A Guide to Comparing Medigap Plans in Texas

Table of Contents

When it comes to your health care, timing is everything. This is especially true when you’re enrolling in Medicare. There is a specific, one-time, six-month window when you can sign up for any Medigap policy you want, with no health questions asked. This is your Medigap Open Enrollment Period, and it’s the golden ticket to getting the best coverage at the best price, guaranteed. If you miss this window, it can become much harder and more expensive to get a plan later. This guide explains these critical timelines in plain English, ensuring you have the knowledge to act at the right moment and secure one of the best Medigap plans in Texas.

Key Takeaways

Prioritize Your Open Enrollment Window: Your 6-month Medigap Open Enrollment Period is a one-time opportunity to buy any plan without facing medical questions. Missing this window means insurers can use your health history to charge you more or deny coverage, so timing your application is critical.
Compare Prices, Not Benefits: All Medigap plans of the same letter (like Plan G) offer identical, government-standardized benefits. This allows you to choose the coverage level you need first, then shop around to find the most competitive monthly premium from a reputable insurance company.
Remember to Cover Prescriptions Separately: Medigap plans are designed to fill the gaps in Original Medicare Parts A and B, but they do not include prescription drug coverage. You will need to enroll in a separate Medicare Part D plan to help pay for your medications.

What is a Medigap Plan?

If you’ve ever felt surprised by a medical bill, you know how stressful unpredictable health care costs can be. That’s where Medicare Supplement Insurance, often called Medigap, comes in. Think of it as a safety net for your Original Medicare coverage. A Medigap plan is extra insurance you can buy from a private company to help pay for some of the out-of-pocket costs that Original Medicare (Part A and Part B) doesn’t cover. These plans are designed to make your health care expenses more predictable by covering expenses like deductibles, copayments, and coinsurance.

How Medigap Supplements Original Medicare

It’s important to understand that a Medigap plan works with your Original Medicare, not as a replacement for it. You must be enrolled in both Medicare Part A and Part B to buy a Medigap policy. When you receive medical care, Medicare first pays its share of the approved amount, and then your Medigap plan steps in to pay its portion. This partnership helps reduce what you owe out of pocket. One key point to remember is that Medigap policies do not work with Medicare Advantage plans. You can have one or the other, but not both at the same time.

Filling the Gaps in Your Medicare Coverage

The term “Medigap” is quite literal—these plans are designed to fill the financial “gaps” in Original Medicare. While Medicare Part A and Part B provide great foundational coverage, they leave you responsible for certain costs. Medigap plans help pay for these remaining expenses, which can include your Part A hospital deductible or the 20% coinsurance for Part B services. For Texans who became eligible for Medicare after January 1, 2020, the most popular Medigap plans are Plan G and Plan N. These plans offer comprehensive coverage that helps many people feel more financially secure about their health care.

Which Medigap Plans Can You Get in Texas?

If you live in Texas, you have access to all ten standardized Medicare Supplement plans, also known as Medigap. This is great news because it gives you a wide range of options to find coverage that fits your specific needs and budget. The plans are labeled A, B, C, D, F, G, K, L, M, and N. While having so many choices is a plus, it can also feel a bit overwhelming.

The key thing to remember is that these plans are designed to fill the “gaps” in Original Medicare, like deductibles, coinsurance, and copayments. Each lettered plan offers a different combination of benefits. Think of it like choosing a trim level for a car—some have more features than others. While all ten plans are available, most people find that a few specific plans offer the best value and coverage. We’ll walk through which plans are the most popular in Texas and why, so you can feel more confident as you start to compare your options.

A Quick Look at Every Texas Medigap Plan

One of the best features of Medigap is standardization. This means that a Plan G from one insurance company provides the exact same medical benefits as a Plan G from any other company. The only differences will be the monthly premium you pay and the company’s customer service reputation. This rule makes it much easier to compare plans apples-to-apples. You don’t have to worry about hidden clauses or different coverage levels between carriers for the same lettered plan. Your main job is to first decide which plan letter (like G or N) has the benefits you need, and then find the most competitively priced policy from a reliable company.

The Most Popular Medigap Plans in Texas

You’ll hear a lot about three plans in particular: Plan F, Plan G, and Plan N. These are by far the most popular choices among Texans. For anyone new to Medicare, Plan G is often the top contender. It’s the most comprehensive option available, covering nearly all of your out-of-pocket costs under Original Medicare. The only thing it doesn’t cover is the annual Medicare Part B deductible. Plan N is another excellent choice if you’re looking for a lower monthly premium and don’t mind paying small copays for some doctor visits and emergency room trips. We have a detailed Texas Medigap guide that explores these popular plans more deeply.

Who Can Still Enroll in Plan C and Plan F?

You might have heard that Plan F is the “cadillac” of all Medigap plans because it covers everything, including the Part B deductible. While that’s true, a federal law changed who can buy it. Plans C and F are now only available to individuals who were eligible for Medicare before January 1, 2020. If you became eligible for Medicare on or after that date, you won’t be able to purchase Plan C or F. For this reason, Plan G has become the new go-to plan for comprehensive coverage for new Medicare beneficiaries. It offers the same robust benefits as Plan F, with the single exception of the Part B deductible.

How Do Medigap Plans Differ?

While all Medigap plans are designed to fill the gaps in Original Medicare, they don’t all offer the same level of coverage. The primary difference between the standardized plans comes down to which out-of-pocket costs they cover and how much you’ll pay in monthly premiums. Some plans cover nearly everything, leaving you with very predictable medical bills. Others have lower monthly premiums but require you to share some of the costs, like paying small copayments for doctor visits.

Think of it as a trade-off: would you rather pay a higher premium each month for more comprehensive coverage, or a lower premium for a plan that requires you to pay for some services as you use them? Understanding these key differences will help you find a plan that fits both your healthcare needs and your budget. Let’s look at some of the most popular options side-by-side to see how they work.

Comparing Plan G vs. Plan N

Two of the most popular choices for new Medicare members are Plan G and Plan N. They both offer robust coverage but have a few important distinctions that can make one a better fit for you than the other.

Plan G is often considered the most comprehensive option available to anyone new to Medicare. It covers almost all of your out-of-pocket costs, including your Part A deductible and all coinsurance. The only thing it doesn’t cover is the annual Medicare Part B deductible. Once you meet that deductible yourself, Plan G picks up the rest of the Medicare-approved costs for the year. This makes it a great choice if you value predictability and want to minimize surprise medical bills.

Plan N is an excellent alternative if you’re looking for a lower monthly premium and don’t mind some cost-sharing. Like Plan G, you’ll still pay the annual Part B deductible. After that, Plan N requires you to pay a small copayment for some doctor visits (up to $20) and emergency room visits (up to $50). It also doesn’t cover Part B excess charges, which are extra fees that some doctors can charge. For many people, the monthly savings on Plan N are well worth these potential out-of-pocket costs.

Understanding High-Deductible Plans

For those who are generally healthy and want the lowest possible monthly premium, a high-deductible plan might be a good fit. Both Plan G and Plan F are available in high-deductible versions. With these plans, you pay a much lower premium, but you must first pay a significant annual deductible out-of-pocket before the plan begins to cover your costs.

For 2024, the deductible for the High-Deductible Plan G is $2,800. This means you are responsible for the first $2,800 of your Medicare-approved medical expenses for the year. After you’ve met that deductible, the plan functions just like a standard Plan G, covering 100% of your remaining costs. This option can be a smart financial choice if you’re comfortable covering the deductible in the event of an unexpected health issue.

What Each Medigap Plan Covers

The most important thing to remember when comparing Medigap plans is that they are standardized by the federal government. This means that a Plan G from one insurance company offers the exact same basic benefits as a Plan G from any other company. The same is true for Plan N and all other lettered plans. This standardization makes your job much easier because you don’t have to worry about differences in coverage from one carrier to the next.

All Medigap plans are designed to help pay for the costs that Original Medicare (Part A and Part B) leaves behind. These “gaps” include expenses like deductibles, coinsurance, and copayments. When you’re shopping for a plan, you’re not comparing benefits—you’re comparing the monthly premium and the reputation of the insurance company offering the plan.

When Should You Enroll in a Texas Medigap Plan?

When it comes to Medigap, timing is everything. Choosing the right moment to enroll is just as important as choosing the right plan, and honestly, it’s one of the areas that trips people up the most. Your age and specific life events, like retiring from a job, create specific windows of opportunity to sign up. Missing these windows can make it much harder—and more expensive—to get the coverage you want later on. The key is to understand your personal enrollment periods before they begin so you can act at the right time.

This knowledge gives you the power to get the best plan at the best price, without any hassle. Think of these periods as a protected time when the rules are in your favor, and insurance companies have to offer you a policy regardless of your health history. It might seem complicated at first, with different names for different enrollment windows, but it all boils down to a few key timelines. Once you know when your personal windows open and close, the whole process becomes much clearer and far less stressful. Let’s walk through the most important enrollment periods you need to know about so you can feel confident in your decision and avoid any costly mistakes.

Your One-Time Medigap Open Enrollment Window

Your Medigap Open Enrollment Period is the absolute best time to buy a policy. This is a six-month window that starts on the first day of the month you are both 65 or older and enrolled in Medicare Part B. During this one-time period, you have the right to buy any Medigap plan sold in Texas. An insurance company cannot use medical underwriting to make decisions. This means they can’t refuse to sell you a policy, charge you more, or make you wait for coverage to begin, even if you have pre-existing health conditions. It’s a golden opportunity to get the coverage you want, guaranteed.

What Are Guaranteed Issue Rights?

If you miss your Open Enrollment Period, you might get another chance to enroll in a Medigap plan through what are called “guaranteed issue rights.” These rights apply in specific situations, such as if you lose your employer health coverage after turning 65 or if you have a Medicare Advantage plan that is leaving your service area. When you have guaranteed issue rights, insurance companies must sell you a Medigap policy without considering your health history. However, your plan choices may be more limited than during your Open Enrollment Period. These rights are designed to protect you from losing coverage due to circumstances outside of your control.

What Happens if You Miss Your Enrollment Window?

If you apply for a Medigap plan outside of your Open Enrollment Period and don’t have guaranteed issue rights, the rules change. Insurance companies can require you to go through medical underwriting. This means they will review your medical history and can ask you detailed health questions. Based on their review, they have the right to deny you coverage altogether or charge you a significantly higher monthly premium for the same plan. This is why planning ahead and enrolling during your initial six-month window is so critical. It’s the simplest and most effective way to secure your Texas Medigap plan without worrying about your health history affecting your eligibility or your rates.

How Are Medigap Premiums Calculated in Texas?

When you start shopping for a Medigap plan in Texas, you’ll quickly notice that the monthly premiums for the exact same plan can vary quite a bit from one insurance company to another. A Plan G from one carrier might have a different price tag than a Plan G from a competitor, even though the benefits are standardized by the government. This is because each company has its own way of calculating what you’ll pay.

Understanding how these premiums are set is key to finding a plan that not only fits your health needs but also your long-term budget. It’s not just about finding the cheapest plan today; it’s about understanding how that cost might change in the future. Several factors come into play, from the pricing method the insurer uses to your personal details like age and where you live. Let’s break down what goes into that monthly premium so you can make a more informed choice.

How Insurance Companies Set Your Rates

Insurance companies in Texas generally use one of three methods to price their Medigap policies. The method they choose directly impacts how your premium may change over the years.

Attained-Age Rated: Your premium is based on your current age and will increase as you get older. These plans often start with lower premiums but can become more expensive over time.
Issue-Age Rated: Your premium is based on your age when you first buy the policy. It won’t go up simply because you have a birthday, but it can still increase due to inflation and other factors.
Community-Rated: Everyone with the same policy pays the same monthly premium, regardless of their age.

Knowing which pricing method an insurer uses is crucial for planning your future healthcare expenses.

What Determines Your Monthly Premium?

Beyond the company’s pricing method, several personal factors will influence your final monthly premium. When you apply for a plan, insurers will look at your specific situation to determine your rate. Key factors include your location, as rates can differ by ZIP code, and your age at the time of enrollment.

Your gender and whether you use tobacco can also affect the cost. Most companies offer a lower rate for non-smokers. All these elements are combined to calculate the premium you’ll pay. This is why two people living in different Texas cities could see very different prices for the same Medigap plan. It highlights the importance of getting personalized quotes for your specific circumstances.

Example Medigap Premiums in Texas

To give you a real-world idea of how much prices can differ, let’s look at some sample monthly premiums. These examples are for a 65-year-old, non-smoking female living in Dallas.

For Medigap Plan G, you might see prices like:

AARP/UnitedHealthcare: $136
Mutual of Omaha: $152
State Farm: $160

For Medigap Plan N, the range could look like this:

AARP/UnitedHealthcare: $98
State Farm: $112
Mutual of Omaha: $115

As you can see, shopping around is essential. The best Medicare Supplement plans aren’t just about coverage; they’re also about finding a price that works for you.

How to Choose the Right Medigap Plan for You

Picking the right Medigap plan feels like a big decision, but it doesn’t have to be overwhelming. By breaking it down and looking at your personal situation, you can find a plan that fits your needs and gives you peace of mind. It really comes down to three things: your health, your budget, and understanding some common misconceptions.

Assess Your Health and Medical Needs

First, take a moment to think about your health. Are you generally healthy, or do you have chronic conditions that require frequent doctor visits? Medigap plans are designed to help pay for the costs that Original Medicare doesn’t cover, like deductibles, coinsurance, and copayments. If you anticipate needing more medical care, a more comprehensive plan might save you money in the long run by covering these out-of-pocket expenses.

For most people new to Medicare, the most popular choices are Plan G and Plan N. Plan G offers very broad coverage, second only to Plan F, which is no longer available if you became eligible for Medicare after January 1, 2020. Thinking honestly about your current and potential future health needs is the best first step in narrowing down your options.

Consider Your Monthly Budget

Next, let’s talk about your budget. The monthly premium is the amount you’ll pay to keep your plan active, and it’s important to find one that you’re comfortable with. What’s interesting is that prices for the exact same Medigap plan can vary quite a bit between different insurance companies. This is why it’s so important to compare your options.

For example, for a 65-year-old female nonsmoker in Dallas, a Plan G premium could range from about $105 to $152 per month. That difference adds up over a year. When you compare prices, you’re making sure you don’t overpay for the same coverage you could get for less elsewhere. Remember to balance the monthly premium against the potential out-of-pocket costs you might face with a less comprehensive plan.

Common Myths About Choosing a Plan

Finally, let’s clear up a few common myths that can cause confusion. First, not everyone with Medicare needs a Medigap plan. If you already have health coverage from a current or former employer, a Medicare Advantage plan, or Medicaid, you likely don’t need to purchase a Medigap policy. These plans work differently and can’t be combined with Medigap.

Another point of confusion is around Plan F. While you may hear people talk about it, if you became eligible for Medicare on or after January 1, 2020, you cannot buy it. For new enrollees, Plan G is now the most comprehensive option available and covers nearly everything Plan F did. Understanding these key facts can help you focus on the plans that are actually available to you and prevent you from spending time on options that aren’t a fit.

What Isn’t Covered by Medigap?

Medigap plans do an excellent job of covering the out-of-pocket costs that come with Original Medicare, like deductibles and coinsurance. It’s easy to assume that once you have a Medigap plan, you’re covered for everything. However, it’s just as important to understand what these plans don’t cover to avoid unexpected medical bills down the road.

Think of Medigap as a partner to Original Medicare (Part A and Part B). The rule of thumb is simple: if Medicare doesn’t cover a service in the first place, your Medigap plan won’t cover it either. These plans are designed to fill the “gaps” in Medicare’s coverage, not to add new benefits. The primary exceptions are some plans that offer foreign travel emergency care, which is a benefit Original Medicare doesn’t provide. But for most domestic healthcare services, the coverage follows Medicare’s lead.

This means that several major categories of healthcare fall outside of what Medigap can help with. Generally, Medigap plans are not designed to pay for services like prescription drugs, long-term care, or routine dental and vision appointments. Understanding these limitations is key to building a complete health coverage strategy that truly protects your health and your savings. Let’s walk through the major services that fall outside of Medigap coverage so you can plan accordingly.

Why You Still Need a Part D Plan

This is one of the most common points of confusion, so let’s clear it up: Medigap plans sold today do not cover prescription drugs. While some older plans sold before 2006 did offer this benefit, those are no longer available to new Medicare enrollees. To get help paying for your medications, you will need to enroll in a separate Medicare Part D plan. These standalone plans are offered by private insurance companies and are designed specifically to cover the costs of prescription medications. Think of it as the final piece of the puzzle alongside Original Medicare and your Medigap plan.

Does Medigap Cover Long-Term Care?

Another major area that Medigap does not cover is long-term care. This refers to custodial care services that help with daily activities like bathing, dressing, and eating, whether at home or in a facility like a nursing home. Original Medicare also doesn’t cover most long-term care, so a Medigap plan won’t have any costs to supplement. It’s important to plan for these potential expenses separately, as they can be significant. Medigap is there for your medical needs, but not for the day-to-day assistance that defines long-term care.

Getting Coverage for Vision and Dental

If you need a routine eye exam, a new pair of glasses, or a dental cleaning, you’ll have to look beyond your Medigap plan. Just like Original Medicare, Medigap doesn’t cover routine dental, vision, or hearing care. This also includes items like dentures and hearing aids. While Medicare might cover a procedure if it’s deemed medically necessary (like cataract surgery), it won’t pay for the day-to-day upkeep. Many people choose to buy separate, standalone dental and vision plans to fill this gap and manage the costs of keeping their teeth and eyes healthy.

How to Compare Medigap Plans and Companies

Once you have an idea of which Medigap plan letter (like G or N) fits your needs, your next step is to choose an insurance company to buy it from. This is a key part of the process because while the plans are standardized by the government, the companies are not. A Plan G from one carrier offers the exact same medical benefits as a Plan G from another, but the price, rate stability, and customer service can be worlds apart. To make a smart choice, you’ll want to look at a few key factors: the monthly premium, the company’s reputation, and how the plan preserves your freedom to choose your healthcare providers.

Compare Premiums from Different Carriers

The single biggest difference between insurance companies offering the same Medigap plan is the price. You might find that one company charges significantly more than another for the identical Plan G coverage. Because the benefits are set by law, you aren’t getting anything extra for that higher price. This is why it’s so important to shop around. You should compare prices from several different carriers before making a decision. Getting multiple quotes allows you to see the full range of what’s available and ensures you’re not overpaying for your coverage. Think of it like buying a car—you wouldn’t just accept the first offer you see.

Check an Insurance Company’s Reputation

A low premium is appealing, but it’s not the only thing that matters. You also want an insurance company that is stable, reliable, and easy to work with. Before you sign up, take a moment to look into the company’s reputation. How long have they been in business? Do they have a history of large, unpredictable rate increases? You can check a company’s complaint history and verify that they are licensed to operate in Texas. The Texas Department of Insurance is a great resource for this. Working with an experienced agent can also give you valuable insight into which companies have a strong track record for customer satisfaction and fair pricing over the long term.

Keep Your Freedom to Choose Your Doctors

One of the best features of Medigap is the freedom it gives you. With a Medigap plan, you can see any doctor or go to any hospital in the United States, as long as they accept Original Medicare. You don’t have to worry about staying within a specific network, and you never need a referral to see a specialist. Your Medigap plan simply works alongside your Original Medicare benefits. When you receive medical care, Medicare pays its share first, and then your Medigap plan pays its portion of the bill. This straightforward process gives you the flexibility to choose your own doctors and get care wherever you are, providing peace of mind.

How to Apply for a Medigap Plan in Texas

Once you’ve compared your options and have a plan in mind, the application process is fairly straightforward. Getting your application ready doesn’t have to be a headache, especially when you know what to expect. The key is understanding what you’ll need, when you’ll need to provide it, and how your timing affects the entire process. Let’s walk through the three main steps so you can feel confident when you’re ready to apply.

What Paperwork Will You Need?

Before you can apply for any Medigap plan in Texas, you first need to be enrolled in Original Medicare. This means you must have both Medicare Part A (hospital insurance) and Part B (medical insurance). Your red, white, and blue Medicare card is the main piece of paperwork you’ll need, as it contains your Medicare number and the dates your Part A and B coverage started. Think of it as your ticket to apply. If you’re under 65 and qualify for Medicare due to a disability, you may also be eligible to purchase a Medigap plan. The most important first step is ensuring your Original Medicare coverage is active.

Will You Have to Answer Health Questions?

The short answer is: it depends entirely on when you apply. If you apply during your 6-month Medigap Open Enrollment Period, insurance companies in Texas cannot use your health history against you. They are required to sell you any plan they offer at the standard price, regardless of any pre-existing conditions. This is a critical protection called “guaranteed issue rights.”

However, if you miss this window, the rules change. Insurance companies can then ask you detailed health questions and perform medical underwriting. Based on your answers, they could charge you a higher premium or even deny your application altogether. This is why timing your application is so important for your Texas Medigap options.

Your Application Timeline and Next Steps

Timing is everything when it comes to Medigap. Your best opportunity to enroll is during your one-time, 6-month Medigap Open Enrollment Period. This window automatically begins on the first day of the month you are both 65 or older and enrolled in Medicare Part B. Applying during this period guarantees your acceptance into any plan you choose.

If you miss this initial window, you may have other opportunities to apply, but they are not guaranteed. The next step is to mark your calendar with your personal enrollment dates. Once you know your window, you can focus on choosing the right plan and company without the pressure of a looming health screening.

Medigap vs. Medicare Advantage: Which is Right for You?

One of the biggest decisions you’ll make when you enroll in Medicare is choosing between a Medigap plan and a Medicare Advantage plan. Think of it as two different paths you can take to round out your health coverage. Both have their own set of rules, costs, and benefits, and the right choice really comes down to your personal health needs, budget, and how you prefer to get your medical care.

It’s important to know that these two types of plans are mutually exclusive. You can’t have both a Medigap policy and a Medicare Advantage plan at the same time. Medigap plans are designed to work alongside Original Medicare (Part A and Part B), while Medicare Advantage plans (also called Part C) are an alternative way to receive your Medicare benefits through a private insurance company. Understanding this core difference is the first step in figuring out which path is the best fit for you.

How Their Coverage Differs

The main difference lies in how each plan works with your basic Medicare benefits. A Medigap plan is a supplement. It works with your Original Medicare coverage, not in place of it. When you visit a doctor or hospital, Medicare pays its approved amount first for a covered service. Then, your Medigap plan steps in to pay its share, which typically includes things like deductibles, copayments, and coinsurance. This partnership helps cover the out-of-pocket costs that Original Medicare leaves behind.

On the other hand, a Medicare Advantage plan replaces your Original Medicare. You’re still in the Medicare program, but a private insurance company manages your benefits. These plans must cover everything Original Medicare does, and they often include extra perks like prescription drug, dental, or vision coverage. The Texas Department of Insurance makes it clear that Medigap policies do not work with Medicare Advantage plans, so you have to choose one or the other.

Comparing the Costs

When you look at costs, the two options have very different structures. With a Medigap plan, you’ll pay a separate monthly premium in addition to your Part B premium. However, once you’ve paid that premium, your out-of-pocket costs for medical care are often very low or even zero, depending on which plan you choose. This makes your healthcare spending predictable. Because Medigap plans are standardized by the government, a Plan G from one company has the exact same basic benefits as a Plan G from another. This makes it much easier to compare plans based on price.

Medicare Advantage plans often have low or even $0 monthly premiums, which can be very appealing. However, you’ll typically pay for services as you use them in the form of copayments, coinsurance, and deductibles. These plans also have an annual out-of-pocket maximum, which is the most you’ll have to pay for covered services in a year. While the low premium is attractive, your total annual costs can be less predictable and may be higher if you need frequent medical care.

Doctor Choice and Flexibility

Your freedom to choose doctors and hospitals is another major point of contrast. If you have Original Medicare and a Medigap plan, you have a nationwide network. You can see any doctor or go to any hospital in the U.S. that accepts Original Medicare. You generally don’t need a referral to see a specialist, giving you incredible flexibility and control over your healthcare decisions. This is a huge advantage for people who travel often or want to see specific specialists without network restrictions.

Medicare Advantage plans usually operate with local provider networks, like an HMO or a PPO. This means you’ll need to use doctors, hospitals, and specialists that are in the plan’s network to get the lowest costs. Going out of network can be expensive or might not be covered at all, except in emergencies. You may also need a referral from your primary care physician to see a specialist. This trade-off in flexibility is often what allows these plans to offer lower premiums and extra benefits.

Frequently Asked Questions

I missed my Medigap Open Enrollment Period. Can I still get a plan? Yes, you can still apply for a Medigap plan at any time, but the process is different. Outside of your initial six-month window, insurance companies can require you to answer health questions. This means they can review your medical history and potentially charge you a higher premium or deny your application based on pre-existing conditions. That’s why your Open Enrollment Period is so valuable—it’s the one time you are guaranteed acceptance without any health screening.

If all Plan Gs have the same benefits, why are the prices so different? This is a great question because it gets to the heart of shopping for a plan. While the government standardizes the medical benefits for each lettered plan, it doesn’t regulate the price. Each insurance company sets its own monthly premiums based on its own business model, pricing structure, and risk assessment. This is why you could see the exact same Plan G coverage offered for a wide range of prices, and it’s the main reason why comparing quotes from different companies is such a critical step.

Can I switch to a different Medigap plan later on? You can apply to switch your Medigap plan at any time, but there’s a catch. Unless you have a special circumstance that gives you guaranteed issue rights, you will likely have to go through medical underwriting to switch. An insurance company can review your health history and may decide not to approve your application for a new plan. Because of this, it’s best to choose your initial plan carefully during your Open Enrollment Period when your acceptance is guaranteed.

Do I really need a separate Part D plan if I have Medigap? Yes, you absolutely do. Medigap plans sold to new Medicare members do not include coverage for prescription drugs. Medigap is designed to help pay for your hospital and medical costs under Part A and Part B, but it leaves a gap for medications. To get help with those costs, you will need to enroll in a standalone Medicare Part D prescription drug plan.

Is Medigap or Medicare Advantage a better choice? Neither one is universally “better”—the right choice depends entirely on your personal priorities. If you value predictable monthly costs and the freedom to see any doctor in the country who accepts Medicare without a referral, a Medigap plan is likely a great fit. If you prefer a lower monthly premium and are comfortable using a local network of doctors in exchange for bundled benefits like drug and dental coverage, a Medicare Advantage plan might be more suitable.