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Why Medigap Policies were Standardized

supplemental coverage, federal government website
May 16, 2022

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What are Medigap Plans?

Will Century Medicare tell me about the Medigap plan? Medigap plans are Medicare supplement insurance that is provided for sale through a private insurer if it meets the requirements of federal Medicare guidelines. Medicare enrollees cannot obtain a health care insurance policy from a private health insurer. The Medigap plan is not compatible with Medicare.

Though Medigap policies are offered through private insurers, the policy is standardized. There is a wide selection of Medigram options for consumers in every state except California.

Medigap enrollment and consumer protection vary across states

One out of four Medicare recipients has health insurance to cover Medicare deductibles or cost-sharing, as well as prevent catastrophic medical expenses. This brief issue presents a summary of Medigap enrollment. There's also a coinsurance charge under Part A for skilled nursing facility stays that exceed 20 days

As with Part B, there is no cap on how much an enrollee can spend in out-of-pocket costs under Part A. Medigap plans protect Medicare beneficiaries from those deductibles and coinsurance charges – that is, they bridge the “gap” in Medicare.


In a move that is indicated here, MIPPA has changed the standard Medigap policy that will be offered for sale after January 1, 2010. The new legislation aims at reducing the amount available for standardized plans from 14 to 12. Plan A & E is eliminated from this system as of September 2023. Plans HH, I, and J became duplicated in Medicare's prescription drug and medication reform bill.

The bill was amended by the pub. In October 2003, the government introduced prescription drug subsidies in Medicare. A second MIPPA update made plan E unnecessary. In reviving the “acute and permanent disability” benefit under the Medicare program, the Medigap plan will be reduced by the Medicare plan in the following year.

Medigap policies are standardized

Every Medicare supplement policy must comply with the federal law that provides the best protection for you and must have the label Medicare Supplement Insurance. Insurance companies can only offer standard insurance policies that are written in most state names. All insurance policies offer basic benefits, but others offer more.

Medigap policies are standardized differently for each state in the U.S. All insurance companies determine what Medigap coverage they will be selling, though certain states can affect which one they offer. Each plan offers a different combination of these benefits in addition to the core benefits. Insurance companies can only sell you a “standardized” Medigap policy. Medigap policies must follow Federal and state laws.

Part A hospital deductible ($1,100 in 2010); Part B deductible ($155 in 2010); Part B charges above the Medicare-approved amount (if the provider does not accept assignment); Skilled nursing facility care coinsurance; Foreign travel emergency coverage; At-home recovery (Home health aide services).

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Excess cost $6620 in 2020 $3310 in 2020* Some plans offer a high-deductible program. The Medicare-protected deductible is $2,490 and is payable in 2022 before any policy payments are made. Plans CF is not applicable to people who became eligible for Medicare in January 2020. For Plans K and L after meeting the corresponding out-of-pocket annual maximum deductible, Medicare will pay the deductible in full for the following year.


Starting January 1, 2020, new Medicare patients cannot get Part B insurance despite having an existing plan. The plan will cease to be available for people new to Medicare on January 1, 2020. You are entitled to receive this plan if you have enrolled for any of the 2 plans before 1 February 2021. Unless you're currently enrolled in Medicare you can purchase the Plan C or F plan if you are eligible. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.

Compare Medigap plans side-by-side

The table below lists the benefits Medigap policies cover. The Medigap policy covers only the amount paid for your Medigap policy. This means that all policies labeled with the same letter have the same benefits, no matter which company provides them or their price.

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Starting Octomber 15, you can enroll in 2022 plans.


After January 1, 2010, only Medigap policies conforming with these changes can be sold. Generally, the only difference between Medigap policies sold by different insurance companies is the cost. Applicants who currently have Medigap plans may renew or maintain their Medigap policies at this point. Nonetheless, the policies will eventually cost more to implement with the decline in policyholder numbers.

According to the National Association of Insurance Commissioners and the NAIC governing agencies that are developing the Medigap policy, each insurance company should decide whether it can offer a new plan to beneficiaries without having to apply for the new plan. Under federal law, Medigap insurers are not required to sell Medigap policies to the over 9 million Medicare beneficiaries who are under the age of 65, many of whom qualify for Medicare based on a long-term disability.


The Medigap program was conceived to address the gaps in traditional Medicare through the pay of copayments, co-insurance in certain cases, and deductible payments. Many people with Medicare coverage on their original policies pay little for their health insurance. However, Congress has pushed for more Medicare payments in the recent past as some Medicare-related policy reduction measures have not helped.

In 1997, Congress passed Medicare Select plans requiring providers to pay for their supplementary coverage. Medigap help pay certain Medicare costs, including deductibles, coinsurance, and copays.

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The federal health insurance industry is required to offer Medigap insurance in all states except Wisconsin. This plan includes two types, F and J. Both of these plans offer an extremely high deductible. Its letters were designed to simplify the comparison of plans. Medigap insurance pays most of the cost of traditional Medicare coinsurance and can also include the deductible.

If you have any questions feel free to contact us today.

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