F, G & J Deductible Announcements
Guidance for deductible amount for Medigap High Deductible Options F, G & J for Calendar Year 2020.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: February 11, 2020
October 2024 Announcement
Deductible Amount for Medigap High Deductible Options F, G & J for Calendar Year 2025
Summary:
Medicare supplemental (Medigap) Plans F and G can be sold with a high deductible option. Before June 1, 2010, Medigap Plan J could also be sold with a high deductible. The high deductible version of Plan F is only available to those who are not new to Medicare before 1/1/2020. High deductible Plan G is available to individuals who are new to Medicare on or after 1/1/2020. People new to Medicare are those who turn 65 on or after January 1, 2020, and those who first become eligible for Medicare benefits due to age, disability or ESRD on or after January 1, 2020.
Effective January 1, 2025, the annual deductible amount for these three plans is $2,870. The deductible amount for the high deductible version of plans G, F and J represents the annual out-of-pocket expenses (excluding premiums) that a beneficiary must pay before these policies begin paying benefits. CMS updates the deductible amount for plans G, F and J each year, after release of the August Consumer Price Index for all Urban Consumers (CPI-U) figures by the Bureau of Labor Statistics, which generally occurs in mid-September.
Calculation of the Deductible:
The deductible for plans F, G and J is determined in accordance with section 1882(p)(11)(C)(i) of the Social Security Act. This provision prescribed a deductible of $1,500 for 1998 and 1999 and directed that the amount increase each subsequent year by the percent increase in the CPI-U, all items, US city average. The increase in the applicable CPI-U from 2024 to 2025 is 2.53%, which results in a deductible of $2,870 after rounding to the nearest $10 in accordance with section 1882(p)(11)(C)(ii) of the Social Security Act.
For Further Information:
Contact: Martha Wagley at 410-786-3778 for actuarial issues or Derrick Claggett at (410) 786-2113 for policy related issues.
If you need help regarding enrollment in a Medigap plan please contact your local State Health Insurance Assistance Program (SHIP). Find your local SHIP on Medicare.gov at https://www.medicare.gov/talk-to- someone. You can find Medigap plans available in your area on Medicare.gov at http://www.medicare.gov/medigap-supplemental-insurance-plans/.
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DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.