What Does Medicare Supplement (Medigap) Plan B Cover?

Medicare Benefits Solutions
Feb 14, 2021

Recipients of Original Medicare have certain out-of-pocket costs that you’re responsible for paying each year before your insurance covers your medical expenses. These expenses include things like your coinsurance, copayments, and deductibles. Medigap insurance could help you pay for some of these costs, which is important if you end up with an unexpected hospitalization or chronic condition. If you’re considering purchasing a Medigap plan, you may want to compare the available plans. Let’s take a closer look at Medigap Plan B.  

Understanding Medigap Plan B

Plan B is one of the 10 different supplemental plans available in almost every state. Minnesota, Wisconsin, and Massachusetts have their own version of this standardized plan. The different supplemental plan types help pay different amounts of out-of-pocket costs. It’s also important to note that Original Medicare Part B is different from the supplemental Plan B, but many people get confused because their names are so similar. 

If you choose this Medigap Plan B, it includes the following coverage options: 

• Copayments for Medicare Part B
• Coinsurance for Medicare Part B
• The first three pints of blood you get when you’re an outpatient or inpatient in the hospital. Original Medicare will kick in and cover any pints you get after this point.
• Deductible for Medicare Part A
• Coinsurance and hospital expenses for Medicare Part A up to a full 365 days after you deplete your Medicare benefits
• Copayment or coinsurance for hospice care

However, there are things that this supplemental insurance won’t cover, including: 

• Medicare Part B excess charges
• Deductible for Medicare Part B
• Prescription drugs

It’s also important to note that private insurance companies are the ones that offer these supplemental insurance options. The availability and costs will differ depending on the company and your location. However, private companies do provide the same set of standardized benefits because the law requires it. 

Costs Associated with Medigap Coverage

Private insurance companies offer Medigap plans, so they can set their own premiums that they base on three price rating systems. They can choose from attained-age-rated, issue-age-rated, or community-rated premium tiers. They may also charge different coverage amounts for the same plans based on your health status, age, gender, and location. Additionally, the companies that offer plans aren’t allowed to cancel your coverage unless you don’t pay your premium, the company goes insolvent or bankrupt, or you weren’t truthful when you applied for it. 

When to Enroll in Medigap

Ideally, the best time you can enroll is during the Medigap six-month open enrollment period. It starts on the day you turn 65 and have Medicare Part B coverage. During this six-month window, you have a guaranteed issue right to enroll in any Medigap plan sold in your state, regardless of any pre-existing medical conditions. If you wait to buy a Medigap policy after this period, you may be subject to medical underwriting and could be turned down for coverage or charged more for your policy.

Key Information Surrounding Medigap Plan B

You’ll pay a monthly premium for this policy to your private insurance company, and you’ll still pay your monthly Plan B premium for your regular Medicare coverage. Additionally, this policy is only for one person. If both you and your spouse both want supplemental coverage, you’ll have to purchase individual policies. Make a point to shop around and look at the options available to you when you make your choice to ensure you get the coverage that’s right for you.