Basic Benefits

All Medigap plans must cover certain basic benefits. These basic benefits are as follows:

Medicare Part A coverage:

• Coinsurance for hospital days 61-90 ($248 in 2007) and 91-150 ($496 in 2007)
• Cost of 365 more hospital days in your lifetime, once you’ve used all Medicare hospital benefits

Medicare Part B coverage:

• Generally, all coinsurance and co-payment amounts after your meet the $131 (in 2007) yearly deductible for Medicare Part B
• The first three pints of blood

Medigap Plan A

• Basic Benefits

Medigap Plan B

• Basic Benefits
• Medicare Part A Hospital Deductible: $992 in 2007 for each benefit period for hospital services

Medigap Plan C

• Basic Benefits
• Medicare Part A Hospital Deductible
• Skilled Nursing Home Costs: Your cost ($124 in 2007) for days 21-100 in a skilled nursing home
• Medicare Part B Deductible: Yearly deductible for doctor services ($131 in 2007)
• Foreign Travel Emergency
  • 80% of the cost of emergency care outside the U.S.
  • Up to $50,000 during your lifetime
  • You pay a yearly deductible of $250

Medigap Plan D

• Basic Benefits
• Medicare Part A Hospital Deductible
• Skilled Nursing Home Costs
• Foreign Travel Emergency
• At-Home Recovery
  • Help for activities of daily living, such as bathing and dressing, if you are already receiving skilled home care covered by Medicare.
  • Help for up to eight weeks after you no longer need skilled care
  • Will pay up to $40 per visit, seven visits per week, or a total of $1,600 per year

Medigap Plan E

• Basic Benefits
• Medicare Part A Hospital Deductible
• Skilled Nursing Home Costs
• Foreign Travel Emergency
• Preventive Care: Up to $120 per year for preventive services not covered by Medicare

Medigap Plan F*

• Basic Benefits
• Medicare Part A Hospital Deductible
• Skilled Nursing Home Costs
• Medicare Part B Deductible
• Medicare Part B Excess Charges: Pays 100% of the difference between your doctor’s charge and the Medicare approved amount, if your doctor does not accept assignment
• Foreign Travel Emergency

Medigap Plan G

• Basic Benefits
• Medicare Part A Hospital Deductible
• Skilled Nursing Home Costs
• Medicare Part B Excess Charges: Pays 80% of the difference between your doctor’s charge and the Medicare approved amount, if your doctor does not accept assignment
• Foreign Travel Emergency
• At-Home Recovery

Medigap Plan H

• Basic Benefits
• Medicare Part A Hospital Deductible
• Skilled Nursing Home Costs
• Foreign Travel Emergency

Medigap Plan I

• Basic Benefits
• Medicare Part A Hospital Deductible
• Skilled Nursing Home Costs
• Medicare Part B Excess Charges: Pays 100% of the difference between your doctor’s charge and the Medicare approved amount, if your doctor does not accept assignment
• Foreign Travel Emergency
• At-Home Recovery

Medigap Plan J*

• Basic Benefits
• Medicare Part A Hospital Deductible
• Skilled Nursing Home Costs
• Medicare Part B Deductible
• Medicare Part B Excess Charges: Pays 100% of the difference between your doctor’s charge and the Medicare approved amount, if your doctor does not accept assignment
• Foreign Travel Emergency
• At-Home Recovery
• Preventive Care

Medigap Plan K**

• Basic Benefits
  • 100% of Part A coinsurance plus coverage for 365 days after Medicare benefits end
  • 50% hospice cost-sharing
  • 50% of Medicare-eligible expenses for the first three pints of blood
  • 50% Part B coinsurance after you meet the yearly deductible for Medicare Part B, but 100% coinsurance for Part B preventive services
• 50% of Skilled Nursing Home Coinsurance
• 50% of Medicare Part A Hospital Deductible
• Annual out of pocket limit of $4,140 in 2007.

Medigap Plan L**

• Basic Benefits
  • 100% of Part A coinsurance plus coverage for 365 days after Medicare benefits end
  • 75% hospice cost-sharing
  • 75% of Medicare-eligible expenses for the first three pints of blood
• 75% Part B coinsurance after you meet the yearly deductible for Medicare Part B, but 100% coinsurance for Part B preventive services
• 75% of Skilled Nursing Home Coinsurance
• 75% of Medicare Part A Hospital Deductible
• Annual out of pocket limit of $2,070 in 2007.

*Plans F and J also have a “high deductible option.” If you choose the “high deductible option” on Medigap Plans F and J, you will first have to pay a $1,860 deductible in 2007 before the plan pays anything. This amount can go up every year. High deductible policies have lower premiums, but if you get sick, your costs will be higher.

**The basic benefits for plans K and L include similar services as plans A-J, but the cost-sharing for the basic benefits is at different levels. The annual out-of-pocket limit increases each year for inflation.

In addition to the A-L standard Medigap policies, Medicare SELECT is a type of Medigap policy that can cost less than standard Medigap plans. However, you can only go to certain doctors and hospitals for your care. Check with your state insurance department to find out if Medicare SELECT policies are available in your state.