First dollar coverage means your insurance pays from the very first bill without a prior deductible or copay. You pay your premium and covered claims are paid immediately — from the first dollar to the last.
Outside Medicare, this term appears in auto, home, business, and health insurance. Within Medicare, it most often refers to how certain Medigap (Medicare Supplement) plans handle deductibles and other out‑of‑pocket costs.
How It Works With Medigap
Some Medigap plans historically covered Medicare deductibles (true “first dollar” designs) — but availability has changed. Plans are standardized by letter, and you can compare them on our chart: Medigap Comparison Chart.
Plans That Used To Offer True First Dollar Coverage
- Plan F – Covered both Part A and Part B deductibles.
- Plan C – Also covered Part A and Part B deductibles.
- Plan J – Discontinued in 2010.
Eligibility rules: If you first became Medicare‑eligible on or after January 1, 2020, you can’t enroll in Plan F or Plan C. If you were eligible before 2020, you may still be able to apply where offered, and existing members can keep their plans. Learn more under Eligibility and Enrollment and the Medigap Open Enrollment Period.
Current Ways To Get “First Dollar” Help For Part A Costs
Several plans still cover the full Medicare Part A deductible (hospital coverage). These include: Plan B, Plan D, Plan G, and Plan N.
Partial Part A deductible coverage: Plan L (75%) and Plan M (50%).
All Medigap plans also cover some combination of other out‑of‑pocket costs like coinsurance, copayments, skilled nursing facility coinsurance, and more. See details in our Medigap Benefits overview.
Quick Benefits Comparison
Use this grid to see which lettered plans cover deductibles, coinsurance, foreign travel emergency care, and more.
Benefits offered by each Medigap plan
Compare the benefits of each lettered plan to help you find one that meets your needs now and in the future. You might not be able to switch Medigap policies later.
✔ = Plan covers 100% ✘ = Plan doesn’t cover % = Amount the plan covers
| Benefits | A | B | C | D | F | G | K | L | M | N |
|---|---|---|---|---|---|---|---|---|---|---|
| Part A coinsurance & hospital costs | ✔ | ✔ | ✔ | ✔ | ✔ | ✔ | ✔ | ✔ | ✔ | ✔ |
| Part B copays/coinsurance | ✔ | ✔ | ✔ | ✔ | ✔ | ✔ | 50% | 75% | ✔ | ✔ |
| Blood (first 3 pints) | ✔ | ✔ | ✔ | ✔ | ✔ | ✔ | 50% | 75% | ✔ | ✔ |
| Part A hospice | ✔ | ✔ | ✔ | ✔ | ✔ | ✔ | 50% | 75% | ✔ | ✔ |
| Skilled nursing facility | ✘ | ✘ | ✔ | ✔ | ✔ | ✔ | 50% | 75% | ✔ | ✔ |
| Part A deductible | ✘ | ✔ | ✔ | ✔ | ✔ | ✔ | 50% | 75% | 50% | ✔ |
| Part B deductible | ✘ | ✘ | ✔ | ✘ | ✔ | ✘ | ✘ | ✘ | ✘ | ✘ |
| Part B excess charges | ✘ | ✘ | ✔ | ✘ | ✔ | ✔ | ✘ | ✘ | ✘ | ✔ |
| Foreign travel emergency | ✘ | ✘ | 80% | 80% | 80% | ✘ | ✘ | ✘ | 80% | 80% |
| $7,220 | $3,610 | |||||||||
Why The Rules Changed
Medicare limited first dollar designs to manage overall program costs and reduce unnecessary utilization. When some out‑of‑pocket responsibility exists (like a deductible), people tend to use the emergency room less for non‑emergencies and choose lower‑cost, appropriate care settings.
Standardization, States, and Special Cases
Every Medigap policy follows federal and state rules and offers standardized benefits by letter. Note: Massachusetts, Minnesota, and Wisconsin standardize Medigap differently. Start at States to see what applies where you live.
Insurers don’t have to offer every plan, but if they sell Medigap at all, they must offer Plan A. Benefits like Part B excess charges, skilled nursing facility coinsurance, and foreign travel emergency care vary by plan.
High Deductible Options (Not First Dollar)
If you prefer a lower premium, consider high deductible designs such as High Deductible Plan G. These are the opposite of first dollar coverage — you’ll meet a higher deductible before the plan pays, but monthly premiums are typically lower. Legacy High Deductible Plan F details are here: High Deductible Plan F.
Next Steps
Questions? We’re happy to help – reach out via Contact.
Compare plans and rates: Check your options on Compare Plans and Compare Rates.
See what’s offered near you: Start with Find a Medigap Policy and browse your state page.