Medicare Supplement

Reading the Medigap chart in Milwaukee: what Plans G, N, K, L and high-deductible G actually do

Medigap shopping can feel like alphabet soup — Plan G here, Plan N there, a "high-deductible G" tucked in the corner of the chart. If you live in Milwaukee and you've been staring at one of those grids trying to figure out what actually changes from column to column, here's the good news: the letters themselves are set by federal rule. A Plan G is a Plan G, whether you see it printed on a glossy mailer or a plain brochure.

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That standardization is the whole point of the Medigap chart. Once you understand what each letter covers, you can compare apples to apples.

Why the same letter means the same coverage

Under federal rules from the Centers for Medicare & Medicaid Services (CMS), Medigap policies sold in most states must fit one of a set of standardized plans identified by letters — A, B, D, G, K, L, M, N, and a few others. Each letter has a fixed list of benefits.

That means the Plan G benefit chart at one insurer matches the Plan G benefit chart at another. The insurer can change the price, the customer service, the underwriting questions and the extras (like a gym membership add-on), but not the core benefits attached to the letter.

So when a friend says, "I've got Plan G," you already know a lot about what that policy pays toward your Medicare cost-sharing — even if you don't know the company name.

What Plan G covers (and doesn't)

Plan G is one of the most comprehensive letters available to people newly eligible today. It generally helps pay the gaps in Original Medicare — things like the Part A hospital deductible, coinsurance for hospital and skilled nursing stays, Part B coinsurance and copays, the first three pints of blood, hospice cost-sharing, and Part B "excess charges" from doctors who don't accept Medicare assignment.

What Plan G does not cover: the annual Part B deductible. You pay that yourself before Plan G kicks in on outpatient care.

Plan G also does not cover prescription drugs (that's Part D), routine dental, vision, hearing aids, or long-term custodial care. Those are separate decisions.

What Plan N covers differently

Plan N covers most of the same gaps as Plan G, with two notable differences:

• You may pay a copay of up to $20 for some office visits and up to $50 for emergency room visits that don't result in an inpatient admission.
• Plan N does not cover Part B excess charges, so if your provider doesn't accept Medicare assignment, you could owe the extra amount.

Like Plan G, Plan N does not pay the Part B deductible. People who don't mind small copays at the doctor's office sometimes look at N; people who want the fewest surprises at the counter often look at G. Neither is "better" — they're different trade-offs.

How Plans K and L work

Plans K and L are structured differently. Instead of paying most gaps in full, they cover a set percentage of certain costs — K generally pays 50% of many Part B and hospital-related cost-sharing amounts, and L generally pays 75%.

In exchange, K and L come with an annual out-of-pocket limit. Once you hit that yearly cap (the amount is set by CMS and updated each year), the plan pays 100% of covered Medicare cost-sharing for the rest of the calendar year. After that, you also have to meet the Part B deductible before the plan pays its share of Part B services.

These are the "cost-sharing" letters. They usually carry lower premiums than G or N, but you take on more of the day-to-day costs until the cap is reached.

High-deductible Plan G

High-deductible Plan G (sometimes shown as "HDG" on charts) covers the same benefits as regular Plan G, but only after you meet a yearly deductible set by CMS. Until you meet that deductible, you pay the Medicare-approved cost-sharing yourself.

It's the same letter, just with a bigger threshold up front. People who don't expect heavy medical use sometimes consider it; people who want predictable costs from January 1 usually don't.

Why Plans C and F aren't on the newer charts

If you're helping a parent who has had Medigap for years, you may see Plan C or Plan F on their paperwork. Those plans pay the Part B deductible — and because of a federal law change, they are closed to people who became newly eligible for Medicare on or after January 1, 2020. People who were already eligible before that date can still keep or, in some cases, buy them.

That's why most "which letter should I pick?" conversations today center on G, N, K, L and high-deductible G.

Wisconsin is one of three states that's different

Here's the twist for Milwaukee readers: Wisconsin does not use the letter system the way most states do. Wisconsin — along with Massachusetts and Minnesota — has its own standardized Medigap framework, built around a base policy with optional riders you add on.

So a chart from a national website that shows "Plan G, Plan N, Plan K, Plan L" may not match what you actually see quoted for a policy in Milwaukee. Milwaukee is in Milwaukee County, and Medigap policies sold to Wisconsin residents follow the Wisconsin structure. The concepts above — what's covered, what's not, cost-sharing versus high-deductible designs — still help you understand the trade-offs, but the labels on your quote will look different.

When you compare Wisconsin Medigap options, focus on the base plan plus the specific riders (for example, additional home health care, Part A deductible, Part B copayment/coinsurance, and so on). Ask the insurer to show you the standardized Wisconsin outline of coverage.

How to actually use the chart

A few practical steps:

1. Ignore the insurer names for a minute and look only at the benefit rows. 2. Decide which gaps matter most to you — hospital costs, doctor visit copays, excess charges, a yearly cap. 3. Match those priorities to a letter (or, in Wisconsin, a base plan plus riders). 4. Only then compare prices and companies for that same design.

If you skip step one, you can end up comparing two policies that aren't really the same product.