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 $1,024 hospital deductible per stay 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–J) and two high-deductible Medigap plans (K and L). Nearly everyone who chooses Medigap chooses from the traditional Medigap plans (A –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.

Core Benefits for Plans A-J

• All Part A Hospital coinsurance (days 61-90 + 60 lifetime days)
• 365 additional lifetime hospital days
• Part B coinsurance (20%) after Part B deductible
• 3 pints of blood (Parts A and B)

Additional Benefits (2008)	A	B	C	D	E	F	G	H	I	J
Part A Hospital Deductible
Skilled Nursing Facility Copayment
Part B Deductible
Part B Excess Charges						100%	80%		100%	100%
Foreign Travel Emergencies
At-Home Recovery
Preventative Care

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 Senior Educators Insurance Services was created for—to provide free, unbiased 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 representative can be well informed about your healthcare preferences. Or simply give us a call at 1-800-236-4613 and speak with a trained and licensed representative 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 the Senior Educators Insurance Services’ 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 it’s how we can afford to provide excellent, unbiased information and help.