What is Medigap Plan B

Eligibility Team
Researcher & Writer
January 20, 2020

If you’re enrolling in Original Medicare, you may wonder if you’ll be left with gaps in your coverage. That’s why many people turn to Medicare Supplement plans (Medigap): to help provide peace of mind for future medical needs. Medigap plans work in tandem with your Parts A and B coverage to pay for additional expenses that Medicare may not include.

Medigap Plan B, also known as Medicare Supplement Plan B, is one of 10 available offerings. Each has its own unique benefits. Read on to learn more about this supplemental insurance that provides an additional layer of coverage to help reduce out-of-pocket costs.

What is Medigap Plan B?

Also known as Medigap, Medicare Supplement is designed to help pay some of the health care costs that Original Medicare doesn’t cover. Medigap Plan B is one such supplement option.

Medigap Plan B—not to be confused with Medicare Part B, which covers outpatient medical care such as doctor’s visits, labs and X-rays—is one of the most basic, and thus affordable, plans available.

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What does Medigap Plan B cover?

As a basic-level plan, Medigap Plan B covers the following costs and benefits:

  • Medicare Part A deductible
  • Part A hospital expenses and coinsurance costs (up to an additional 365 days after Medicare benefits are exhausted)
  • Part A hospice care copayment or coinsurance
  • Medicare Part B copayments and coinsurance
  • First three pints of blood used in an approved medical procedure (annually)

Is Medigap Plan B right for me?

Medigap Plan B will help defray out-of-pocket medical costs by extending the coverage of your Medicare plan. To determine if this supplemental insurance plan is right for you, or if you should choose a more comprehensive Medigap plan, examine the grid below. It may also be helpful to consult this supplement plan comparison guide.

Joni has been a Medicare recipient for years and wants a little more coverage as they age. She knows Medigap premiums can be steep at her age, so she wants a low-cost plan. Joni's top priority is covering the Part A hospital coinsurance and deductible, so she's chosen Medigap Plan B.

Benefit
Considerations

Covered by Medigap Plan B

Medicare Part A (hospital) deductible

Your hospital deductible is calculated per-incident, (not annually) which can become costly if you are hospitalized multiple times each year.

Yes

Part A hospice care coinsurance or copayment

You may need to pay 5% of the Medicare-approved amount for inpatient respite care, and a copayment of no more than $5 for each prescription drug for pain relief and symptom control while you're at home.

Yes

Part A hospital costs and coinsurance

Medicare Part A pays most of your hospital costs for stays up to 60 days; after this time period, you’ll be responsible for a portion of the bill.

Yes

Medicare Part B coinsurance or copayment

Copays are the fixed amount you pay for a service, such as a doctor’s visit; coinsurance is the portion you pay after reaching your deductible.

Yes

First three pints of blood

If your hospital or medical provider has to buy blood for a transfusion, you’ll need to cover the costs of the first three units each calendar year.

Yes

Part B excess charges

Legally, doctors are allowed to charge 15% more than what Medicare agrees to pay for that service—and you’ll be billed that difference.

No(consider Plans F or G)

Part B deductible

You are responsible for meeting your deductible ($198 in 2020)1 before Medicare pays any claims.

No(consider Plans C or F)

Skilled nursing facility (SNF) care coinsurance

Medicare Part A covers skilled nursing care provided in an SNF in certain conditions and for a limited time period; during a stay of 21–100 days, you’ll be responsible for a portion of that bill; starting day 101, you’ll be responsible for 100% of the costs.

No(consider Plans C, D, F, G, K, L, M and N)

Foreign travel emergency care

Medicare doesn’t cover health care outside of the United States, which means a medical emergency while on vacation can leave you with 100% of the costs incurred.

No(consider Plans C, D, F, G, M or N)

Table created using information available at Medicare.gov as of 1/20/2020.


How much does Medigap Plan B cost?

Each insurance company sets its own monthly premium, which means pricing varies between carriers. Even though Medigap Plan B is typically one of the lowest cost options (due to its scaled-back coverage), it’s wise to shop around to make sure you’re getting the best deal.

How do I enroll in Medigap Part B?

The best time to purchase any Medigap policy is during your open enrollment period, which is a six-month period that begins the month your Medicare Part B coverage begins. During this time, insurance companies cannot decline coverage, even if you have pre-existing conditions or are in poor health. Once this period has passed, there’s no guarantee you’ll meet the medical underwriting requirements, unless you meet specific criteria to qualify for another Medigap open enrollment period.

The bottom line

Medigap Plan B policies offer some additional coverage benefits to help lower your out-of-pocket costs without charging a high premium (compared to most other Medicare Supplement plans). If you don’t travel outside of the United States often, are in relatively good health with few pre-existing conditions, and aren’t concerned about excess Medicare Part B charges negatively impacting your budget, then this additional coverage may save you money and provide you peace of mind.

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Sources

  1. Medicare, "Costs at a Glance"
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