Medigap Plans

Medigap is a health insurance policy designed to fill the “gaps” in your original Medicare plan. EMI Health’s Medigap policies help you pay some of the healthcare costs that Medicare doesn’t pay. You can also receive emergency healthcare coverage while traveling outside of the United States.

Medicare supplement insurance can be sold in only ten standard plans, plus one high deductible plan. This chart shows the benefits included in each plan. Every company must make available Plan A. Some plans may not be available in your state. EMI Health does not offer Plan M.

Basic Benefits

Included in all plans. Hospitalization: Part A coinsurance plus coverage for 365 additional days after Medicare benefits end. Medical Expenses: Part B coinsurance (generally 20 percent of Medicare-approved expenses) or, in case of hospital outpatient department services under a prospective payment system, applicable copayments. Blood: First three pints of blood each year.

Click on the plan name below for details of that plan.

A B C D F G K L M N
Medicare Part A Coinsurance Hospital Costs up to an additional 365 days after Medicare benefits are used up

X

X

X

X

X

X

X

X

X

X

Medicare Part B Coinsurance or Copayment

X

X

X

X

X

X

50%

75%

X

X

Blood (First 3 Pints)

X

X

X

X

X

X

50%

75%

X

X

Part A Hospice Care Coinsurance or Copayment

X

X

X

X

X

X

50%

75%

X

X

Skilled Nursing Coinsurance

X

X

X

X

50%

75%

X

X

Medicare Part A Deductible

X

X

X

X

X

50%

75%

50%

X

Medicare Part B Deductible

X

X

Medicare Part B Excess

X

X

Foreign Travel Emergency

80%

80%

80%

80%

80%

80%

Medicare Preventive Care Part B Coinsurance

X

X

X

X

X

X

X

X

X

X

* For Plans K and L, after you meet your out-of-pocket yearly limit and your yearly Part B deductible, the Medigap plan pays 100% of covered services for the rest of the calendar year. In 2016, the Plan K limit was $4,960, and the Plan L limit was $2,480.

* Plan N pays 100% of Part B coinsurance, except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don't result in an inpatient admission.

* Plan F also has an option called a high deductible Plan F. (EMI Health does not offer this high deductible plan.) This means the beneficiary must pay for Medicare-covered costs (coinsurance, copayments, and deductibles) up to the deductible amount of $2,180 (in 2016) before the policy pays anything.

Enrollment Application

medicare.gov