Medigap Plan Comparison Tool

$20 & $50 Copay Plan50% Cost Sharing Plan75% Cost Sharing PlanBasic PlanExtended Basic PlanHigh Deductible Plan
Monthly Cost (Premium)(See policies)Medigap 50% Cost Sharing PlanMedigap 75% Cost Sharing Plan(See policies)(See policies)(See policies)
Hospital (Part A) Deductible$0$816$408$1,632$0$0
Medical (Part B) Deductible$240$240$240$240$240$240
Part B Copays/Coinsurance$0 with some $20 and $50 copays10% up to $7,0605% up to $3,530$0$0$0 after $2,800 deductible
Hospital Stays$0 for Days 1-150, All costs after$816 for Days 1-60, $0 for Days 61-150, All costs after$408 for Days 1-60, $0 for Days 61-150, All costs after$1,632 for Days 1-60, $0 for Days 61-150, All costs after$0 for Days 1-150, All costs after$0 for Days 1-150, All costs after
Skilled Nursing Facility$0 for Days 1-100, All costs after$0 for Days 1-20, $102 for Days 21-100, All costs after$0 for Days 1-20, $51 for Days 21-100, All costs after$0 for Days 1-100, All costs after$0 for Days 1-120, All costs after$0 for Days 1-100, All costs after
Blood (during a hospital stay)$050% of cost for first 3 pints, $0 after25% of cost for first 3 pints, $0 after$0$0$0
Hospice Care$050% of Medicare copay/coinsurance25% of Medicare copay/coinsurance$0$0$0
Home Health Care$0$0$0$0$0$0
Durable Medical Equipment$240 (Part B deductible), $0 after$240 (Part B deductible), 10% of cost after$240 (Part B deductible), 5% of cost after$240 (Part B deductible), $0 after$240 (Part B deductible), $0 after$240 (Part B deductible), $0 after
Covered Part B Services$240 (Part B deductible), $0 after$240 (Part B deductible), 10% up to $7,060, $0 after$240 (Part B deductible), 5% up to $3,530, $0 after$240 (Part B deductible), $0 after$240 (Part B deductible), $0 after$240 (Part B deductible), $0 after
Preventive Services (covered by Medicare)$0$0$0$0$0$0
Preventive Services (not covered by Medicare)All costsAll costsAll costsGenerally all costsBalance after Medigap policy pays $120Balance after Medigap policy pays $120
Part B Excess ChargesAll costsAll costsAll costsAll costs$0All costs
Blood (outside a hospital stay)$240 (Part B deductible), $0 after50% of cost for first 3 pints, $240 (Part B deductible), 10% after25% of cost for first 3 pints, $240 (Part B deductible), 5% after$240 (Part B deductible), $0 after$240 (Part B deductible), $0 after$240 (Part B deductible), $0 after
Tests for Diagnostic Services$0$0$0$0$0$0
Physical Therapy (when covered by Medicare)$0$0$0$0$0$0
Outpatient Mental Health Services (when covered by Medicare)$0$0$0$0$0$0
Foreign Travel Emergency$250 then 20%All costsAll costs20%20%$0
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