Medicare Supplement (Medigap) Plans Explained
Original Medicare leaves gaps in coverage. A Medicare Supplement (Medigap) policy is private insurance that helps fill those gaps - giving you more predictable out-of-pocket costs.
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What Medigap Covers
Original Medicare (Parts A and B) covers a significant portion of medical costs, but it does not cover everything. You are still responsible for deductibles, coinsurance, and copayments. For hospital stays, Part A coinsurance can become substantial. For outpatient care, Part B typically covers 80% after the deductible - leaving you responsible for 20% with no cap.
Medigap policies help cover these out-of-pocket costs. The specific gaps they cover depend on the plan letter you choose.
Common Gaps Medigap Policies Help Cover
Part A coinsurance and hospital costs
Part A deductible (varies by plan letter)
Part B coinsurance (20% for covered services)
Part B excess charges (varies by plan letter)
Skilled nursing facility coinsurance
Foreign travel emergency care (varies by plan)
What each plan covers depends on the plan letter. Standardized benefits mean a Plan G from one carrier covers the same things as a Plan G from another carrier - but premiums vary.
Standardized Benefits: What This Means for You
Medigap policies sold in most states are standardized by the federal government. Each plan is identified by a letter - like Plan G or Plan N - and that letter defines what the plan covers. This standardization applies across all insurance companies offering that plan letter in your state.
What this means in practice: A Plan G sold by Carrier A covers the same Medicare gaps as a Plan G sold by Carrier B. The benefits are identical by design. The difference is the premium and the insurance company you are working with.
This standardization makes it easier to compare policies - but you still need to compare premiums, carrier reputation, and rate history in your specific area.
Plan G vs Plan N: A Brief Comparison
Plan G and Plan N are two commonly considered Medigap plan letters. Here is a general overview of how they differ. Availability and pricing vary by carrier and location.
Plan G
- •Covers Part A and Part B coinsurance
- •Covers Part A deductible
- •Covers skilled nursing facility coinsurance
- •Covers Part B excess charges
- •You pay only the Part B deductible (annually)
- •Generally higher premium than Plan N
Plan N
- •Covers Part A and Part B coinsurance (with some copays)
- •Covers Part A deductible
- •Covers skilled nursing facility coinsurance
- •Does not cover Part B excess charges
- •May have copays for office and emergency room visits
- •Generally lower premium than Plan G
Plan availability and pricing vary by carrier and location. Review plan details with a licensed agent before choosing.
All Medigap Plan Types at a Glance
Medicare Supplement plans are standardized by the federal government. Every plan letter covers the same benefits regardless of which insurance company sells it - only the premium and carrier differ. Use this chart to compare what each plan letter covers.
| Benefit | A | B | C | D | F | G | K | L | M | N |
|---|---|---|---|---|---|---|---|---|---|---|
| Part A hospital coinsurance & costs (up to 365 days after Medicare benefits used) | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ |
| Part A deductible | - | ✓ | ✓ | ✓ | ✓ | ✓ | 50% | 75% | 50% | ✓ |
| Part B coinsurance or copayment | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | 50% | 75% | ✓ | ✓ |
| Part B deductible | - | - | ✓ | - | ✓ | - | - | - | - | - |
| Part B excess charges | - | - | - | - | ✓ | ✓ | - | - | - | - |
| Skilled nursing facility coinsurance | - | - | ✓ | ✓ | ✓ | ✓ | 50% | 75% | ✓ | ✓ |
| Foreign travel emergency (up to plan limits) | - | - | 80% | 80% | 80% | 80% | - | - | 80% | 80% |
| Annual out-of-pocket limit | - | - | - | - | - | - | $7,220 | $3,610 | - | - |
† Plan N: Covers Part B coinsurance with copayments - up to $20 for office visits and up to $50 for emergency room visits if not admitted as an inpatient.
Plans C and F: Not available to Medicare beneficiaries who became eligible on or after January 1, 2020. If you were eligible before that date, you may still be able to purchase these plans.
Plans K and L have out-of-pocket limits that reset annually. After you reach the limit, the plan pays 100% of covered Medicare costs for the rest of the calendar year.
Benefits are standardized by CMS. Premium amounts, carrier availability, and plan letter offerings vary by state and insurance company. Always confirm current plan details with a licensed agent.
Underwriting and When You Apply Matters
When you can enroll in Medigap - and whether you need to answer health questions - depends on timing.
Medigap Open Enrollment
When you are both 65 or older and newly enrolled in Medicare Part B, you typically have a 6-month Medigap Open Enrollment Period. During this window, insurers generally cannot deny coverage based on health conditions or charge more due to pre-existing conditions. This is generally the most favorable time to purchase Medigap.
Outside Open Enrollment
Outside your open enrollment window, most states allow insurers to use medical underwriting. This means they may ask health questions, decline to offer coverage, or charge a higher premium based on your health history. Some states have additional protections - this varies by state.
The timing of when you apply for Medigap can significantly affect your options. Enrolling during your guaranteed-issue window - if you qualify for one - is generally advisable.
Medigap Does Not Include Prescription Coverage
Medigap policies work alongside Original Medicare (Parts A and B). They do not include prescription drug coverage. If you choose this path - Original Medicare plus Medigap - you will generally need to add a standalone Medicare Part D plan to cover prescription drugs.
Enrolling in a Part D plan when you are first eligible helps avoid the Part D late enrollment penalty. Even if you take few medications now, having creditable drug coverage protects you from future penalties. Learn more about Part D.
Questions About Medigap?
A licensed agent can walk you through which plan letters are available in your area, current pricing, and how Medigap fits into your overall Medicare picture.
Benefits vary by plan, county, and eligibility.
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