The process of choosing a health plan can feel restrictive, often forcing you into a limited network of doctors. With a Medigap plan, you get to keep the freedom that comes with Original Medicare. You can see any doctor or visit any hospital in the country that accepts Medicare, with no referrals needed to see a specialist. This flexibility is one of the most valuable benefits of these plans. If you have doctors you’ve known and trusted for years, you can continue that relationship without interruption. We’ll explain how these Medicare supplements work alongside your Original Medicare to provide this freedom, all while protecting your finances.
Key Takeaways
- Focus on Financial Predictability: A Medigap plan’s main job is to make your healthcare costs predictable by covering the out-of-pocket expenses, like deductibles and coinsurance, that Original Medicare leaves behind. It doesn’t add new benefits, so you’ll still need a separate Part D plan for prescription drugs.
- Enroll on Time to Guarantee Your Coverage: Your six-month Medigap Open Enrollment Period is a critical, one-time event. It starts when you’re 65 and have Part B, and it’s the only time you can get any plan you want without answering health questions. Missing this window can make finding affordable coverage much more difficult later on.
- Separate the Plan from the Price: Since all plans of the same letter (like Plan G) offer identical medical benefits, your decision is a two-step process. First, choose the plan letter that fits your needs. Second, compare the monthly premiums for that specific plan from different insurance companies to find the best value.
What Is Medigap (Medicare Supplement Insurance)?
When you first enroll in Original Medicare (Part A and Part B), you might notice it doesn’t cover everything. You’re still responsible for costs like deductibles, copayments, and coinsurance, which can add up quickly. This is where Medicare Supplement Insurance, often called Medigap, comes in. Think of it as a helper policy designed to fill the financial “gaps” left by Original Medicare.
Sold by private insurance companies, Medigap policies are specifically designed to work alongside your Part A and Part B coverage. They help pay for your share of the costs for services that Medicare covers. To get a Medigap plan, you must be enrolled in both Medicare Part A and Part B. It’s not a standalone health plan but rather a companion to your Original Medicare benefits.
While private companies sell these plans, the federal government standardizes them. This means that a Medigap Plan G from one company offers the exact same basic benefits as a Plan G from another company; the only difference is the price and the company’s customer service. This standardization makes it easier to compare plans and find one that fits your budget and healthcare needs without having to sort through confusing variations in coverage.
How Medigap and Original Medicare Work Together
The partnership between Original Medicare and Medigap is straightforward. When you receive medical care, Medicare pays its portion of the approved costs first. After that, your Medigap policy steps in to pay its share, which could be some or all of the remaining amount, depending on the plan you choose.
For example, let’s say you have a doctor’s appointment. Medicare Part B typically covers 80% of the cost after you’ve met your annual deductible. You would normally be responsible for the remaining 20% coinsurance. With a Medigap plan, that 20% could be fully or partially covered, significantly reducing your out-of-pocket expenses. This process happens automatically between your providers and the insurance companies, so you don’t have to worry about filing claims.
Medigap vs. Medicare Advantage: What’s the Difference?
It’s easy to mix up Medigap and Medicare Advantage, but they are two very different paths. The most important thing to remember is that you cannot have both at the same time. A Medigap policy supplements your Original Medicare benefits, while a Medicare Advantage plan is an alternative way to receive them.
With Medigap, you keep Original Medicare and add the supplement plan to help with costs. With a Medicare Advantage (Part C) plan, you get your Part A and Part B benefits through a private insurer, often with prescription drug coverage and other extras bundled in. One of the biggest Medigap misconceptions is that it includes drug coverage—it doesn’t. You’ll need a separate Part D plan for prescriptions if you choose Medigap.
What Costs Does a Medigap Plan Cover?
Think of a Medigap plan as a financial safety net for your healthcare. Original Medicare (Parts A and B) covers a lot, but it doesn’t cover everything. You’re still responsible for out-of-pocket costs like deductibles, copayments, and coinsurance. These expenses can add up quickly, especially if you have a serious health issue or need frequent medical care. This is where Medigap comes in. Its primary job is to help pay for those “gaps” in Original Medicare’s coverage, making your healthcare costs much more predictable and manageable.
Different Medigap plans cover different combinations of these costs. While some plans are very comprehensive and leave you with very few out-of-pocket expenses, others cover just the basics. The key thing to remember is that these plans work with Original Medicare—they don’t replace it. A Medigap policy helps pay for its share of costs after Medicare pays its portion first. This partnership between Original Medicare and your Medigap plan is what provides such robust financial protection. Below, we’ll break down the most common costs that Medigap plans are designed to handle, from the 20% you typically owe for doctor visits to emergency care when you’re traveling abroad.
Covering Your Copayments and Coinsurance
One of the most significant costs you face with Original Medicare is the Part B coinsurance. After you meet your annual Part B deductible, you are typically responsible for 20% of the Medicare-approved amount for most doctor services, outpatient care, and medical supplies. This 20% has no annual limit, which can be a major financial risk. Medigap policies are designed to help with this exact scenario. Most plans cover the Part B coinsurance in full or in part, protecting you from potentially large and unpredictable bills. This is a core feature of Medicare Supplement Insurance and a primary reason many people choose to enroll.
Handling Deductibles and Excess Charges
Beyond coinsurance, Medigap plans can also help with other upfront costs. For example, if you are admitted to a hospital, you have to pay the Medicare Part A deductible, which can be a substantial amount. Several Medigap plans cover this deductible for you. Some plans also cover a less common but important cost: Part B excess charges. This happens when a doctor doesn’t accept Medicare assignment and is legally allowed to charge you up to 15% more than the Medicare-approved amount. If your Medigap plan covers excess charges, you won’t have to pay that extra bill out of your own pocket.
Getting Covered While You Travel
If you love to travel, this is a benefit you’ll want to pay close attention to. Original Medicare generally does not cover healthcare you receive outside of the United States. This can leave you completely exposed financially if you have a medical emergency while abroad. Fortunately, several Medigap plans include a benefit for foreign travel emergencies. These plans typically cover 80% of your emergency care costs after you meet a small deductible. This coverage gives you valuable peace of mind, allowing you to explore the world without worrying about what would happen if you suddenly needed medical attention far from home.
A Breakdown of the 10 Standardized Medigap Plans
When you start looking at Medigap plans, you’ll notice they’re named with letters like A, B, C, and so on. In most states, there are 10 standardized plans available, labeled A through N. The word “standardized” is key here. It means that the basic benefits for each plan letter are the same, no matter which insurance company sells it. So, a Plan G from one company will offer the exact same medical coverage as a Plan G from another.
This standardization is a huge help because it simplifies the comparison process. Instead of getting bogged down in different coverage details for the same plan letter, you can focus on the things that do differ between companies: the monthly premium, the company’s reputation for customer service, and its rate increase history. Think of it this way: your job is to first pick the plan letter (like G or N) that best fits your healthcare needs and budget. Once you’ve decided on a letter, you can then shop around for the best price on that specific plan from different insurance carriers. This approach makes finding the right coverage much more straightforward.
Spotlight on Popular Plans: G and N
Among the 10 options, Plans G and N are two of the most popular choices for good reason. Plan G is considered the most comprehensive coverage available to new Medicare enrollees. It covers nearly all of your out-of-pocket costs, including your Part B coinsurance and even Part B excess charges (which are extra fees some doctors can charge). The only thing it doesn’t cover is your annual Part B deductible.
Plan N is another excellent option that offers a great balance of coverage and lower monthly premiums. It pays 100% of your Part B coinsurance, but you’ll have small copayments for doctor and emergency room visits. You might pay up to $20 for some office visits and up to $50 for an ER visit that doesn’t result in a hospital stay. For many, these predictable copays are a worthwhile trade-off for a lower premium. You can learn more about the different Medicare Supplement plans to see which one aligns with your needs.
Exploring High-Deductible Options
If you’re comfortable with paying more out-of-pocket for your medical care in exchange for a much lower monthly premium, a high-deductible plan might be a good fit. High-Deductible Plan G and Plan F are available, and they work just like their standard counterparts, but with one major difference. You must first pay a set amount in out-of-pocket costs before the plan begins to cover anything.
For 2025, this deductible is $2,870. Once you’ve met that amount through paying for things like copayments and coinsurance, your plan will kick in and cover 100% of your costs for the rest of the year. These plans can be a smart financial choice for healthy individuals who want the security of a Medigap plan for major medical events but prefer to keep their fixed monthly expenses low. You can always compare Medigap plan benefits on the official Medicare website.
Which Plans Are No Longer Available?
You may have heard friends or family members talk about their Medigap Plan F or Plan C. For a long time, Plan F was the most popular plan because it covered everything, including the Part B deductible. However, a federal law changed the Medigap landscape. If you became eligible for Medicare on or after January 1, 2020, you can no longer purchase Plan C or Plan F.
Don’t worry—if you already had one of these plans before that date, you can keep it. Your coverage will continue as long as you pay your premiums. For anyone new to Medicare, Plan G is now the most comprehensive option available, functioning almost identically to the old Plan F. The only difference is that you are responsible for paying your annual Part B deductible yourself.
Which Medigap Plan Offers the Best Coverage?
Trying to find the “best” Medigap plan can feel like searching for a needle in a haystack. The truth is, the best plan is the one that fits your specific health needs and budget. What works perfectly for your neighbor might not be the right choice for you. The good news is that Medigap plans are standardized, which makes comparing them much easier than it seems. This means that the benefits for each plan letter (like Plan G or Plan N) are the same, no matter which insurance company sells it.
While there are several different plans to choose from, most people find that their needs are met by one of two popular options: Plan G or Plan N. These two plans strike a great balance between comprehensive coverage and manageable costs. Plan G is known for its extensive benefits, covering nearly all the gaps in Original Medicare. Plan N offers a slightly lower premium in exchange for some predictable out-of-pocket costs. Understanding the key differences between these two will help you decide which approach to coverage gives you the most peace of mind.
Plan G: Is It the Most Comprehensive?
For many people new to Medicare, Plan G is the top choice for comprehensive coverage. It’s designed to cover almost everything that Original Medicare doesn’t, leaving you with very few out-of-pocket medical costs. After you pay your annual Medicare Part B deductible, Plan G picks up the rest, including your Part A deductible and all coinsurance costs.
One of its most valuable features is that it covers Part B “excess charges.” These are extra fees that some doctors can charge above the Medicare-approved amount. With Plan G, you don’t have to worry about these surprise bills. It offers predictable costs and robust protection, making it the most thorough Medicare Supplement plan available to new enrollees.
Plan N: A Cost-Effective Choice
If you’re looking for a plan with a lower monthly premium than Plan G but still want strong coverage, Plan N is an excellent option. It covers your major medical costs but asks you to share a small portion of the expenses for routine care. With Plan N, you may have a copayment of up to $20 for some doctor’s office visits and up to $50 for an emergency room visit that doesn’t result in a hospital stay.
This trade-off—a lower premium for small, predictable copayments—is a great fit for people who are generally healthy and don’t visit the doctor frequently. You still get coverage for the big things, like your Part B coinsurance, without paying the higher premium that comes with Plan G.
How to Compare Plans for Your Needs
The most important thing to remember when shopping for a Medigap policy is that the benefits are standardized by the government. A Plan G from one company offers the exact same medical coverage as a Plan G from another. This means your first step is to decide which plan letter (G, N, or another) best suits your healthcare needs and risk tolerance.
Once you’ve chosen a plan letter, your next step is to find the company that offers that plan at the best price. Because the benefits are identical, you can confidently compare Medigap plans based on cost. You’ll also want to consider the insurance company’s reputation for customer service and its history of rate increases to ensure you’re making a stable, long-term choice.
When Is the Best Time to Enroll in Medigap?
When it comes to buying a Medigap plan, timing is everything. Unlike other types of insurance you might be used to, there’s a specific, one-time window that gives you the most power and protection as a consumer. Think of it as a golden ticket—it guarantees you can get any plan you want without any health-related hurdles. Missing this window can make finding affordable coverage much more difficult down the road.
The key is to sign up during your Medigap Open Enrollment Period. This is your prime opportunity to get the coverage you need. Let’s walk through what this period is, why it’s so important, and what happens if you miss it.
Your One-Time Medigap Open Enrollment Window
Your Medigap Open Enrollment Period 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. For most people, this happens right around their 65th birthday. It’s a one-time opportunity, and once it’s over, it doesn’t come back.
During these six months, you can enroll in any Medigap plan sold in your state, and your acceptance is guaranteed. It’s the perfect time to compare Medigap policies and choose the one that fits your life and budget, knowing that you can’t be turned away.
Understanding Guaranteed Issue Rights
The reason this enrollment window is so critical is because of something called “guaranteed issue rights.” This is a legal protection that means insurance companies cannot use your health history against you. During your six-month open enrollment period, an insurer must sell you any Medigap policy it offers, cannot charge you more because of past or present health problems, and cannot make you wait for coverage to start.
This is a huge advantage. If you have a pre-existing condition like diabetes or heart disease, it doesn’t matter. You have the right to buy a plan at the same price as someone with a perfect health record. These guaranteed issue protections are designed to make sure everyone has fair access to coverage when they first become eligible for Medicare.
What Happens If You Enroll Late?
If you miss your six-month Medigap Open Enrollment Period, you lose those guaranteed issue rights. After that window closes, you can still apply for a Medigap plan, but the rules change completely. Insurance companies are generally allowed to use medical underwriting to decide whether to accept your application and how much to charge you.
This means the insurer will review your medical history, ask you health questions, and can legally deny you coverage or charge you a much higher premium based on your health status. Waiting to enroll can be a costly gamble, as you may find it difficult or even impossible to get a Medigap policy later on, especially if your health changes.
How Much Do Medigap Plans Cost?
One of the most common questions we hear is about the cost of Medigap plans. It’s a practical and important concern. While the federal government standardizes the benefits for each plan letter, it doesn’t regulate the price. This means that the cost for the exact same plan can vary significantly from one insurance company to another.
Think of it like buying a specific brand of milk at different grocery stores—the milk is identical, but the price on the shelf can change depending on where you shop. Understanding how these plans are priced and what factors influence your premium is the first step to finding a policy that fits your budget without sacrificing the coverage you need.
How Are Premiums Priced?
The amount you pay each month for your Medigap policy is called a premium. The most important thing to remember is that the benefits for each lettered plan are the same, no matter which company sells it. A Plan G from Company A offers the exact same medical benefits as a Plan G from Company B.
The only difference between them is the premium. Insurance companies set their own prices, which is why you can see a wide range of costs for identical plans. This is why comparing options is so critical. You are essentially shopping for the best price on a standardized product, and the differences in Medigap premiums can add up to hundreds of dollars a year.
What Factors Affect Your Rates?
So, why does one person pay more than another for the same plan? Several factors influence your monthly premium. While you can’t change some of these, knowing what they are helps you understand your quotes.
The main factors that determine your rate include:
- The plan you choose: A plan with more comprehensive coverage, like Plan G, will generally have a higher premium than a plan with more cost-sharing, like Plan N.
- The insurance company: As we mentioned, each company sets its own prices.
- Your location: Where you live has a big impact on cost, as healthcare prices vary by state and even zip code.
- Your age and gender: Your premium is often based on your age when you first enroll and may increase as you get older.
How to Shop for the Best Price
The key to finding the best value is to make an apples-to-apples comparison. Once you’ve decided which plan letter fits your needs (for example, Plan G), your goal is to find the company offering that specific plan at the most competitive price. Since the benefits are identical, you don’t need to worry that a lower-cost plan is offering less coverage.
You can compare Medigap plans by getting quotes from several different insurance carriers that offer policies in your area. This process can feel a bit overwhelming, which is why many people choose to work with an independent agent who can gather all the quotes for you and present them in a clear, easy-to-understand format.
What Doesn’t Medigap Insurance Cover?
Medigap plans are fantastic for making your healthcare costs more predictable by covering things like copayments and deductibles from Original Medicare. However, it’s just as important to understand what they don’t cover. A common misconception is that a Medigap plan is an all-in-one solution that covers every possible health expense, but that’s not quite right. Thinking of a Medigap plan as a partner to Original Medicare helps clarify its role—it fills in the cost-sharing gaps for services that Medicare already approves, but it doesn’t add entirely new benefits.
This is a key point: if Original Medicare doesn’t cover a service in the first place, your Medigap plan generally won’t either. This design is intentional, keeping the plans focused and straightforward, which helps manage their costs. Knowing about these specific coverage gaps ahead of time is empowering. It allows you to create a complete healthcare strategy, budget accurately, and avoid unexpected bills down the road. Instead of being caught by surprise, you can proactively seek other coverage for these items or plan for them financially. Let’s walk through the main services and items that fall outside of Medigap coverage so you can plan with confidence.
Prescription Drugs: A Common Coverage Gap
This is one of the most frequent points of confusion. Medigap plans sold today do not include prescription drug coverage. If you rely on medications, you’ll need to enroll in a separate plan to help with those costs.
The solution is a standalone Medicare Part D plan. These plans are offered by private insurance companies and are specifically designed to cover your prescription drug costs. When you have Original Medicare, a Medigap plan for your medical services, and a Part D plan for your prescriptions, you create a comprehensive coverage package that addresses your major healthcare needs.
What About Long-Term Care?
Another area Medigap doesn’t cover is long-term care. This refers to custodial care you might receive in a nursing home or at home, which helps with daily activities like bathing, dressing, and eating. While Medicare might cover short-term skilled nursing care after a hospital stay, it doesn’t pay for extended long-term care.
Because Medigap policies are designed to supplement Original Medicare, they follow the same rules. They help with your share of the costs for Medicare-covered services, but since long-term care isn’t typically covered by Medicare, Medigap won’t cover it either.
Vision, Dental, and Hearing: Are They Covered?
Routine care for your eyes, teeth, and ears is essential for your overall health, but unfortunately, Medigap plans don’t cover these services. This means things like routine dental cleanings, fillings, dentures, eye exams for glasses, and hearing aids are not included in your Medigap benefits.
Just like with prescription drugs, you would need to find separate, private insurance plans if you want coverage for these specific needs. Some people find standalone dental or vision plans that work for them, while others budget for these expenses out-of-pocket. Understanding that vision or dental services are not part of your Medigap plan is key to planning your annual healthcare budget.
Is a Medigap Plan Worth It? Key Benefits to Consider
When you’re looking at your budget, the thought of adding another monthly premium can be a tough pill to swallow. You might be wondering if a Medigap plan is truly worth the extra expense. The answer really comes down to what you value most in your healthcare coverage. For many, the cost is a small price to pay for financial predictability and the freedom to choose their own care.
A Medigap plan acts as a safety net for your Original Medicare coverage, filling in the gaps where you would otherwise have to pay out-of-pocket. Think of it as trading unpredictable, potentially high medical bills for a fixed, manageable monthly payment. This can make a world of difference in your financial planning and overall peace of mind. Beyond the cost savings, Medigap plans offer some significant advantages that give you more control over your health journey. Let’s look at three of the biggest benefits that make these plans a valuable addition for many people on Medicare.
The Peace of Mind of Guaranteed Renewability
One of the most reassuring features of a Medigap plan is that it is guaranteed renewable. In simple terms, this means that as long as you continue to pay your premiums on time, the insurance company cannot cancel your policy. Your coverage is permanent, even if your health changes or you develop a serious medical condition down the road.
This provides an incredible layer of security. You won’t have to worry about losing your coverage when you need it most. This guarantee allows you to plan for the future with confidence, knowing that your Medigap plan will be there to help cover your costs year after year. It’s a promise of stability in a time of life when you want fewer things to worry about.
Choose Any Doctor Who Accepts Medicare
With a Medigap plan, you have the freedom to see any doctor or visit any hospital in the U.S. that accepts Medicare. You are not restricted to a specific network of providers, and you don’t need a referral from a primary care physician to see a specialist. If you have doctors you’ve trusted for years, you can continue to see them without interruption.
This flexibility is a major advantage, especially if you travel or have family in other states. Your coverage goes with you wherever you are in the country. This freedom of choice puts you in the driver’s seat, allowing you to build the healthcare team that you feel is best for your needs. You can use Medicare’s official physician finder tool to see which providers in your area accept Medicare.
Making Your Healthcare Costs Predictable
Original Medicare has out-of-pocket costs like deductibles, copayments, and coinsurance that can add up quickly, especially after a hospital stay. A Medigap plan helps cover these expenses, smoothing out your healthcare spending. Instead of facing a large, unexpected bill, you pay a steady monthly premium for your Medigap policy.
This transforms your medical expenses from a variable, potentially budget-breaking cost into a predictable line item. While the monthly premium for Medigap varies based on the plan and company you choose, it makes it much easier to manage your finances. Knowing what to expect each month gives you the stability to enjoy your retirement without the constant worry of surprise medical debt.
Clearing Up Common Medigap Myths
When you start looking into Medicare Supplements, you’ll likely come across a lot of information—and some of it can be misleading. Getting your facts straight is key to choosing a plan that truly fits your needs and budget. Let’s clear the air by tackling some of the most common myths about Medigap policies. Understanding the truth behind these misconceptions will help you make a confident and well-informed decision about your healthcare coverage.
Myth: Medigap Covers Everything
It’s easy to think that a “supplement” plan will cover every health cost that Original Medicare doesn’t, but that’s not quite how it works. Medigap policies are designed specifically to fill the cost-sharing “gaps” in Medicare Part A and Part B, like deductibles, copayments, and coinsurance. However, they generally don’t pay for services that Original Medicare doesn’t cover in the first place. This means things like long-term care, routine dental or vision exams, hearing aids, and prescription drugs are typically not covered by a Medigap plan. For prescription drug coverage, you’ll need to enroll in a separate Medicare Part D plan.
Myth: All Medigap Plans Are the Same
This one is partially true, which is what makes it so confusing. The benefits for each lettered plan are standardized by the government. This means a Plan G from one insurance company must offer the exact same basic coverage as a Plan G from any other company. Where they differ, however, is in the price. The monthly premiums for the same plan can vary significantly from one insurer to the next. That’s why it’s so important to compare quotes from different companies. You could end up paying much more than you need to for the identical plan if you don’t shop around.
Myth: You Can Enroll Anytime Without Penalty
Timing is everything when it comes to enrolling in a Medigap plan. While you can technically apply at any time, your best opportunity is during your six-month Medigap Open Enrollment Period. This window starts on the first day of the month you are both 65 or older and enrolled in Medicare Part B. During this protected period, insurance companies cannot deny you a policy or charge you more due to your health history. If you miss this window, you lose those guaranteed issue rights. An insurer can then use medical underwriting to review your health, which could lead to higher premiums or even an outright denial of your application.
How to Choose and Apply for a Medigap Plan
Once you’ve decided a Medigap plan is the right fit for you, the next step is to choose a specific plan and insurance company. This part of the process can feel like the biggest hurdle, but it’s much more straightforward when you break it down into a few simple steps. Think of it as a final checklist to get you across the finish line to more predictable healthcare costs.
The key is to move at a comfortable pace, gather your information ahead of time, and pay close attention to enrollment deadlines. With a little preparation, you can confidently select a plan that protects both your health and your budget for years to come. Let’s walk through how to compare your options, what you’ll need to apply, and what the application process looks like.
How to Compare Plans and Insurance Companies
First, it’s important to remember that Medigap plans are standardized. This means that a Plan G from one company has the exact same medical benefits as a Plan G from another. What isn’t standardized is the price. Premiums for the same plan can vary significantly between insurance companies, so it’s worth shopping around.
Understanding the specific benefits and coverage of each plan letter allows you to make an informed decision. Start by comparing the different Medigap plans to see which one aligns with your health needs and budget. Once you’ve picked a plan letter, you can then compare the companies that offer it. Look beyond the monthly premium and consider the company’s rate increase history and customer service reputation.
What Paperwork Will You Need?
Having your documents in order before you apply will make the process much smoother. You don’t need a mountain of paperwork, just a few key items. The most important document is your Medicare card, as it contains your Medicare number and your Part A and Part B effective dates. The insurance company will need this information to coordinate your new coverage.
You should also be prepared with some basic personal information, like your address and Social Security number. While you may not be asked about your health history if you apply during your Open Enrollment Period, having a list of your doctors and prescriptions handy is always helpful. This is especially true if you need to go through medical underwriting because you’re applying later.
The Application Process, Simplified
The best time to apply for a Medigap plan is during your Medigap Open Enrollment Period. This is a one-time, six-month window that starts on the first day of the month that you are both 65 or older and enrolled in Medicare Part B. During this period, you have a guaranteed right to buy any Medigap policy sold in your state, regardless of your health status. Insurance companies cannot deny you coverage or charge you a higher premium because of pre-existing conditions.
Once you’ve chosen your plan and company, the application itself is simple. You can often complete it online, over the phone, or with the help of an agent. You’ll provide your Medicare information, answer a few questions, and set up your payment method. After you submit your application, the insurance company will review it and let you know when your coverage begins.
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Frequently Asked Questions
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 how to shop for a plan. While the government standardizes the medical benefits for each plan letter, it doesn’t regulate the price. Insurance companies are free to set their own monthly premiums. One company might charge more based on its business costs or its long-term rate stability, while another might offer a lower price to attract new customers. This is why your final step, after choosing a plan letter like G or N, should always be to compare quotes for that specific plan from several different companies.
What’s the real difference between Plan G and Plan N? Think of it as a trade-off between your monthly premium and your out-of-pocket costs. Plan G is the most comprehensive option for new enrollees and covers nearly everything after you pay your annual Part B deductible. This results in a higher monthly premium but very few, if any, medical bills. Plan N offers a lower monthly premium, but in exchange, you agree to pay small, predictable copayments for some doctor’s office visits (up to $20) and emergency room trips (up to $50). It’s a great choice if you want solid protection but are comfortable with minor cost-sharing for routine care.
Do I still need a separate plan for my prescriptions if I have Medigap? Yes, you absolutely do. This is one of the most common points of confusion. Medigap plans sold today are designed to work with Original Medicare Parts A and B and do not include coverage for prescription drugs. To get help with the cost of your medications, you will need to enroll in a separate Medicare Part D prescription drug plan.
I missed my initial enrollment window. Can I still get a Medigap plan? You can still apply, but it’s not a sure thing. Your six-month Medigap Open Enrollment Period is the only time when you have a guaranteed right to buy any plan without answering health questions. If you apply outside of that window, insurance companies can generally use medical underwriting. This means they can review your health history and may charge you a higher premium or even deny your application based on pre-existing conditions.
Can I keep my current doctors if I sign up for a Medigap plan? Yes, and this is one of the biggest benefits of choosing a Medigap plan. Because Medigap supplements your Original Medicare coverage, you have the freedom to see any doctor or visit any hospital in the country that accepts Medicare. You are not limited to a specific network of providers, and you don’t need a referral to see a specialist. This allows you to continue seeing the doctors you already know and trust.