What do MyBlueSM Medigap plans cover?
Who is this for?
If you're considering a MyBlue Medigap plan, this explains the services they cover and pay for.
We offer three MyBlue Medigap plans. Some cover more services than others, so you can choose the right one for your needs.
MyBlue Medigap Plan A is the most basic. After you meet your Medicare deductibles, it pays:
- Your Medicare Part A hospital coinsurance plus the costs for 365 additional days in the hospital after your Medicare benefits end.
- Your Medicare Part B medical coinsurance (generally 20 percent of Medicare-approved expenses) or copayments for hospital outpatient services.
- The cost of the first three pints of blood you need each year.
- Your Medicare Part A coinsurance for hospice.
MyBlue Medigap Plan N pays for more things than Plan A, but fewer than Plan F. It pays for everything Plan A does plus:
- Your share of the costs for care you get in a skilled nursing facility.
- Your Medicare Part A hospital deductible.
- Eighty percent of your costs of emergency care outside the U.S. after you pay a $250 deductible, with a $50,000 lifetime maximum.
Like Plan A, Plan N pays your share of the costs for medical services included in Medicare Part B. But you'll have to pay up to $20 for some office visits and up to $50 if you go the emergency room and you're not admitted to the hospital as a result.
MyBlue Medigap Plan F is the most comprehensive. It pays for everything Plan A and Plan N does, plus:
- Your Medicare Part B medical deductible.
- The difference between what a doctor may charge for a service and Medicare pays. This is called an excess charge.
You won't have to pay anything for doctor office or emergency room visits.
What's not covered
At one time, some Medigap plans included prescription drug coverage. That ended in 2006. All plans sold after that year don't cover prescription drugs. A Medigap plan with drug coverage you have from before 2006 might not meet today's standards.
You can enroll in a separate Part D plan, like a Prescription Blue℠ PDP plan. It'll protect you from high costs at the pharmacy and from possible penalties for not having drug coverage.
Original Medicare covers some dental, vision and hearing services. Your MyBlue Medigap plan will pay your share of the cost in those cases. Medicare doesn't cover routine dental or vision care or hearing aids. Your MyBlue Medigap plan doesn't cover those either.