Standard Plans
Standardized Medicare Supplement Plans for Most States (excluding MA, MN and WI )
Every company offering Medicare Supplement insurance must offer Plan A. In addition, companies may have some, all, or none of the other plans.
Basic Benefits (Included in Plans A - G):
Inpatient Hospital Care: Covers the cost of Part A coinsurance and the cost of 365 extra days of hospital care during your lifetime after Medicare coverage ends.
For medicare supplement plans, Medical Costs: Covers the Part B coinsurance (generally 20% of Medicare-approved payment amount) or copayment amount which may vary according to the service. For hospital outpatient services, the copayment amount will be paid under a prospective payment system. If this system is not used, then 20% of eligible expenses will be paid.
Blood: Covers the first 3 pints of blood each year.
| Options | A | B | C | D | F* | G |
| Basic Benefits | | | | | | |
| Part A: Inpatient Hospital Deductible | | | | | | |
| Part A: Skilled-Nursing Facility Coinsurance | | | | | | |
| Part B: Deductible | | | | | | |
| Foreign Travel Emergency | | | | | | |
| Part B: Excess Charges | | | | | 100% | 100% |
* Plan F also has a high deductible option. If you choose this option, in 2019 you must pay $2,300 out-of-pocket per year before the plans pay anything. Insurance policies with a high deductible option generally cost less than those with lower deductibles. Your out-of-pocket costs for services may be higher if you need to see your doctor or go to the hospital.
Basic Benefits (Plans K- N):
Basic Benefits for Plans K, L and N include similar services as Plans A through G and M, but cost sharing for the basic benefits is at different levels.
| Options | K** | L** | M | N |
| Basic Benefits | 100% of Part A Hospitalization Coinsurance plus coverage for 365 days after Medicare Benefits end 50% Hospice cost-sharing 50% of Medicare eligible expenses for the first three pints of Blood 50% Part B Coinsurance, except 100% Coinsurance for Part B Preventive Services | 100% of Part A Hospitalization Coinsurance plus coverage for 365 days after Medicare Benefits end 75% Hospice cost-sharing 75% of Medicare eligible expenses for the first three pints of Blood 75% Part B Coinsurance, except 100% Coinsurance for Part B Preventive Services | | Basic, Including 100% co-insurance, except up to $20 copayment for office visit, and up to $50 copayment for ER |
| Skilled Nursing Coinsurance | 50% Skilled Nursing Facility Coinsurance | 75% Skilled Nursing Facility Coinsurance | | |
| Part A: Deductible | 50% Part A Deductible | 75% Part A Deductible | 50% Part A Deductible | |
| Part B: Deductible | | | | |
| Part B: Excess (100%) | | | | |
| Foreign Travel Emergency | | | | |
| At-Home Recovery | | | | |
| Preventive Care NOT Covered by Medicare | | | | |
| $5,560 Out of Pocket Annual Limit (2019) *** | $2,780 Out of Pocket Annual Limit (2019) *** | | |
**Plans K and L provide for different cost-sharing for items and services than Plans A through G and M. Once you reach the annual limit, the plan pays 100% of the Medicare copayments, coinsurance, and deductibles for the rest of the calendar year. The out-of-pocket annual limit does NOT include charges from your provider that exceed Medicare-approved amounts, called "Excess Charges". You will be responsible for paying excess charges.
***The out-of-pocket annual limit will increase each year for inflation.