A Guide to Medigap: F, G, K, And L

If you’re in the market for medicare supplemental insurance, you probably have a lot of questions. What is Medigap coverage? What is the difference between each Medigap? In order to…

April 14, 2022

Written by Nikki Grillo

If you’re in the market for medicare supplemental insurance, you probably have a lot of questions. What is Medigap coverage? What is the difference between each Medigap? In order to choose the right plan for you, it’s important to understand what each plan covers and where they might fall short.

To help you better understand the difference between Medigap plans F-L, we decided to take a look at each plan and break them down individually. In this article, we will cover everything ranging from the basic overview of each plan to the important facts you should know before making a decision.

How Does Medigap Work?

Medigap is a type of health insurance that helps cover the gaps in your Original Medicare coverage. This includes things like co-pays, co-insurance, and deductibles. Medigap is offered by private insurance companies and can help you pay for some of the costs that Medicare doesn’t cover.

There are four different types of Medigap policies: F, G, K, and L. Each policy covers a different set of benefits, so it’s important to choose the one that best fits your needs. We’ll go over what each policy entails.

Medigap Plan F

This is the most comprehensive Medigap policy available. It covers all of the gaps in Original Medicare, including co-pays, co-insurance, and deductibles. It also includes coverage for foreign travel emergencies. 

Plan F Benefits

Covers All Gaps In Original Medicare: This entails things like co-pays, co-insurance, and deductibles.

It Also Covers Foreign Travel Emergencies: So if you’re traveling outside of the country and need emergency medical care, this policy has you covered.

You Will Pay A Monthly Premium To Your Insurance Company: In return, they will cover the costs of your Medicare co-pays, co-insurance, and deductibles. 

Difference Between Plan F And Other Policies

Plan F is the only Medigap plan that covers the Part B deductible. All other plans require policyholders to pay this deductible out of pocket. 

Plan F is also the only Medigap policy that covers foreign travel emergency care. Other policies offer this coverage as an optional rider. 

What Isn’t Covered by Plan F?

  • Long-term care
  • Vision or dental care
  • Private duty nursing
  • Hospice care
  • Home health care

Medigap Plan F Costs

The most expensive Medigap plan, Plan F, covers all of the gaps left by Original Medicare. This includes Part A and B coinsurance, copayments, and deductibles. It also offers some limited coverage outside of the U.S.

Plan F Enrollment

Plan F is not available to people who are newly eligible for Medicare (as of January 2020). If you became available any time before 2020, then you can enroll in Plan F without any issues. 

Medigap Plan G

Medigap Plan G is very similar to Plan F, with one key exception: it does not cover the Part B deductible. Other than that, it provides the same level of coverage as Plan F.

Plan G Benefits:

  • Covers all gaps in Original Medicare
  • Does not cover the Part B deductible
  • Covers co-pays, co-insurance, and deductibles

Differences Between Plan G And Other Medigap Plans

The main difference between Plans G and F is that Plan G does not cover the Part B deductible. This could be a major drawback for policyholders who do not want to pay this expense out of pocket. However, since the Part B deductible is usually quite low, many people find it easier to just pay this amount themselves. 

What Isn’t Covered By Plan G?   

  • Nursing
  • Vision or dental care
  • Hearing aids
  • Alternative therapies (like acupuncture)

Medigap Plan G Costs

Similar to Plan F, but with a higher deductible. Covers all inpatient costs after the first $166 per day in 2020, as well as Part A and B coinsurance and copayments but does not cover outpatient prescription drugs.

Plan G Enrollment

You can enroll in Plan G during your Medicare initial enrollment period or during a special enrollment period. 

Medigap Plan K

Plan K is very similar to both Plans F and G. It covers all of the gaps in Original Medicare, including co-pays, co-insurance, and deductibles. However, it does not include coverage for the Part B deductible or foreign travel emergencies.

Plan K Benefits:

  • Covers all gaps in Original Medicare
  • Covers co-pays, co-insurance, and deductibles
  • Plan K is a great option for people who want comprehensive coverage but don’t want to pay for the extra benefits that come with Plans F and G. It’s also a good choice for people who are comfortable with paying a little more out-of-pocket for their healthcare.

Differences Between Plan K And Other Medigap Plans:

The main difference between Plans K and F is that Plan K does not cover the Part B deductible or foreign travel emergencies. This could be a major drawback for policyholders who want this coverage. However, since the Part B deductible is usually quite low, many people find it easier to just pay this amount themselves.

What Isn’t Covered By Plan K? 

  • Vision or dental care
  • Hearing aids
  • Alternative therapies

If you’re looking for comprehensive Medigap coverage and don’t want to pay the Part B deductible, Plan K is a good option. Keep in mind that it doesn’t cover certain types of care, like long-term care, private duty nursing, vision or dental care, hearing aids, and alternative therapies. 

Medigap Plan K Costs: 

The least expensive Medigap plan still covers part A and B co-insurance and deductibles. Does not cover Skilled Nursing Facility care or Part D premiums.

Plan K Enrollment

You can enroll in Plan K during your Medicare initial enrollment period or during a special enrollment period. 

Medigap Plan L

Plan L has the same benefits as Plan K, with one key exception: the out-of-pocket limit. With Plan L, you’ll have to pay a smaller share of your medical costs before your policy kicks in.

What Does Plan L cover?

  • Covers all gaps in Original Medicare, except for the Part B deductible
  • Covers co-pays, co-insurance, and deductibles
  • Covers foreign travel emergencies 
  • The out-of-pocket limit is the maximum amount you’ll have to pay in a calendar year for covered services. After you reach this limit, your policy will pay 100% of your medical costs for the rest of the year.

Differences Between Plan L And Other Medigap Plans:

Plan L is the only Medigap policy that does not cover

  • Long-term care
  • Private duty nursing

What Isn’t Covered by Plan L?  

  • Vision or dental care
  • Hearing aids
  • Alternative therapies

Plan L Costs

Usually, Plan L has a lower premium than other Medigap plans, but this can vary depending on the insurance company you acquire it from. Plan L covers all basic benefits that are required by Medicare Supplement Plans, however, the costs are only covered partially. 

Plan L Enrollment

You can enroll in Plan L during your Medicare initial enrollment period.

Who Is Eligible For Medigap?

To be eligible for Medigap, you must first be enrolled in Medicare Part A and Part B. You can enroll in a Medigap plan during your six-month Medigap Open Enrollment Period, which begins the month you turn 65 years old and are enrolled in Medicare Part B. If you have a pre-existing condition, you may still be able to enroll in a Medigap plan during this time period.

Is It Necessary To Acquire Medigap? 

Most people find that it’s necessary to have some type of Medigap coverage in order to fully protect themselves from the high costs of healthcare. Medicare does not cover everything, and even after you’ve paid for your premiums for Medicare Part A and B, you could still be left with significant out-of-pocket expenses. A Medigap policy can fill in the gaps and help you pay for services that are not covered by Medicare.

However, if you have access to a good quality health insurance plan through an employer or union, you may not need a Medigap policy. Be sure to speak with an agent to determine whether or not you need supplemental coverage. 

How To Get Started With Your Medigap Plan? 

If you’re ready to enroll in a Medigap plan, the process is pretty straightforward. You can contact any insurance company that sells Medigap plans in your state and ask for a quote. Be sure to have your Medicare number handy when you call. Once you find a plan that meets your needs and budget, you can sign up for it.

Your Medigap plan will start on the first day of the month after your enrollment is approved. You’ll receive a letter from your insurance company telling you when your policy begins and how much your premium will be.

Remember, you can only have one Medigap plan at a time. If you want to switch plans, you’ll need to cancel your old policy and enroll in the new one.

Let Us Help You Choose Your Medigap Plan

Our team at Nesso Medicare can help you find the best Medigap plan for your specific needs. We’ll work hard to ensure no detail is missed and you’ll be well taken care of. Our goal is to provide the guidance you need to make an informed decision. 

At Nesso Group, we’ll work hard to provide all the information you need to choose the Medigap plan that best meets your needs and budget. Don’t hesitate to contact us today to get started.

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