Medicare Supplement Plans
Medicare Supplement Overview
Medicare supplement insurance helps pay some out-of-pocket costs that come with Original Medicare.
What is a Medicare Supplement (Medigap) Plan?
A Medigap policy provides supplemental insurance through a private insurance company. The policy helps cover costs not covered by Original Medicare (like copayments, deductibles, etc). Medigap plans require enrollment in Original Medicare and can be used with any health care provider that accepts Medicare.
Medigap policies offer standardized benefits across 11 plan options, with varying coverage and costs. Therefore, the features of specific plans do not change based on insurance company.
Medicare Supplement Select (Medigap Select) Plans
Typical Medigap plans are accepted by any health care provider that accepts Original Medicare. Medigap Select plans, however, have a network of health care providers, similar to most Medicare Advantage plans. Most Select plans only have hospital networks.
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Popular Medigap Plans |
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Plan F |
Pays the full 20% left by Medicare (No copays, deductibles, or coinsurance) |
Plan G |
Pays the full 20% left by Medicare, after Part B Deductible is satisfied |
Plan N |
Pays all costs, excluding copays, Part B, and excess charges |
Plan F-HD* |
Deductible amount must be paid before plan pays anything |
* High-Deductible version of Plan F (not available in all states)
Medicare Part B Excess Charges
Part B Excess Charges occur when a doctor charges more than the Medicare-approved amount.
Doctors who accept “assignment” have agreed to accept the Medicare-approved amount as full payment for services rendered. Doctors who do not accept “assignment” may overcharge the Medicare rate for a particular service by a maximum of 15%. This is called an “excess charge.”
States with Additional Rules:
- Minnesota: Prohibition on excess charge does not apply to ambulances, medical supplies, or equipment. Notification required.
- New York: 5% excess charges allowed, however some procedure codes may be billed at the federal 15% excess charge limit.
- Pennsylvania: Medicare physicians must post a physical sign disclosing the prohibition of excess charges.
- Vermont: Some procedure codes may be billed at federal 15% excess charge limit. A disclosure notice must be signed by the patient, and must be posted.
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States that DO NOT Allow Excess Charges |
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Connecticut |
