by Russell Noga | Updated Aug 17, 2023
All American seniors can register for Medicare when they turn 65. You get Medicare Part A as part of your Social Security benefits and automatic enrollment into the plan.
Part A covers hospital care, and Part B covers medical care. Part B has optional enrollment, and you can choose to delay purchasing your Part B policy if you have existing healthcare with your employer.
Original Medicare Parts A & B cover 80% of the expenses involved with healthcare services. The beneficiary must settle the remaining out-of-pocket costs.
As a result, seniors can incur hefty healthcare costs, even though they have financial assistance from Medicare.
Medicare Part A & B beneficiaries can take a Medicare supplement plan (Medigap policy) to cover the remaining out-of-pocket costs.
These plans partially or fully cover the rest of their medical expenses associated with Original Medicare Parts A & B.
What Is Medicare Supplement Plan J?
Medicare Supplement Plan J is one of the last old-generation Medigap plans still used by Medicare beneficiaries for their supplemental policy.
However, very few providers carry this plan anymore, and you’ll struggle to find it amongst any healthcare insurers Medigap range.
Plan J was popular due to its comprehensive coverage. It was part of the range of Medigap plans offering coverage for the Part B deductible, which is no longer acceptable under modern Medigap standards after the introduction of the 2015 MACRA Act.
What Does Medicare Supplement Plan J Cover?
Medigap Plan J was the only really true Medicare supplement plan offering “first dollar coverage” for all your healthcare needs. This plan included the Part B deductible and provided coverage for prescription medications and preventative care.
Today, no Medigap plan in 2024 covers prescription drugs; you need Part D for those benefits. No plan offers preventative care coverage for physiotherapy, chiropractic, and similar services.
Plan J was truly one of the best offerings, and it’s sad to see it go from the Medigap range.
Here’s a list of benefits available to Plan J policyholders.
- Part A coinsurance and hospital costs for up to 365 days after using up Medicare benefits.
- Part A hospice care coinsurance or copayment.
- Part B coinsurance or copayment.
- Blood transfusion costs for the first three pints of blood.
- Part A deductible.
- Part B deductible.
- Part B excess charges.
- Skilled nursing facility care coinsurance.
- Preventive care.
- Prescription drug benefits.
- 80% of emergency healthcare costs when traveling outside the US for 60 days. ($250 deductible and $50,000 maximum apply).
- Unlimited coverage for all out-of-pocket costs.
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What Isn’t Covered by Medicare Supplement Plan J?
Plan J covered practically everything with Medicare Part A & B services and some extra benefits as well.
The plan’s inclusion of drug coverage was a huge benefit to beneficiaries.
Today you need a Part D Medicare policy for those benefits.
What are the Average Monthly Premiums for Medicare Supplement Plan J?
Plan J is still available to seniors previously enrolled in the policy. At the last update, the monthly cost of Plan J premiums averaged $237 across all providers and states.
The annual Part A deductible for Plan J is $2,700 in 2023, which is similar to the high-deductible versions of Plan F & G.
Plan J came with optional drug coverage for policyholders. Those beneficiaries who had this benefit included in their plan would pay an annual deductible of $250.
However, Plan J is no longer available to new Medicare beneficiaries, so no provider will quote you on this plan.
Is Medicare Supplement Plan J Available in Massachusetts, Minnesota, or Wisconsin?
Since Plan J is no longer part of the modern Medigap range, it’s unavailable in Minnesota, Massachusetts, or Wisconsin.
These states have different ways of standardizing their Medigap offering.
You can take a Basic plan, Basic with riders, Extended Basic, and Medigap plans F, K, L, M, and N.
How Do You Enroll in Medicare Supplement Plan J?
You can’t enroll in Medigap Plan J due to it being discontinued from the Medigap range. The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 stopped the availability of this Medigap plan in 2010.
However, those seniors enrolled in the plan at the cut-off date had the option of maintaining their benefits, provided they continued paying their monthly premiums.
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What are the Best Alternatives to Medicare Supplement Plan J?
The next best alternative to Plan J was Plan F. Medigap Plan F is the most comprehensive of the modern Medigap range, offering coverage for the Part B deductible.
However, the “first dollar coverage” provided by Plan F means its subject to phasing out due to the introduction of the MACRA Act in 2015.
However, if you were eligible for Medicare before the January 1, 2020, cut-off date, you can still apply for a Plan F policy. Many carriers still offer Plan F and high-deductible Plan F in their range.
Call us for advice on joining a Plan F policy if you were eligible for Medicare before January 1, 2020.
New Medicare beneficiaries get the most comprehensive offering from Plan G.
Plan G has the same benefits as Plan F but doesn’t cover the Part B deductible. However, the monthly premiums on Plan G are more affordable than Plan F.
As a result, you can usually account for the cost of the Part B deductible with the annual savings you make on a Plan G policy over Plan F.
Plan G is also available in a “high-deductible” version. The HD plan G has the same benefits as the standard version of the plan.
However, your annual Part A deductible increases from $1,600 to $2,700. In return, you get a 75% to 80% saving on your monthly premiums with the HD plan.
Call Us to Learn More About Medicare Supplement Plan J
For more information on Medicare supplement Plan J, contact our team at 1-888-891-0229.
Our knowledgeable, fully licensed Medigap agents offer free consultations and quotes on all Medigap policies.
If you can’t contact us right now, leave your details on the webform on this site, and we’ll get a Medigap professional to connect with you. Or use the tool on this site to get a free automated quote on any Medicare supplement plan.
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Frequently Asked Questions
What is Medicare Supplement Plan J?
Medicare Supplement Plan J, also known as Medigap Plan J, was a Medicare supplement insurance plan that offered additional coverage beyond what Original Medicare provided. However, as of June 1, 2010, Plan J is no longer available to new enrollees.
What coverage did Medicare Supplement Plan J provide?
Medicare Supplement Plan J offered comprehensive coverage, including coverage for Medicare Part A and Part B deductibles, coinsurance, and copayments. It also provided coverage for skilled nursing facility care coinsurance, foreign travel emergency care, and preventive care.
Why is Medicare Supplement Plan J no longer available?
In 2010, the Centers for Medicare and Medicaid Services (CMS) made changes to standardized Medigap plans. These changes eliminated several plans, including Plan J, to simplify the options available to beneficiaries and ensure consistency across plans.
Can existing Plan J policyholders keep their coverage?
Yes, if you already have a Medicare Supplement Plan J, you can keep your coverage. Your plan is considered “grandfathered” and remains valid. You can continue to receive the benefits outlined in your policy.
What are the alternatives to Medicare Supplement Plan J?
Since Plan J is no longer available to new enrollees, individuals seeking Medicare supplement coverage have other options to choose from. Plan G and Plan F are popular alternatives that provide comprehensive coverage similar to Plan J.
Are there any significant differences between Plan J and its alternatives?
While Plan G and Plan F offer similar coverage to Plan J, there may be slight variations in benefits. For example, Plan G does not cover the Medicare Part B deductible, while Plan F covers both the Part A and Part B deductibles.
Can I switch from Plan J to a different Medicare supplement plan?
Yes, you can switch from Plan J to another Medicare supplement plan. However, if you choose to change plans, you may be subject to medical underwriting, which means the insurance company can consider your health status when determining your eligibility and premium rates.
Is it recommended to switch from Plan J to an alternative plan?
The decision to switch from Plan J to another plan depends on your individual needs and circumstances. It’s advisable to review your current coverage, compare the benefits and costs of alternative plans, and consult with a Medicare specialist or insurance agent to determine the best course of action.
Are there any other changes in Medicare supplement plans I should be aware of?
Apart from eliminating Plan J, there have been other changes to Medicare supplement plans in recent years. Plans C and F, for instance, no longer cover the Part B deductible for new enrollees starting January 1, 2020. It’s important to stay updated on any changes and evaluate your options accordingly.
Where can I get more information about Medicare supplement plans?
You can find more information about Medicare supplement plans, including available options in your area, by visiting the official Medicare website (medicare.gov) or contacting your State Health Insurance Assistance Program (SHIP). Additionally, insurance agents specializing in Medicare can provide guidance and answer specific questions about Medicare supplement plans.
