Standardized Plan Structure (Medigap Plan Letters)
Medigap policies are standardized by plan letter in most states. Each plan letter provides a defined set of benefits that remains consistent regardless of which insurance company sells the policy within the same state. This standardization allows individuals to compare benefits based on coverage structure rather than carrier branding.
What “Standardized” Means
Standardized benefits mean that each Medigap plan letter includes a specific combination of cost-sharing protections defined by regulation. For example, a Plan G offered by one insurer provides the same core benefits as a Plan G offered by another insurer in the same state. Premiums, underwriting practices, and pricing structures may differ between carriers, but covered benefits for each plan letter remain the same.
Plan Letter Coverage Overview
Medigap plans are typically identified by letter designation, such as Plan A, Plan G, or Plan N. Each plan letter covers a defined set of Medicare cost-sharing elements, which may include Part A coinsurance, Part B coinsurance, blood benefits, skilled nursing facility coinsurance, and other cost-sharing components.
Why Plan F Is Limited for Newly Eligible Beneficiaries
Federal legislation discontinued the availability of Medigap plans that cover the Medicare Part B deductible for individuals who became newly eligible for Medicare on or after January 1, 2020. As a result, Medigap Plan F is generally available only to individuals who were eligible for Medicare before that date, subject to state availability and plan participation.
Using a Coverage Comparison Table
Medigap plans are identified by letter designation, including Plans A, B, D, G, High Deductible G, K, L, M, and N. Plans C and F are generally available only to individuals who were eligible for Medicare before January 1, 2020. Each plan letter covers a defined combination of Medicare cost-sharing elements.
| Benefit Category | A | B | D | G | HD-G | K | L | M | N | C* | F* |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Part A Coinsurance & Hospital Coverage | ✔ | ✔ | ✔ | ✔ | ✔ | ✔ | ✔ | ✔ | ✔ | ✔ | ✔ |
| Part B Coinsurance / Copay | ✔ | ✔ | ✔ | ✔ | ✔ | 50% | 75% | ✔ | ✔* | ✔ | ✔ |
| Blood (First 3 Pints) | ✔ | ✔ | ✔ | ✔ | ✔ | 50% | 75% | ✔ | ✔ | ✔ | ✔ |
| Part A Hospice Coinsurance | ✔ | ✔ | ✔ | ✔ | ✔ | 50% | 75% | ✔ | ✔ | ✔ | ✔ |
| Skilled Nursing Facility Coinsurance | — | — | ✔ | ✔ | ✔ | 50% | 75% | ✔ | ✔ | ✔ | ✔ |
| Part A Deductible | — | ✔ | ✔ | ✔ | ✔ | 50% | 75% | 50% | ✔ | ✔ | ✔ |
| Part B Deductible | — | — | — | — | — | — | — | — | — | ✔ | ✔ |
| Part B Excess Charges | — | — | — | ✔ | ✔ | — | — | — | — | — | ✔ |
| Foreign Travel Emergency | — | — | ✔ | ✔ | ✔ | — | — | ✔ | ✔ | ✔ | ✔ |
| Annual Out-of-Pocket Limit | — | — | — | — | — | ✔ | ✔ | — | — | — | — |
Legend: ✔ = Benefit Covered | 50% / 75% = Partial coverage under plan design | — = Not covered
Notes: ✔* = Copayments may apply for certain office or emergency room visits. HD-G = High Deductible Plan G (benefits apply after the deductible is met).
*Eligibility note: Plans C and F are generally available only to individuals who were eligible for Medicare before January 1, 2020.
Disclaimer: This information is provided for educational purposes only and is based on publicly available guidance from the Centers for Medicare & Medicaid Services (CMS). It has not been reviewed or endorsed by Medicare, CMS, or any federal agency. This content does not constitute plan-specific advice. For individual coverage questions, please consult a licensed insurance professional.