Most, but not all, Medigap plans do not require a separate deductible. Original Medicare has two deductibles (Part A and B) and not all Medigap plans will cover these deductibles. Find out why some new Medigap policyholders will pay at least one of these Medicare deductibles.
What are Original Medicare’s Deductibles?
In general, a deductible is a fee that you must pay first before the insurance will pay for your health costs. Original Medicare has two different deductibles to cover hospital and doctor coverage: Medicare Part A and B costs. Each works very differently. Let us explain in the chart below.
|Deductible Details||Medicare Part A Deductible||Medicare Part B Deductible|
|How much will you pay?||$1,600||$226|
|How often do you pay?||Up to 5 times a year*||Once a year|
|What does it cover?||Hospital deductible||Doctor deductible|
*Medicare Part A’s deductible is paid every 60-day benefit period. This means if you are hospitalized from February 2 -5 and reenter the hospital on April 20th, you’d have to pay your deductible again.
How does Medigap cover Medicare’s Deductibles?
It depends on the plan. Plan F pays both Medicare Part A (even if it is required more than once in the same year) and Part B deductible. Plan F is no longer available to those who turned 65 after Jan 1, 2020. Medigap Plan G will cover your Part A Medigap deductible but you’ll have to pay your annual Part B deductible out-of-pocket. If you enroll in Medigap Plan A, on the other hand, you’ll have to pay BOTH deductibles.
Note: As explained in the chart above, the Medicare Part A deductible is based on the benefit period and may have to be paid more than once in the same calendar year.
Pro tip: We cannot stress enough how important it is to compare Medigap plans early. In most states, if you miss your initial Medigap open enrollment period, you may have to go through medical underwriting and could be denied. Call us at 800-930-7956 if you need help comparing or would like to enroll over the phone.
What About High Deductible Medigap Plans?
Just to add to the confusion, there are a few Medigap plans that indeed have their own separate deductible. They are called High Deductible Medigap plans and our client’s enrollment numbers on these plans are low in most states (New York being a notable exception).
There are three High Deductible Medigap Plans (F, G and J) but only High Deductible Plan G is currently available to those new to Medicare after 2020. With High Deductible G, you must first pay $2,700 before your traditional G benefits kick in. You can learn more about Medigap High Deductible G here.
If you need help comparing Medigap plans or enrolling, call one of our licensed agents at 800-930-7956.
Our agents can NOT charge you a fee for a quote or to enroll in a plan so give us a call.