Medigap policies exist to cover some or all of the non-drug (prescription) medical expenses that Medicare does not cover. They can give you peace of mind that your financial health will not be harmed by expenses caused by your physical health. If you choose to buy a Medigap policy within six months of turning 65 and enrolling in Medicare, you can’t be denied coverage nor charged premiums based on existing health conditions, unless you have end stage renal disease.
Understanding Medigap policies and shopping for the most appropriate one is complicated, but you can receive help from us and trained, licensed professionals who can help you identify the best plan for your specific personal needs. Fill out the zip code form to compare plans and rates instantly and to speak with a professional who can help you determine the best plan for you.
The federal government has established 10 plans for Medigap policies and named them with letters of the alphabet. Plan F is the most popular and most comprehensive, while Plan A is usually the least expensive. All plans are sold in Idaho, but most insurance companies only offer a handful. All 39 Idaho Medicare supplemental insurance companies offer Plans A and F, but only a third of those companies offer Plan F with a high deductible option. About three-quarters of Medigap policyholders in Idaho choose Plan F or Plan C.
Check marks in the chart denote a coverage of 100% of the described Medigap benefit. If there is no check mark and instead a percentage marker, Medigap policies on each plan cover up to that percentage for the according benefit provision. If a box is blank, the Medigap policy is not sufficient for that benefit. You should also note that Medigap plans from MedicareSupplementalInsurance.com providers only cover your coninsurance premiums if you have already paid the deductible.
Check marks in the chart denote a coverage of 100% of the described Medigap benefit. If there is no check mark and instead a percentage marker, Medigap policies on each plan cover up to that percentage for the according benefit provision. If a box is blank, the Medigap policy is not sufficient for that benefit. You should also note that Medigap plans from MedicareSupplementalInsurance.com providers only cover your coninsurance premiums if you have already paid the deductible.
Medigap Plans Effective June 1, 2012 |
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Medigap Benefits Chart |
Plan A |
Plan B |
Plan C |
Plan D |
Plan F * |
Plan G |
Plan K |
Plan L |
Plan M |
Plan N | |
| Medicare Part A Coinsurance and Hospital Costs up to an Additional 365 Days After Medicare Benefits are Used Up. |  |
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| Medicare Part B Coinsurance or Copayment | |
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50% | 75% | |
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| Blood (First 3 Pints) | |
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50% | 75% | |
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| Part A Hospice Care Coinsurance or Copayment | |
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50% | 75% | |
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| Skilled Nursing Facility Care Coinsurance | |
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50% | 75% | |
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| Medicare Part A Deductible | |
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50% | 75% | 50% | |
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| Medicare Part B Deductible | |
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| Medicare Part B Excess Charges | |
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| Foreign Travel Emergency (Up to Plan Limits) | |
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| Out-of-Pocket Limit ** | |||||||||||
| $4,620 | $2,310 | ||||||||||
* Medigap Plan F also has a high deductible option available for your policy. Under the high deductible choice, it is your responsibility to cover the $2,070 for the 2012 period before your Medigap plan covers any additional cost.
** Medigap Plans K and G have additional out of pocket limits that will only require you pay $4,620 and $2,310, accordingly. Once that is covered by you (and you have also paid your yearly Part B deductible), the MedicareSupplementalinsurance.com provider Medigap plans will pay 100% of your covered services the rest of that calendar year.
*** Medigap Plan N will pay for 100% of your Part B consinsurance payment, up to a maximum of $20 for office visitations, as well as a $50 copayment for unexpected emergency room hospital visits that don't conclude in an longer duration stay at the hospital.
** Medigap Plans K and G have additional out of pocket limits that will only require you pay $4,620 and $2,310, accordingly. Once that is covered by you (and you have also paid your yearly Part B deductible), the MedicareSupplementalinsurance.com provider Medigap plans will pay 100% of your covered services the rest of that calendar year.* Medigap Plan F also has a high deductible option available for your policy. Under the high deductible choice, it is your responsibility to cover the $2,070 for the 2012 period before your Medigap plan covers any additional cost.
*** Medigap Plan N will pay for 100% of your Part B consinsurance payment, up to a maximum of $20 for office visitations, as well as a $50 copayment for unexpected emergency room hospital visits that don’t conclude in an longer duration stay at the hospital.
You may have read that insurance companies use one of three methods to price Medigap policies. However, several sources say that all 39 insurance companies that sell Medigap policies in Idaho use the issue-age method (state and federal resources do not list information for all companies). This method increases the rates of your Medigap policies as you get older, and may be a disadvantage if you are well beyond 65 when you initially buy the policy, but knowing that all companies in Idaho use it simplifies shopping.
Medicare Advantage is not the same as Medigap insurance. Medicare Advantage policies are federally regulated private insurance plans that substitute for regular Medicare. In most case, they also include benefits that would be comparable to what you get through a Medigap policy and a Medicare Part D prescription drug plan.
The average annual premium paid for Medigap policies in Idaho in 2010 was $2,016. You can play less and still get the best coverage.
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