Medigap Supplement Plans Explained β€” Plain-English Guide | Medicare Self Enroll
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Medigap Β· Medicare Supplement Insurance

Understanding Medigap Supplement Plans

Plain English. Five calm steps. No pressure.

Original Medicare pays a lot, but not everything. Medigap is extra insurance from a private company that helps pay the gaps β€” like your 20% coinsurance and hospital deductible β€” so your costs are more predictable. When you buy it matters as much as which plan you pick.

Start Step 1

Free Β· Private Β· About a 12-minute read

Step 1 What It Is

Medigap = Medicare Supplement Insurance

How Medigap Works

Medicare pays its share of a covered bill first. Then your Medigap policy pays its share of what's left β€” depending on your plan letter. Many people with a Medigap plan see few or no bills for covered care.

Covers the 20%

Original Medicare's 20% coinsurance has no yearly cap. Most Medigap plans pay all or part of it.

Helps with hospital costs

Many plans pay the Part A hospital deductible and add 365 extra hospital days after Medicare's run out.

Any Medicare provider

No networks and no referrals. If a doctor or hospital accepts Medicare, your Medigap plan works there β€” anywhere in the U.S.

Guaranteed renewable

As long as you pay your premium, the company can't cancel your policy because of your health.

What Medigap does not cover: prescription drugs (you'll want a separate Part D plan), routine dental, vision and hearing care, and long-term care. Medigap also can't be used with a Medicare Advantage plan.

To buy a Medigap policy, you need:

  • Medicare Part A and Part B
  • To stay in Original Medicare (not Medicare Advantage)
  • Your own policy β€” spouses each buy separately
  • To keep paying your Part B premium

Step 2 The Plan Letters

Same Letter, Same Benefits

Understanding the Plan Letters

In most states, Medigap plans are standardized and named by letter. A Plan G from one company has exactly the same benefits as a Plan G from another β€” so once you choose a letter, you're comparing price and company service.

Plan G

Covers nearly all the gaps. You pay only the Part B deductible each year ($283 in 2026); after that, covered care is generally paid in full.

Most popular for new enrollees

Plan N

Similar to G, usually with a lower premium. You pay the Part B deductible, plus copays of up to $20 for some office visits and up to $50 for ER visits that don't lead to admission.

Lower premium, small copays

High-Deductible Plan G

The same benefits as Plan G after you pay a $3,050 deductible in 2027. Premiums are usually much lower.

Lowest premium, more risk

Plans K & L

Pay a share (50% or 75%) of many costs, with a yearly out-of-pocket limit: $8,360 for K and $4,180 for L in 2027.

Cost-sharing plans

The full chart (βœ“ = pays 100%):

Medigap benefits by plan letter
BenefitABDGKLMN
Part A coinsurance + 365 extra hospital daysβœ“βœ“βœ“βœ“βœ“βœ“βœ“βœ“
Part B coinsurance or copayβœ“βœ“βœ“βœ“50%75%βœ“βœ“*
Blood (first 3 pints)βœ“βœ“βœ“βœ“50%75%βœ“βœ“
Hospice coinsuranceβœ“βœ“βœ“βœ“50%75%βœ“βœ“
Skilled nursing coinsuranceβ€”β€”βœ“βœ“50%75%βœ“βœ“
Part A deductibleβ€”βœ“βœ“βœ“50%75%50%βœ“
Part B deductibleβ€”β€”β€”β€”β€”β€”β€”β€”
Part B excess chargesβ€”β€”β€”βœ“β€”β€”β€”β€”
Foreign travel emergencyβ€”β€”80%80%β€”β€”80%80%
Yearly out-of-pocket limit (2027)β€”β€”β€”β€”$8,360$4,180β€”β€”

* Plan N: you pay up to $20 for some office visits and up to $50 for ER visits that don't result in admission. Plans C and F also pay the Part B deductible, but they can only be bought by people who became eligible for Medicare before January 1, 2020. Massachusetts, Minnesota and Wisconsin standardize their plans differently. Source: Medicare.gov and CMS.

What are "excess charges"? Doctors who don't accept Medicare's approved amount as full payment can charge up to 15% more. Plan G pays this; Plan N doesn't. Some states don't allow excess charges at all.

Step 3 Costs & Pricing

Same Benefits, Different Prices

What Medigap Costs

You pay a monthly premium to the insurance company, on top of your Part B premium. Prices vary by company, plan letter, ZIP code, age, and sometimes tobacco use β€” so it pays to compare.

Three ways companies set prices:

Community-rated

Everyone pays the same premium regardless of age. Prices can still rise with inflation.

Age doesn't change price

Issue-age-rated

Your premium is based on your age when you buy. It won't go up just because you get older.

Buy younger, pay less

Attained-age-rated

Your premium is based on your current age, so it goes up as you get older β€” plus any inflation increases.

Often cheapest at first

Look past the first-year price. A low starting premium can climb quickly with age. Ask each company how it prices its policies and how its rates have changed in recent years.

Your full monthly picture: with Medigap, you'll usually pay three premiums β€” Part B, your Medigap plan, and a separate Part D drug plan. In return, your costs when you get care are low and predictable. See how this compares on our Medicare Advantage page.

Step 4 When to Buy

Your Medigap Open Enrollment Period

Your One-Time 6-Month Window

Your Medigap Open Enrollment Period starts the first month you're 65 or older and have Part B, and lasts 6 months. During it, a company can't turn you down or charge you more because of your health. It happens only once β€” and it can't be paused or restarted.

🟒 Guaranteed acceptance β€” no health questionsAfter this, most states allow health questions

After your window closes

In most states, companies can ask health questions and may charge more or decline to sell you a policy. That's why many people buy during their first window.

Health questions likely

Delaying Part B because you're working?

Your window waits until your Part B starts β€” so choose your Part B start date with Medigap in mind. Read the Part B guide β†’

Window starts with Part B

Guaranteed issue rights

In certain situations β€” like your Medicare Advantage plan leaving your area, or using your 12-month trial right β€” you can buy certain Medigap plans without health questions.

Special situations

Your state may give you more

Some states give extra protections. New York, for example, lets you buy Medigap at any time of year without health questions. Others offer yearly chances to switch.

Varies by state

Under 65 with Medicare? Federal law doesn't require companies to sell Medigap to people under 65, but many states do. Check with your State Health Insurance Assistance Program (SHIP).

Step 5 Compare & Enroll

When You're Ready β€” And Only Then

Choose a Plan & Enroll Yourself

Medigap is bought directly from a private insurance company, not through Social Security or Medicare. Here's how to choose with confidence.

  • Pick a plan letter first, based on the coverage you want
  • Compare premiums for that letter across companies
  • Ask how each company prices its policies
  • Check for household or other discounts
  • Line up a separate Part D drug plan too
  • Apply during your 6-month window if you can

Switching from another Medigap plan? Don't cancel your current policy until your new one is approved and in effect. You get a 30-day "free look" to decide whether to keep the new policy.

Choose your state to explore your options and enroll yourself:

Want to see every Medigap policy in your area? Use the Medigap search at Medicare.gov, call 1-800-MEDICARE (TTY 1-877-486-2048), or contact your State Insurance Department or SHIP for free, unbiased help.

Keep Learning

Part A & Part B

The Original Medicare that Medigap supplements. Part A guide β†’
Part B guide β†’

Part D

Medigap doesn't cover drugs β€” pair it with a drug plan. Part D guide β†’

Medicare Advantage

The other main path, and how the two compare. Medicare Advantage guide β†’

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Common Questions

Medigap Questions, Answered

What's the difference between Medigap and Medicare Advantage?

Medigap adds to Original Medicare and helps pay your share of costs, letting you see any provider that accepts Medicare. Medicare Advantage replaces Original Medicare with a private plan that usually uses networks. You can't have both at the same time.

Which Medigap plan is the most popular?

For people new to Medicare, Plan G is the most comprehensive plan available and is a common choice. Plan N is popular with people who prefer a lower premium and don't mind small copays. The right letter depends on your budget and how much cost-sharing you're comfortable with.

Does Medigap cover prescription drugs?

No. Medigap plans sold today don't include drug coverage. Most people with Medigap also join a separate Part D prescription drug plan.

When is the best time to buy Medigap?

During your 6-month Medigap Open Enrollment Period, which starts the first month you're 65 or older and have Part B. During this window, companies must sell you any Medigap policy they offer in your state, at the same price as people in good health.

Can I change Medigap plans later?

Yes, at any time β€” but outside of your Open Enrollment Period or a guaranteed issue situation, most states let companies ask health questions and decline or charge more. Some states, like New York, have more protective rules.

Can my spouse and I share one Medigap policy?

No. Each policy covers one person, so spouses buy separate policies. Some companies offer a household discount when both of you buy from them.

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We do not offer every plan available in your area. Currently we represent 1 organization which offers 1 product in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.

Medicare Self Enroll is operated by Advocate Health LLC. We are not affiliated with or endorsed by the federal Medicare program, the Centers for Medicare & Medicaid Services (CMS), the Social Security Administration, or any government agency. Medicare Supplement (Medigap) insurance is sold by private insurance companies and is not connected with or endorsed by the U.S. government or the federal Medicare program. Availability, eligibility and pricing vary by state and insurance company. Enrollment in Parts A and B is handled by the Social Security Administration or the Railroad Retirement Board. This page provides general educational information; it is not medical, legal, tax, or financial advice. Dollar amounts are 2027 figures published by CMS unless noted, and change each year. Premiums vary by company, plan, location and age. Not a complete description of benefits. The AI Avatar and AI Assistant are computer-generated, provide general educational information only, and can make mistakes β€” they are not a substitute for professional advice or official Medicare and Social Security materials.

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