Helping a parent with their Medicare decisions is a significant responsibility. You want to make sure they have the best possible coverage, but the sheer volume of information can feel like a tidal wave of confusing terms and options. You’re not alone in feeling this way. Our goal is to give you clear, straightforward information so you can feel confident in the guidance you provide. One of the most important choices you’ll help with is whether to add a Medicare Supplement Insurance plan to their Original Medicare. These plans, also called Medigap, are designed to cover out-of-pocket costs and can make a huge difference in their financial security. This guide will explain everything you need to know to help them make a smart choice.
Key Takeaways
- Medigap is a financial safety net for Original Medicare: It’s private insurance designed to cover your share of the costs, like deductibles and coinsurance. This gives you more predictable healthcare spending and the freedom to see any doctor nationwide who accepts Medicare.
- Your enrollment timing is a critical, one-time event: The best time to buy a Medigap plan is during your six-month Open Enrollment Period, which starts when you’re 65 and enrolled in Part B. This is your guaranteed chance to get any policy without being denied or charged more for your health history.
- Choose your plan letter first, then compare company prices: Since benefits for each plan letter (like G or N) are standardized, your first step is to pick the coverage level that fits your needs. After that, you can compare prices for that exact plan from different insurance companies to find the best rate.
What is Medicare Supplement Insurance (Medigap)?
If you’ve chosen Original Medicare (Part A and Part B), you might be wondering how to handle the costs that Medicare doesn’t cover. That’s where Medicare Supplement Insurance, often called Medigap, comes in. Think of it as a safety net. It’s extra insurance you can buy from a private company that helps pay for some of the out-of-pocket costs that Original Medicare leaves behind. These plans are designed to fill the “gaps” in your coverage, giving you more predictable healthcare expenses and peace of mind.
What does Medigap do?
At its core, a Medigap plan helps cover your share of the costs for services that Original Medicare approves. When you see a doctor or have a hospital stay, you’re often responsible for certain payments even after Medicare pays its portion. Medigap is designed to help with these expenses. Specifically, Medigap helps pay for things like your copayments, coinsurance, and deductibles. For example, Medicare Part B typically covers 80% of the cost for doctor visits and other outpatient services after you’ve met your deductible. A Medigap plan can step in to cover the remaining 20%, which can save you a significant amount of money, especially if you need frequent medical care.
How Medigap works with Original Medicare
It’s important to know that Medigap and Original Medicare work together as a team. You must be enrolled in Medicare Part A and Part B to purchase a Medigap policy. After you receive care, Medicare pays its approved amount first. Then, your Medigap plan pays its share directly to the provider. One of the most critical rules to remember is that you can only have Medigap if you have Original Medicare. You cannot use a Medigap policy with a Medicare Advantage plan, as they are two completely different ways to get your Medicare coverage. Choosing Medigap means you’re adding to your Original Medicare benefits, not replacing them.
The key benefits of Medigap
The most significant benefit of having a Medigap plan is financial security. While these plans aren’t required, they can protect you from high and unexpected medical bills. Original Medicare is a great foundation, but it doesn’t cover everything. After you meet your deductible, it generally only pays for 80% of your outpatient costs. A Medigap plan helps cover the rest, making your healthcare spending much more predictable. This can be a huge relief, preventing a single health issue from becoming a major financial burden. Another key benefit is freedom of choice. With a Medigap plan, you can see any doctor or visit any hospital in the U.S. that accepts Medicare without needing a referral.
Clearing up common Medigap myths
A common misconception is that Medigap plans cover all out-of-pocket healthcare costs, but that isn’t the case. It’s essential to understand what isn’t included. Medigap policies generally don’t cover services like routine dental or vision care, hearing aids, or long-term care in a nursing home. Most importantly, Medigap plans sold today do not include prescription drug coverage. To get help with the cost of medications, you will need to enroll in a separate Medicare Part D plan. Understanding these limitations from the start helps you build a complete coverage package that truly meets all of your health and budget needs without any surprises down the road.
A Guide to the Medigap Plan Types
An overview of Plans A through N
When you start looking at Medigap, you’ll see plans labeled with letters A through N. In most states, there are 10 different options, and each one offers a unique mix of benefits. Think of it like a menu where you can pick the coverage that best fits your needs. For instance, Plan G is very popular because it covers most of your out-of-pocket costs, but it comes with a higher monthly premium. Plan N is another great option that offers solid coverage with a lower premium, though you’ll have small copayments for some doctor and emergency room visits.
It’s also good to know that Plans C and F are no longer available to people who became eligible for Medicare on or after January 1, 2020. If you were eligible before that date, you might still be able to buy one. You can compare Medigap plan benefits side-by-side to get a clear picture of what each one includes.
How to compare coverage between plans
Choosing the right plan comes down to your personal situation. The best way to start is by taking a moment to think about your health and your budget. Do you have chronic conditions that require frequent doctor visits? Or are you generally healthy and just want a safety net for unexpected issues? Your answers will help you decide how much coverage you really need.
Consider your financial comfort zone, too. A plan with a higher premium might save you money in the long run if you have significant medical expenses, while a lower-premium plan could be perfect if you want to keep monthly costs down. It’s all about finding a balance that gives you peace of mind without straining your budget. Thinking about your annual health expenses can help you make a more informed decision.
What “standardized” plans really means
You’ll hear the term “standardized” a lot with Medigap, and it’s a feature that makes shopping much simpler. It means that the benefits for each plan letter are the same, regardless of which insurance company sells it. So, a Plan G from one company provides the exact same medical coverage as a Plan G from any other company. The only differences will be the monthly premium and the company’s customer service.
This setup is incredibly helpful because it allows you to do an apples-to-apples comparison. Once you decide which plan letter (like G or N) is right for you, you can focus on finding the company that offers the best price and has a strong reputation. This standardization of plans makes it easier to find the right fit without getting lost in confusing policy details.
Does Medigap cover you abroad?
This is a common question, especially for those who love to travel. While Original Medicare offers very limited coverage outside the U.S., some Medigap plans can help. Specifically, Plans C, D, F, G, M, and N include a benefit for foreign travel emergencies. This isn’t for routine check-ups, but it can be a lifesaver if you have an unexpected medical issue while on a trip.
Typically, these plans cover 80% of your emergency care costs after you meet a small deductible. It’s important to remember that Medigap plans generally don’t cover services like long-term care, dental, vision, or hearing aids. Understanding these coverage limits helps you plan accordingly and ensures there are no surprises down the road.
Medigap Costs and How to Enroll
Once you’ve decided that a Medigap plan is the right choice for you, the next step is figuring out the costs and the enrollment process. This is where timing is everything. Understanding how Medigap plans are priced and when to apply can save you a significant amount of money and ensure you get the coverage you want without any hassle.
The cost of a Medigap plan isn’t one-size-fits-all. Your monthly premium can vary based on several factors, and your rate can change over time. More importantly, there is a specific, one-time window when you can enroll in any plan you want without answering a single health question. Let’s walk through what you need to know to make a smart and timely decision.
What affects your Medigap premium?
The monthly premium for a Medigap plan can differ quite a bit from person to person. Insurance companies look at a few key things when setting your price. First, the plan you choose makes a big difference—a more comprehensive plan like Plan G will naturally cost more than a plan with higher out-of-pocket costs. The company you buy from also matters, as different insurers price the exact same standardized plan differently.
Where you live is another major factor; premiums can vary by state and even by zip code. Your age can also play a role in your initial rate. It’s a good idea to compare prices from several companies to see who offers the best rate for the plan you want in your area.
Your Medigap Open Enrollment Period
Think of your Medigap Open Enrollment Period as your golden ticket. 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 crucial period, you have a guaranteed right to buy any Medigap policy sold in your state. An insurance company cannot turn you down, place conditions on your policy, or charge you more because of any past or present health problems.
This is truly the best time to sign up. If you miss this one-time window, you may have to go through medical underwriting to apply for a plan later. This means an insurer could deny your application or charge you a much higher premium based on your health history.
When you have guaranteed issue rights
Besides your initial Open Enrollment Period, there are a few other situations where you might have “guaranteed issue rights.” These rights protect you if you lose other health coverage, allowing you to buy a Medigap policy without medical underwriting. For example, you may have these rights if your employer-sponsored coverage is ending, if you move out of your Medicare Advantage plan’s service area, or if you tried a Medicare Advantage plan for the first time and want to switch back to Original Medicare within a year.
These rights are specific and time-sensitive, so it’s important to understand your options if you find yourself in one of these scenarios. You can find a full list of qualifying situations on the official Medicare website.
Why your rates might increase
It’s a common question: will my Medigap premium stay the same forever? The short answer is no. You should expect your premium to increase over time. Insurance companies typically raise rates annually to keep up with inflation and the rising cost of medical care. Your premium may also go up as you get older, depending on how the company structures its pricing.
Most plans use “attained-age” pricing, where your rate is based on your current age and increases as you get older. This is a normal part of having a Medigap plan, but it’s also why it’s a good idea to review your coverage each year. Working with an independent agent can help you compare your current plan with others on the market to ensure you still have a competitive rate.
How to Choose the Right Medigap Plan
Choosing the right Medigap plan doesn’t have to be overwhelming. It’s really about matching your personal health needs and financial picture with the right level of coverage. When you know what to look for and what questions to ask, the whole process becomes much clearer. By breaking it down into a few manageable steps, you can find a plan that gives you peace of mind and predictable healthcare costs. Let’s walk through how to find the best fit for you.
Assess your healthcare needs and budget
First, take a moment to think about your health. Do you have chronic conditions that require frequent doctor visits? Your overall health is a great indicator of how much you might use medical services. Medigap plans are designed to help pay for the out-of-pocket costs that Original Medicare leaves behind, like copayments and deductibles. A clear picture of your health needs will point you toward the right level of coverage.
Your budget is the other side of the coin. Consider what you can comfortably afford for a monthly premium. A plan with more comprehensive coverage will likely have a higher premium, but it could save you thousands in the long run if you face unexpected health issues. It’s all about finding a balance that feels right for your financial situation.
Tips for comparing plans
Once you have a sense of your needs, it’s time to compare your options. Medigap plans are labeled A through N, and the great thing is that these plans are standardized. This means a Plan G from one insurance company must offer the exact same basic benefits as a Plan G from another. This makes it much easier to compare them on an apples-to-apples basis.
What isn’t standardized is the price. Premiums for the same exact plan can vary significantly between insurance companies. That’s why it’s so important to compare Medigap policies from different providers. Look at not just the monthly premium but also the company’s history of rate increases and its customer service reputation. A low premium today isn’t the best deal if it rises sharply every year.
Key questions to ask before you choose
As you narrow down your choices, asking the right questions can make all the difference. Whether you’re speaking with an agent or directly with an insurance company, being prepared helps you get the information you truly need. A great starting point is to ask for a clear breakdown of what the plan covers and, just as importantly, what it doesn’t.
You should also ask how the company prices its policies and what you can expect for rate increases in the future. Another key question for an agent is, “Which insurance companies do you represent?” This helps you understand if you’re seeing a wide range of options or just the products of a single company. Getting answers to these questions will help you make a confident decision.
Where to find help comparing plans
You don’t have to do this alone. Comparing dozens of plans and companies can be confusing, and it’s perfectly normal to want a little guidance. A licensed insurance agent who specializes in Medicare can be an invaluable resource. They can help you sort through the options and find a plan that aligns with the needs and budget you’ve already outlined.
When you work with an independent agent, they can provide quotes from multiple insurance carriers, giving you a full view of the market. At The Big 65, our team is dedicated to providing this kind of personalized guidance. We listen to your needs and help you understand your choices so you can feel secure in your decision. There’s never a fee for our help.
Common mistakes to avoid
A few common missteps can lead to paying more than you need to or even being denied coverage. One of the biggest mistakes is missing your Medigap Open Enrollment Period. This is the six-month window that starts the month you’re 65 and enrolled in Medicare Part B. During this time, you can buy any Medigap policy sold in your state, regardless of your health. If you wait, you could be charged more or denied coverage based on your medical history.
Another mistake is choosing a plan based only on the monthly premium. The cheapest plan isn’t always the best value. It’s crucial to compare the benefits and potential out-of-pocket costs to ensure the plan will truly protect you financially when you need it most.
Who Offers Medicare Supplement Plans?
Medicare Supplement plans, or Medigap, are not sold by the government. Instead, they are offered by private insurance companies. You’ll see many familiar names in the health insurance industry offering these plans. While the benefits for each plan letter (like Plan G or Plan N) are standardized by the federal government, the companies that sell them are not all the same.
Each company sets its own monthly premiums, which can vary significantly for the exact same plan coverage. They also differ in their customer service, financial stability, and how they price their plans over time. Some companies might offer lower rates upfront but have a history of larger rate increases down the road. This is why it’s so important to look not just at the plan letter, but also at the company behind the plan. Comparing providers is a key step in making a choice you’ll be happy with for years to come.
The Big 65
Think of us at The Big 65 as your personal guide through the Medicare maze. We are not an insurance company; we are an independent agency. This means we don’t work for any single provider. Instead, we work for you. Our role is to connect you with various Medicare Supplement insurance providers, helping you compare plans and find the best options for your specific needs and budget. We provide the expert, unbiased guidance you need to understand your choices, compare the companies listed below, and feel confident in your decision. Our goal is to make the process simple and clear.
Aetna
Aetna is a large, well-established insurance company that many people are already familiar with. They offer a variety of Medicare Supplement plans designed to cover the out-of-pocket costs that Original Medicare doesn’t, such as coinsurance and deductibles. Choosing a well-known provider like Aetna can offer a sense of stability and reliability. They provide several of the most popular standardized plans, giving you the flexibility to find coverage that aligns with your healthcare expectations and financial situation. Their long-standing presence in the health insurance market makes them a common choice for Medigap coverage.
UnitedHealthcare
UnitedHealthcare offers Medigap plans through a partnership with AARP, a name that is highly trusted among seniors. They provide nationwide coverage and a wide selection of plans, including A, B, C, F, G, K, L, and N. A major advantage of their plans is the extensive medical care coverage, which includes 100% of your Part A coinsurance and up to 100% of your Part B coinsurance. For those who love to travel, some of their plans also include benefits for medical care received internationally, which is a feature not covered by Original Medicare.
Cigna
Cigna is another major national provider known for offering a variety of Medicare Supplement plans. Their plans are designed to help you manage the out-of-pocket costs from Original Medicare, giving you more predictable healthcare expenses. Cigna provides both flexibility and comprehensive coverage options, allowing you to select a plan that fits your life. One of the practical benefits they often provide is a household premium discount, which can be a great money-saver if both you and your spouse are enrolling in a Medigap plan from the company. This makes Cigna an attractive option for couples.
Mutual of Omaha
Mutual of Omaha has been in the insurance business for over a century and has built a strong reputation for customer satisfaction. They provide a range of Medicare Supplement plans and are particularly recognized for their excellent customer service and solid coverage options. For many people, knowing that a friendly and helpful person will be there to answer questions is just as important as the plan’s benefits. Their long history and focus on the customer experience make them a trusted and popular choice for Medigap insurance, providing peace of mind alongside financial protection.
Humana
Humana is a major health and well-being company that offers a variety of 2025 Medicare Supplement plans to help pay for costs not covered by Medicare Parts A and B, like copayments and deductibles. As a company heavily focused on healthcare, Humana often provides additional wellness programs or discounts to its members, though these are separate from the standardized Medigap benefits. Their goal is to offer plans that provide financial security so you can focus on your health. With a strong presence across the country, Humana is a go-to option for many people enrolling in Medicare.
Blue Cross Blue Shield
The Blue Cross Blue Shield (BCBS) Association is one of the most recognized names in health insurance, offering nationwide coverage in all 50 states, Washington D.C., and Puerto Rico. BCBS is unique because it’s a federation of independent, locally operated companies. They offer a very wide range of plans, including A, B, C, D, F, G, K, L, M, and N, as well as high-deductible versions of Plans F and G. This extensive selection means you have a great deal of choice when it comes to finding a plan with comprehensive benefits that fit your needs.
State Farm
Many people know State Farm for home and auto insurance, but they also offer Medicare Supplement plans in 45 states and Washington D.C. They provide some of the most popular plans, including A, C, F, G, and N. A key advantage of State Farm is their focus on straightforward, easy-to-understand coverage. For individuals who already have a relationship with a local State Farm agent, it can be convenient to manage multiple insurance policies in one place. Their reputation for simplicity and customer service makes them a solid choice for those who value a direct approach to insurance.
How to Apply for a Medigap Plan
Once you’ve compared your options and have a plan in mind, the application process is your next step. It’s fairly straightforward, but knowing what to expect can make it feel much easier. Here’s a simple breakdown of how to apply and what you’ll need to get started.
Why work with a licensed insurance agent?
While you can apply for a Medigap plan directly with an insurance company, working with an independent agent can save you a lot of time and potential headaches. A good agent acts as your advocate. They know the ins and outs of the different plans and can help you compare costs from various companies in your area. Since Medigap plans and pricing can vary by location, their local expertise is invaluable. Best of all, their services are typically available at no cost to you, as they are compensated by the insurance carriers. This means you get expert, personalized guidance without any extra fees.
What documents will you need?
Getting your paperwork in order ahead of time makes the application process a breeze. The most important document you’ll need is your red, white, and blue Medicare card. This card contains your Medicare number and the effective dates for your Part A and Part B coverage, which the insurance company needs to verify your eligibility. Medigap plans are designed to supplement Original Medicare, so you must be enrolled in Parts A and B to apply. Beyond that, you’ll just need basic personal information like your address and date of birth.
What to expect from the application process
The application itself is usually a few pages long and asks for the information from your Medicare card, along with some basic personal details. The most critical part of the process is timing your application correctly. The best time to apply is during your Medigap Open Enrollment Period. This six-month window starts on the first day of the month you turn 65 (as long as you are also enrolled in Medicare Part B). Applying during this period means insurance companies cannot use your health history to deny you a policy or charge you a higher premium.
Know your rights as an applicant
As a Medicare beneficiary, you have specific rights that protect you when you apply for a Medigap plan. Your most powerful right is your guaranteed issue right during your Open Enrollment Period. This ensures you can buy any Medigap policy sold in your state, regardless of any pre-existing health conditions. While Medigap isn’t mandatory, it’s a key tool for managing your health care expenses, since Original Medicare generally only covers about 80% of your costs. Choosing to buy a supplemental plan is your right to protect your savings and gain peace of mind.
Get the Most From Your Medigap Benefits
Choosing your Medigap plan is a huge step, so congratulations on getting it done! Now, let’s talk about how to make the most of your new policy. A Medigap plan is a powerful tool for managing your health care costs, but understanding how it works day-to-day is key. Think of it like getting a new appliance—you want to read the manual to make sure you’re using all its best features. By familiarizing yourself with your plan’s details, you can feel confident and prepared for any health care needs that come your way.
Know your policy’s coverage limits
While Medigap plans help cover out-of-pocket costs from Original Medicare, they aren’t a blank check. Each plan type offers a different level of coverage, so it’s important to know exactly what your specific policy includes. Your plan documents are your best friend here. They’ll detail what’s covered for things like copayments, coinsurance, and deductibles. It’s also smart to be clear on what isn’t covered, such as long-term care, dental, or vision. Keeping a summary of your benefits in your wallet or on your phone can help you feel prepared before you visit a doctor or hospital. Private companies offer various Medigap plans, so understanding your specific one is the first step to using it well.
How to use Medigap with other insurance
Using your Medigap plan is usually a seamless process. When you visit a provider that accepts Medicare, you’ll present both your Original Medicare card and your Medigap policy card. Medicare will pay its share of the approved costs first, and then your Medigap plan automatically covers its portion. The most important rule to remember is that you can only have Medigap if you have Original Medicare (Parts A and B). You cannot use a Medigap policy with a Medicare Advantage plan. If you have a Medigap plan and decide to switch to Medicare Advantage, you’ll have to drop your Medigap coverage.
Why you should review your coverage annually
Once you have your Medigap plan, it’s tempting to set it and forget it. However, a quick annual review can save you headaches and money down the road. While your plan’s benefits will stay the same, the private insurance company can—and often will—raise your monthly premium each year. Your own health needs might also change, making a different level of coverage more appropriate. Taking 30 minutes each year to review your premium notice and compare plan costs in your area is a smart financial habit. It ensures you’re not overpaying and that your coverage continues to be the right fit for your life.
Take advantage of your plan’s flexibility
One of the best features of Medigap is its flexibility. Because plans are standardized, a Plan G from one insurer offers the exact same basic benefits as a Plan G from any other. This makes it easier to focus on price and an insurer’s reputation when you first choose a plan. This standardization also means you can budget more effectively for your health care. Beyond that, Medigap gives you the freedom to see any doctor or specialist in the U.S. who accepts Medicare—no referrals needed. This nationwide coverage is a huge advantage, especially if you travel or have family in other states. You can truly rely on your coverage wherever you go.
Related Articles
- Best Medigap Plans: Your Guide to Choosing Coverage – The Big 65 – Medicare Insurance Services
- Medicare Supplements (MediGap Plans) – The Big 65 – Medicare Insurance Services
- Tennessee Medigap Plans: A Complete Guide – The Big 65 – Medicare Insurance Services
- Medigap Plans G vs. N: Which Is Right for You? – The Big 65 – Medicare Insurance Services
Frequently Asked Questions
If all Plan G policies are the same, why does the price vary so much? This is a fantastic question because it gets to the heart of how to shop for a Medigap plan. While the government standardizes the medical benefits of each plan letter, the private insurance companies that offer them are all different. Each company sets its own monthly premium based on its own business model and risk assessment. This is why you can see two different companies offering the exact same Plan G coverage at very different prices. It’s also why it pays to compare providers, looking not just at today’s price but also at their history of rate increases and customer service reputation.
What happens if I miss my Medigap Open Enrollment Period? Your six-month Medigap Open Enrollment Period is your one-time golden ticket to buy any plan you want without answering health questions. If you let this window pass, you lose that guaranteed access. Later on, if you want to apply for a plan, an insurance company can generally require you to go through medical underwriting. This means they can review your health history and can legally charge you a higher premium or even deny your application because of a pre-existing condition.
Will my Medigap premium stay the same every year? You should expect your Medigap premium to increase over time. Insurance companies typically adjust their rates annually to account for inflation and the rising costs of healthcare. Depending on how the company prices its plans, your premium may also go up as you get older. This is a normal part of having this type of coverage, but it’s also why it’s smart to do a quick review of your plan each year to make sure your rate is still competitive.
Can I have a Medigap plan and a Medicare Advantage plan at the same time? No, it’s illegal for an insurance company to sell you a Medigap policy if they know you have a Medicare Advantage plan. These are two fundamentally different ways to receive your Medicare benefits. Medigap plans work with Original Medicare (Part A and Part B) to help pay for out-of-pocket costs. Medicare Advantage plans (Part C) are an alternative to Original Medicare that bundle your benefits into one plan. You must choose one path or the other.
Does Medigap cover prescriptions, dental, or vision care? Medigap plans sold today do not include coverage for prescription drugs. To get help with medication costs, you need to enroll in a separate Medicare Part D plan. Medigap policies also generally do not cover routine services like dental exams, vision care, or hearing aids. Their main job is to fill the “gaps” in your hospital and medical coverage provided by Original Medicare, like paying for your deductibles and coinsurance.