MEDICARE SUPPLEMENT PLANS (Medigap)

Hospitalization: Part A coinsurance plus coverage for 365 additional days after Medicare benefits end.

Medical Expenses: Part B coinsurance (generally 20% of Medicare approved expenses) or copayments for hospital outpatient services. Plans K, L, and N require insureds to pay a portion of the Part B coinsurance or copayment.

Blood: First 3 pints of blood each year.

Hospice: Part A coinsurance for eligible hospice/respite care expenses.

Skilled Nursing Facility Coinsurance After 20 days – $209.50 per day coinsurance as much as $16,760

Part A Deductible: $1,676 in 2025

Part B Deductible Annual: $257 in 2025

Part B Excess Doctor Charges: When a provider accepts Medicare assignment rates, it means that provider won’t bill you above the Medicare-allowable rate by a participating provider. Providers who don’t participate in Medicare-assignment can bill you up to 15% more than the Medicare allowable amount at their discretion which is called Part B excess charges. Statistics suggest that as many as 95% of primary care providers accept assignment. A slightly smaller number of specialist physicians accept it as well. Not all nonparticipating providers will add Part B excess charges if you don’t have a Medigap plan, so you may only rarely see Part B excess charges.

Foreign Travel Emergency: Plan will pay up to 80% of your medical emergency costs after a $250 deductible. It will only pay for emergencies during the first 60 days that you are out of the country. It is also limited to a lifetime benefit of $50,000.

Plan HDF & Plan HDG usually have a lower premium then the traditional Plan F & Plan G, but they require first paying a plan deductible of ($2,870 in 2025) before the plan begins to pay. You will pay the 20% of the Medicare-approved amount until you reach the deductible for the calendar year. Once the plan deductible is met, the plan pays 100% of covered services for the rest of the calendar year. Plan HDG does not cover the Medicare Part B deductible. However, Plan HDF & Plan HDG count your payment of the Medicare Part B deductible toward meeting the calendar year plan deductible.

Plan N pays 100% of Medical Expenses (Part B Coinsurance) except for a copayment of up to $20 for some office visits and up to $50 copayment for emergency room visits that do not result in an inpatient admission. The emergency room copayment is waived if the insured is admitted to any hospital, and the emergency visit is covered as a Medicare Part A expense.

Plan K & Plan L pay 100% of covered services for the rest of the calendar year once you meet the out-of-pocket yearly limit ($6,940 for Plan K, $3,470 for Plan L in 2025). The out-of-pocket annual limit does NOT include the charges from your provider that exceed Medicare-approved amounts, called ‘excess charges’. You will be responsible for paying excess charges. The out-of-pocket annual limit may increase each year for inflation.