Medicare is a government program that provides health insurance coverage for individuals aged 65 and older, as well as for certain individuals with disabilities. While Medicare covers many medical expenses, there are still gaps in coverage that can leave beneficiaries with substantial out-of-pocket costs. To help fill these gaps, private insurance companies offer Medicare Supplement Insurance plans, also known as Medigap plans. Visit Medicare Solutions Team a division of LJM Insurance Agency Ltd. at to review the different types of Medigap plans available in Virginia.

If you reside in Virginia and are eligible for Medicare, you have several options when it comes to Medigap plans. These plans are standardized by the federal government, which means that regardless of the insurance company you choose, the benefits offered by each plan will remain the same. Let’s explore the different types of Medigap plans available in Virginia and understand what they cover.

1. Medigap Plan A

Medigap Plan A is the most basic plan available and covers a set of essential benefits. These benefits include coverage for Medicare Part A coinsurance and hospital costs, Medicare Part B coinsurance or copayment, the first three pints of blood, and hospice care coinsurance or copayment.

2. Medigap Plan B

Similar to Plan A, Medigap Plan B covers the essential benefits outlined in Plan A. In addition, it covers the Medicare Part A deductible.

3. Medigap Plan C

Medigap Plan C provides coverage for all the benefits included in Plan B. Additionally, it covers the Medicare Part B deductible, skilled nursing facility care coinsurance, and emergency medical care during foreign travel.

4. Medigap Plan D

Medigap Plan D covers the same benefits as Plan C, except it does not include coverage for the Medicare Part B deductible. However, it offers coverage for excess charges from Medicare-approved amounts.

5. Medigap Plan F

Medigap Plan F is one of the most comprehensive plans available. It covers all the benefits included in Plan C and also pays for the Medicare Part B deductible. However, starting from January 1, 2020, Medigap Plan F is no longer available to new Medicare beneficiaries. If you were eligible for Medicare before that date and already have Plan F, you can keep it.

6. Medigap Plan G

Medigap Plan G is similar to Plan F in terms of coverage, except it does not cover the Medicare Part B deductible. It has become a popular choice for many beneficiaries since the discontinuation of Plan F for new enrollees.

7. Medigap Plan K

Medigap Plan K offers a lower level of coverage compared to the plans mentioned earlier. It covers 50% of the Medicare Part A deductible, 50% of Medicare Part B coinsurance or copayment, and 50% of skilled nursing facility care coinsurance. It also includes an out-of-pocket limit, after which the plan pays 100% of covered services for the remainder of the year.

8. Medigap Plan L

Medigap Plan L provides a similar level of coverage as Plan K but with higher cost-sharing. It covers 75% of the Medicare Part A deductible, 75% of Medicare Part B coinsurance or copayment, and 75% of skilled nursing facility care coinsurance. Like Plan K, it also includes an out-of-pocket limit.

9. Medigap Plan M

Medigap Plan M is another cost-sharing plan that covers a portion of Medicare Part A deductible, Medicare Part B coinsurance or copayment, and skilled nursing facility care coinsurance. However, it does not cover the Medicare Part B deductible.

10. Medigap Plan N

Medigap Plan N offers coverage for most of the essential benefits. It covers the Medicare Part A deductible, Medicare Part B coinsurance or copayment, skilled nursing facility care coinsurance, and emergency medical care during foreign travel. However, it requires beneficiaries to pay a copayment for some office visits and emergency room visits.

It’s important to note that while these plans provide additional coverage beyond Original Medicare, they do not include prescription drug coverage. If you require prescription drug coverage, you can consider enrolling in a stand-alone Medicare Part D Prescription Drug Plan.

Conclusion

Choosing the right Medigap plan in Virginia is a crucial decision to ensure you have adequate coverage for your healthcare needs. The different types of Medigap plans available provide varying levels of coverage, allowing you to choose the plan that best suits your individual requirements and budget. It’s essential to carefully evaluate each plan’s benefits and compare them with your anticipated healthcare needs to make an informed decision.

FAQs (Frequently Asked Questions)

Q1: Are Medigap plans available to everyone in Virginia? A1: Medigap plans are available to individuals who are eligible for Medicare, including those residing in Virginia. However, it’s important to enroll during your Medigap Open Enrollment Period to avoid potential underwriting and ensure access to all available plans.

Q2: Can I switch between Medigap plans in Virginia? A2: Yes, you can switch between Medigap plans in Virginia. However, if you have pre-existing health conditions, you may be subject to medical underwriting, which could affect your eligibility or premium rates.

Q3: Do Medigap plans cover prescription drugs? A3: No, Medigap plans do not cover prescription drugs. To obtain prescription drug coverage, you can enroll in a stand-alone Medicare Part D Prescription Drug Plan.

Q4: Can I use my Medigap plan outside of Virginia? A4: Yes, Medigap plans provide coverage nationwide, so you can use your plan outside of Virginia as long as the healthcare provider accepts Medicare.

Q5: How do I compare Medigap plans in Virginia? A5: To compare Medigap plans in Virginia, you can use online resources, consult with insurance agents, or contact the Virginia State Health Insurance Assistance Program (SHIP) for personalized assistance.