Medicare Supplement Standardized Plans

Plan A includes only the basic core benefits.

Plan B includes the basic core benefits and the Medicare Part A deductible.

Plan C includes:

  • Core benefits
  • Medicare Part A deductible
  • Skilled nursing facility care
  • Medicare Part B deductible
  • Medically necessary emergency care in a foreign country

Plan D includes:

  • Core benefits
  •  Medicare Part A deductible
  • Skilled nursing facility care
  • Medically necessary emergency care in a foreign country

Plan F includes:

  • Core benefits
  • Medicare Part A deductible
  • Skilled nursing facility care
  • Medicare Part B deductible
  • 100 percent of Medicare Part B excess charges
  • Medically necessary emergency care in a foreign country

High Deductible Plan F includes:

  • All Plan F benefits
  • While premiums are typically lower under the high deductible option, the insured is required to pay the deductible before the policy will cover your health claims
  • The deductible for this plan changes annually

Plan G includes:

  • Core benefits
  • Medicare Part A deductible
  • Skilled nursing facility care
  • 100 percent of Medicare Part B excess charges
  • Medically necessary emergency care in a foreign country

Plan K includes:

  • Core benefits
  • 50 percent of the cost-sharing for Medicare Part A covered hospice expenses
  • First three pints of blood
  • 50 percent of the Part B co-insurance after meeting the annual deductible
  • Payment of the Part A and B deductibles, co-payments, and co-insurance once the annual out-of-pocket spending limit is met
  • The deductible for this plan changes annually

Plan L includes:

  • Core benefits
  • 75 percent of the cost-sharing for Medicare Part A covered hospice expense
  • First three pints of blood
  • 75 percent of the Part B co-insurance after meeting the annual deductible
  • 100 percent of the Part A and B deductibles, co-payments and co-insurance, once the annual out-of-pocket spending limit is met.
  • The deductible for this plan changes annually

Plan M includes:

  • Core benefits
  • 50 percent of the Medicare Part A deductible
  • Skilled nursing facility care
  • Medically necessary emergency care in a foreign country

Plan N includes:

  • Core benefits
  • Medicare Part A deductible
  • Skilled nursing facility care
  • Medically necessary emergency care in a foreign country
  • 100 percent of the Part B co-insurance, except up to $20 co-payment for office visits and up to $50 for emergency department visits