to compare "apples with apples." For example, a plan F policy will provide the same benefits, no matter which insurance company it is purchased from. However, a plan C policy will provide different coverage than a plan D policy. All Medigap policies must provide certain "core" benefits. These standardized plans are not available to those living in Massachusetts, Minnesota, or Wisconsin; there are separate Medigap policies available for residents of these states. Medigap policies are designed to fill the "gaps" in health insurance provided under original Medicare, Parts A and B. These supplemental policies must provide standardized coverage as specified by the federal government.
Through May 31, 2010, 12 standardized Medigap policies could be sold, identified as plans A, B, C, D, E, F, G, H, I, J, K, and L. Effective June 1, 2010, plans E, H, I, and J could no longer be sold, and new plans M and N were added. Individuals who purchased a plan E, H, I, or J before June 1, 2010 may keep those plans.
• Core benefits: Plans A-G, M and N – For Part A hospitalization, cover 100% of all copayments except that for days 1-60 of hospitalization $1,156 in 2012), plus adding 365 lifetime days of hospital coverage after the standard benefit of 150 days is exhausted; 100% of Part B coinsurance amounts 3 after meeting the yearly deductible ($140.00 in 2012); the first three pints of blood. Plans K and L — For Part A hospitalization, cover 100% of all copayments except that for days 1-60 of hospitalization, plus adding 365 lifetime days of hospital coverage after the standard benefit of 150 days is exhausted; for Part B, Plan K pays 50% of the coinsurance amount after the annual deductible is met; Plan L pays 75% of the Part B coinsurance amount after the annual deductible is met; Plan K pays 50% of the cost of the first three pints of blood; Plan L pays 75% of the cost of the first three pints of blood.
1) Plan F has a high-deductible option, with a deductible in 2012 of $2,070.00.
2 In 2012, Plan K has an annual out-of-pocket limit of $4,660.00; Plan L has an annual out-of-pocket limit of $2,330.00.
3) Plan N pays 100% of the Part B coinsurance except for a co-payment of up to $20 for office visits and $50 for emergency department visits.
Steve Savant is a national insurance columnist, financial color commentator and host of the daily Internet talk show, The Business Insurance Zone. Steve's special guest is Sam Corey the Third, National Medicare Supplement Specialist.
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