Are High-Deductible Medicare Supplement Insurance Plans Worth It?

Medicare Supplement Insurance, or Medigap, covers “gaps” in Original Medicare coverage, including certain copays, coinsurance and deductibles.

Some Medigap plans have a high-deductible option. High-deductible Medigap plans have lower premiums than the standard versions, but you have to pay the higher deductible for coverage to kick in.

When you spend enough to meet the deductible, the high-deductible version’s premiums would need to be more than $230 cheaper per month than the standard version for it to end up the better deal in 2024 — which might be unlikely.

But if you expect to have low health care costs most years, high-deductible plans can be a low-cost way to buy peace of mind. However, they’re not the only option — it’s also worth considering other plan types that could offer more benefits along with the peace of mind.

Here’s what you need to know about high-deductible Medigap Plan F and Plan G.

How do high-deductible Medigap plans work?

There are 10 types of standardized Medigap plans with letter names in most states. The benefits for each plan type are regulated by the government. Only two types have high-deductible versions: Plan F and Plan G. If you have a Medicare Advantage plan, you can’t also buy a Medigap plan.

The standard and high-deductible versions of these Medigap plans cover the same benefits; the difference is when that coverage kicks in. Standard plans cover their benefits from the start, but high-deductible plans start paying for covered services only after you meet the annual deductible.

What do high-deductible Medigap plans cost?

You’re responsible for two kinds of costs with a high-deductible Medigap plan — the premiums and the deductible. The deductible is set by law, and it’s the same for everyone: $2,800 in 2024. The Part B deductible and the cost-sharing you pay out of pocket apply toward the high deductible amount.

Premiums aren’t the same for everyone. The private health insurance companies that sell Medigap plans set their prices based on factors that can include your age, sex, location, tobacco use and health information, according to Medicare.gov.

Because high-deductible Medigap plans require you to meet the deductible before the plan pays for covered services, their premiums are lower than the standard versions. For example, in Atlanta, a 65-year-old nonsmoker could pay as little as $39 per month for high-deductible Plan G or $119 per month for standard Plan G.

The difference in premiums between standard and high-deductible versions can grow as you age. For example, the same Medicare beneficiary at age 85 might pay $56 per month for high-deductible Plan G or $181 per month for the standard version.

» MORE: Best Medicare Supplement Plan G companies

When is a high-deductible Medigap plan worth it?

A high-deductible Medigap plan could be worth it in one of two ways:

• If you generally spend enough on health care to meet the deductible, then the high-deductible plan would be worth it if the amount you spend to meet the deductible and the premiums are less expensive than the premiums of a standard insurance policy.

• If you generally don’t spend enough on health care to meet the deductible, a high-deductible plan wouldn’t pay for any services in most years, but you might still want to buy in for peace of mind.

If you’ll meet the deductible

If you’ll spend enough on coinsurance, copayments and deductibles to meet the Medigap deductible for a high-deductible Medigap plan, it’s worth comparing quotes to see which version is most cost-effective.

For the high-deductible version to cost less than the standard option, the lower premiums have to outweigh the added cost of meeting the deductible.

Benefits for high-deductible Medigap plans kick in after a deductible of $2,800 in 2024. Divided over 12 months, that’s $233.33 per month. A high-deductible plan would need to have premiums at least $233.33 per month less than the standard version for you to spend less on it overall, if you end up paying for the full deductible over the course of the year.

If you might not meet the deductible

If you’re not sure whether you’ll meet the deductible most years, a high-deductible Medigap plan may or may not be the best option. It depends on your tolerance for risk, your financial situation and the alternatives available to you.

In years when you don’t spend enough to meet the deductible, a high-deductible plan doesn’t pay for any services. You get no benefits in return for your premium payments, but you have the peace of mind knowing that you’re covered if you end up hitting the deductible in the future.

But high-deductible Plan G isn’t your only option to buy peace of mind. There might be other lower-cost plan types that would offer similar peace of mind while also paying for some of your health care in lower-cost years.

For example, Medigap Plan N covers most of the same benefits as Plan G and usually has lower premiums — although there are copays for certain office and emergency visits. And because there’s no deductible, you don’t need to try to predict whether you’ll have more high-cost or low-cost years — you’re always covered.

» MORE: Medigap Plan N vs. Plan G

Plan N would have higher premiums than high-deductible Plan G, but you might come out ahead even in lower-cost years because it would cover services that you’d have to pay for out of pocket with the high-deductible plan. And you still have the peace of mind knowing that you’re covered in high-cost years.

High-deductible Plan G could be an option to keep your premiums low, but it’s not the only option. If standard Plan G feels too pricey, it’s also worth comparing quotes for other lower-cost options such as Plan N, Plan K or Plan L to find the best balance of premiums and coverage.

» MORE: Best Medicare Supplement Insurance companies