Medicare Supplement Plan J is a policy that helps pay out-of-pocket expenses. This plan has been discontinued for new enrollees.
Medicare supplement insurance, also known as Medigap, are policies that help pay for costs incurred by coinsurance, deductibles, and copayments.
Private insurance companies sell Medigap policies, which must follow Medicare rules. Some Medigap policies become unavailable when Medicare benefits change.
In this article, we discuss what Medicare supplemental insurance is, Medicare Supplement Plan J, and other available options.
Medicare supplement insurance (Medigap) plans fill in the “gaps” in Medicare parts A and B. They help to cover out-of-pocket expenses such as:
- Deductibles: These are what a person must pay themselves before the insurance starts paying.
- Coinsurance: This is a percentage of the cost of care a person pays once they have fully paid their deductible. Coinsurance is often around 20% of a particular service.
- Copayments: This is the fixed amount a person pays at each provider visit.
- Excess charges: This is a charge a person is responsible for paying in addition to any applicable coinsurance and copayment, in the event that a provider charges more than Medicare approves for a service (allowed in some states).
Until 2010, Medicare Supplement Plan J was one of several Medigap plans available to buy, and due to the benefits the policy offered, it was one of the most popular.
Plan J had comprehensive coverage that included:
- Part A hospital costs for 365 days after Medicare benefits are finished
- Part A coinsurance up to 365 days after Medicare benefits are finished
- Part A yearly deductible
- Part B coinsurance or copayments
- Part B yearly deductible
- Part B excess charges
- the first 3 pints of blood
- hospice coinsurance or copayments
- skilled nursing facility care coinsurance
- foreign travel
- preventive services
The plan sometimes included coverage for prescription drugs with a deductible of $250 per year.
Medigap Plan J was also sold with a high deductible option. A person would pay the higher deductible of $2,370 each year before the plan started to pay for approved costs.
In 2003, the Medicare Prescription Drug Improvement and Modernization Act (MMA) became law, and this changed the structure of benefits within Medicare.
MMA added Medicare Part D, a prescription drug plan, to the list of available policies. This change created many similarities between parts J and D. Because of these similarities, sales of Part J stopped as of June 1, 2010.
No Medigap plans sold after January 1, 2006, are allowed to include coverage for prescribed medication. If a person purchased a policy before this date, and prescription drugs were covered, they can keep the plan.
If a person purchased Plan J before June 1, 2010, they are usually able to keep the plan.
Private insurance companies can decide upon the Medigap policies they offer. However, the company must be authorized to operate in-state, meaning that not all plans are available in all states.
A policy that works well for one person may not be suitable for another. A person can compare Medigap policies in their area using the online “Find a Medigap policy that works for you” search tool.
Some Medigap policies often cover benefits not offered by original Medicare. For example, if a person needs medically necessary care when traveling outside the United States, this may be included in the plan.
However, Medigap policies generally do not include:
- eye care
- dental treatment
- hearing aids
- long-term care
- private duty nursing
To buy a Medigap policy, an individual must have Medicare parts A and B and pay the Part B monthly premium.
Medigap plans are subject to a separate monthly premium paid to the private insurance company.
Since Medicare Plan J is no longer available for purchase, individuals have other choices in Medigap plans.
Each policy is labeled with a letter. In 2020 the policies available are Medigap plans A, B, C, D, F, G, K, L, M, and N.
When looking at the coverage for each plan, a person should note:
- All Medigap plans cover the Part A coinsurance and hospital costs up to 365 days after Medicare benefits are exhausted.
- All plans help pay for Part B coinsurance.
- Medigap policies are standardized differently if you live in Massachusetts, Minnesota, or Wisconsin.
- Medigap plans C and F are not available for those new to Medicare.
- When a person meets their yearly out-of-pocket limit for plans K and L the plan pays 100% of covered services for the rest of the year.
- Plan N pays 100% of Part B coinsurance, except for a $20 copayment for office visits. Plan N also requires a $50 copayment for emergency room visits.
Medicare Supplement Plan J is also known as a Medigap plan. It was a popular choice due to the comprehensive benefits offered but is no longer available for those new to Medicare.
If a person purchased a policy before January 1, 2006, and prescription drugs were covered, they can keep the plan. No Medigap plans sold after this date are allowed to include coverage for prescribed medication.
If a person bought a policy after June 1, 2010, they can continue with the plan. If an individual purchased a high deductible Plan J, the deductible might still increase each year.
Other Medigap plans are available and a person can research the best option for their circumstance.
Private insurance companies sell Medigap policies and set the premiums. Costs and plans may vary from state to state.
We will update the 2021 costs as soon as possible after the Centers for Medicare and Medicaid Services (CMS) have released them.
We last updated the costs on this page on October 13, 2020.
The information on this website may assist you in making personal decisions about insurance, but it is not intended to provide advice regarding the purchase or use of any insurance or insurance products. Healthline Media does not transact the business of insurance in any manner and is not licensed as an insurance company or producer in any U.S. jurisdiction. Healthline Media does not recommend or endorse any third parties that may transact the business of insurance.