People join Medigap plans for one primary reason: financial protection. Original Medicare provides excellent basic health insurance, but leaves many costs for the recipient, including a $1,156 hospital deductible per stay for 2012 and 20% of physician costs. Depending on which plan is chosen, all or many costs will be covered by the Medigap plan. Most Medigap plans are generally considered easy to use, with very little paperwork.

Medigap plans are generally health underwritten, which means in order to qualify, one needs to be relatively healthy. However, there are periods of time when anyone with Medicare is guaranteed acceptance, regardless of health status. The most common “guaranteed acceptance” period is three months before and six months after one’s 65th birthday.

For most states, there are ten traditional Medigap plans (A through J) and four high-deductible Medigap plans (K through N). Nearly everyone who chooses Medigap chooses from the traditional Medigap plans (A through J). These plans all share a set of core benefits and then differ based on plan letter. Unlike with Medicare Advantage plans, benefits do not differ among companies, although premiums vary widely.  The chart below shows standard benefits for plans with effective dates of June 1, 2010 and later; for those with plans with earlier effective dates, refer to the Medicare publication "Choosing a Medigap Policy".

Core Benefits for Plans A-N

• All Part A Hospital coinsurance (days 61-90 + 60 lifetime days)
• 365 additional lifetime hospital days
• Part B coinsurance (20%) after Part B deductible (covered at 50% for Plan K and 75% for Plan L; Plan N pays 100% of Part B coinsurance except up to $20 copayment for office visits and up to $50 for emergency department visits)
  
• 3 pints of blood (Parts A and B) (covered at 50% for Plan K and 75% for Plan L)
• Part A hospice Care Coinsurance or Copayment (covered at 50% for Plan K and 75% for Plan L)

Additional Benefits	A	B	C	D	F	G	K*	L*	M	N
Part A Hospital Deductible							50%	75%	50%
Skilled Nursing Facility Copayment							50%	75%
Part B Deductible
Part B Excess Charges
Foreign Travel Emergencies
Preventative Care Coinsurance

*Plans K and L offer Out-of-Pocket Limits of $4,620 and $2,310, respectively.

These days, there are a number of Medicare Advantage plans (MA) plans that, for most people, provide the protection they deserve at a significant cost savings from Medigap plans. If appropriate MA plans are not available in your area, a K or L plan may be an option to cap out-of-pocket expenses.

Many people like help deciding which plan is a good choice for them. Plans vary widely from company to company and from place to place, and when comparing plans between companies it’s important to compare the fine print—not just the premiums. That’s what Aon Hewitt Navigators Insurance Services Inc. (formerly known as Senior Educators Insurance Services) was created for—to provide free, professional assistance to Medicare recipients to help them choose appropriate coverage. To request help now, please fill out the short informational form here so a licensed agent can be well informed about your healthcare preferences. Or simply give us a call to speak with a licensed agent now!

If you prefer to do the research by yourself, we’ve created a number of tools to help you do so. First, we have created our Top 10 Tips for Navigating Medicare, which captures a very high-level perspective on what to consider based on our years of experience. Second, we have created a plan comparison engine that shows you a list of the plans available in your area. To access that tool, enter your zip code on the side of this page and click the “Find Plans” button. We hope that if you find a plan through our tools, you’ll enroll through our organization, as this is allows us to provide excellent, professional and impartial information and help.