Medicare Supplement

Same Plan G, same rules: how to read the Medigap letter chart in Fort Mill

FORT MILL, S.C. — If you've ever compared Medigap policies and wondered why one company's Plan G looks identical to another's, that's not a coincidence. It's federal law. The letters — A, B, D, G, K, L, M, N and high-deductible G — are standardized, meaning the benefits inside each letter are set by Medicare, not by the insurer selling it.

That standardization is what lets Fort Mill shoppers compare apples to apples. What can differ between companies is the price and the customer service, not what the plan pays.

What "standardized" actually means

Under federal rules explained on medicare.gov, every Medigap policy sold with the same letter has to offer the same core benefits. A Plan G bought in Fort Mill covers the same Original Medicare gaps as a Plan G bought anywhere else in South Carolina (or almost any other state).

That means when you compare policies, you're really comparing three things: the monthly premium, the company behind it, and how that company handles rate changes over time. You are not comparing benefits — those are locked in by the letter.

Three states are the exception. Massachusetts, Minnesota and Wisconsin standardize Medigap policies their own way, so a shopper who moves from one of those states to South Carolina — or the reverse — will see a different chart.

Plan G, at a glance

Plan G is one of the most talked-about letters for people who became eligible for Medicare on or after January 1, 2020. It covers the Part A hospital coinsurance and deductible, Part B coinsurance, the first three pints of blood, skilled nursing coinsurance, Part A hospice coinsurance, and Part B "excess charges" (the extra amount some providers can bill above Medicare's approved rate).

What Plan G does not cover: the Part B deductible. You pay that yourself each year before Plan G kicks in on outpatient care. It also does not cover prescription drugs — that's Part D — and it does not cover dental, vision, hearing aids or long-term care.

High-deductible Plan G

High-deductible Plan G offers the same benefits as regular Plan G, but you pay a set deductible each calendar year before the policy begins paying. In exchange, the monthly premium is typically lower. Medicare sets that deductible amount and updates it yearly; you can look up the current figure on medicare.gov.

It is the same coverage as Plan G in what it eventually pays — the difference is the order in which you and the plan pay.

Plan N

Plan N covers most of what Plan G covers, with two key differences. It does not pay Part B excess charges, and it asks you to pay small copays — up to $20 for some office visits and up to $50 for an emergency room visit that does not lead to an inpatient admission.

Like Plan G, Plan N does not cover the Part B deductible.

Plans K and L: the cost-sharing letters

Plans K and L work a little differently. Instead of paying 100% of most gaps, they pay a percentage — 50% for Plan K and 75% for Plan L — of certain costs like the Part A deductible, Part B coinsurance, skilled nursing coinsurance and the first three pints of blood.

In return, both plans include an annual out-of-pocket limit. Once you hit that limit, the plan pays 100% of covered Medicare costs for the rest of the calendar year. Medicare updates those limits each year and posts them on medicare.gov.

Neither Plan K nor Plan L covers the Part B deductible.

Plans C and F: closed to newer enrollees

Plans C and F used to be popular because they covered the Part B deductible. Federal law changed that. If you first became eligible for Medicare on or after January 1, 2020, you cannot buy Plan C or Plan F. People who were eligible before that date may still be able to purchase them.

That is why so much of the current Medigap conversation centers on Plan G, high-deductible G and Plan N — those are the letters most newly eligible beneficiaries are comparing.

Why the same letter can cost different amounts

If the benefits are identical, why do premiums differ? Insurers price Medigap policies using different methods (community-rated, issue-age-rated or attained-age-rated), and each company sets its own rates. Household discounts, underwriting rules outside of open enrollment, and how a company adjusts prices over time all play a role.

In Fort Mill — which is in York County — shoppers can compare Medigap policies through the plan-finder tool at medicare.gov, which lists the letters available in South Carolina and the companies selling them.