Medigap Plans 101: How to Choose the Right One

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Shopping for insurance can often feel overwhelming, with endless options and confusing differences in coverage. Medigap is refreshingly different. The federal government standardized the plans, which means the benefits for each plan letter are the same, no matter which insurance company sells it. A Plan G from one company offers the exact same basic medical benefits as a Plan G from another. This simple but powerful rule makes it much easier to compare your options. Your decision comes down to finding the right level of coverage for your needs and then shopping for the best price from a reputable company. This guide will walk you through how these standardized medigap plans work.

Key Takeaways

Act During Your One-Time Enrollment Window: Your six-month Medigap Open Enrollment Period is your golden ticket. It starts when you turn 65 and enroll in Part B, and it’s the only time you’re guaranteed any plan you want without facing health questions or higher premiums for pre-existing conditions.
Compare Prices, Not Benefits: All Medigap plans with the same letter (like Plan G) offer the exact same basic coverage, no matter which company sells them. Your job is to choose the plan letter that fits your needs, then shop around to find the insurance company offering it at the best price.
Remember to Add Prescription Drug Coverage: Medigap plans do not cover prescription drugs. To avoid a lifelong late enrollment penalty and get help with medication costs, you must purchase a separate Medicare Part D plan.

What Is a Medigap Plan?

Think of a Medigap plan as a helper policy that works alongside your Original Medicare (Part A and Part B). Also known as Medicare Supplement Insurance, Medigap is sold by private insurance companies and is designed to help pay for some of the healthcare costs that Original Medicare doesn’t cover. These are the “gaps” in coverage, like deductibles and coinsurance, that you would otherwise have to pay for out of your own pocket.

One of the most helpful things to know is that Medigap plans are standardized. This means that no matter which company you buy from, a Plan G from one company offers the exact same basic benefits as a Plan G from another. The main differences you’ll find are the monthly premium you pay and the company’s customer service reputation. This standardization makes it much easier to compare plans and find one that fits your budget and healthcare needs without getting lost in confusing benefit details.

How Medigap Supplements Original Medicare

Medigap plans work directly with Original Medicare to coordinate your benefits. To get a Medigap plan, you must first be enrolled in both Medicare Part A and Part B. Once you have your Medigap policy, the payment process is straightforward. When you receive medical care, Medicare pays its share of the approved costs first. Then, your Medigap policy steps in to pay its portion, which could be your deductible, coinsurance, or copayment, depending on the plan you choose. This partnership helps reduce your out-of-pocket expenses and provides more predictable healthcare costs.

What Gaps Do Medigap Plans Cover?

The primary job of a Medigap plan is to cover out-of-pocket costs that can add up quickly with Original Medicare. These gaps include things like your Part A hospital deductible, which you have to pay for each benefit period, and the 20% coinsurance for most doctor services and outpatient care under Part B. Different Medigap plans cover different combinations of these costs. Some plans might cover all of your Part B coinsurance, while others might also cover costs for skilled nursing facility care or even emergency medical care when you’re traveling abroad. You can compare Medigap plan benefits side-by-side to see exactly which gaps each one covers.

What Do Medigap Plans Cover?

Medigap plans are designed to fill the “gaps” in Original Medicare, but not all plans fill the same gaps. The federal government standardizes the plans, which means a Plan G from one insurance company offers the same basic benefits as a Plan G from another. The main difference will be the price.

Understanding what’s included in every plan versus what’s unique to specific plans is the first step in finding the right fit for your healthcare needs and budget.

Benefits Included in Every Plan

Think of this as the core package. No matter which of the 10 Medigap plans you choose, you can count on it covering a few key costs. Every single Medigap plan provides coverage for your Medicare Part A coinsurance and hospital costs for up to an additional 365 days after your Original Medicare benefits are used up. This is a significant benefit that protects you from long, costly hospital stays.

Additionally, all plans offer at least partial coverage for Medicare Part B coinsurance or copayments, Part A hospice care coinsurance or copayments, and the first three pints of blood if you need a transfusion. These foundational benefits ensure a solid layer of protection beyond what Original Medicare provides.

How the Plans Differ

This is where you’ll want to pay close attention. The differences between the plans determine how much you’ll pay out of pocket for certain services. For example, while all plans cover Part B coinsurance to some degree, most cover it at 100%. Plans K and L, however, require you to share the cost until you meet an annual out-of-pocket limit.

Other key differences include coverage for the Part B deductible (only available in plans for those eligible for Medicare before 2020) and Part B excess charges (when a doctor charges more than the Medicare-approved amount). Only Plans F and G cover excess charges. Some plans also offer a benefit for foreign travel emergencies, which is a must-have for frequent travelers.

Meet the 10 Standardized Medigap Plans

When you start looking at Medigap, you’ll see plans labeled with letters, from A through N. It might seem like alphabet soup at first, but there’s a simple and helpful system behind it. There are 10 standardized Medigap plans available in most states.

So, what does “standardized” actually mean for you? It means that the benefits for each plan letter are the same, no matter which insurance company sells it. For example, a Medigap Plan G from one company has the exact same basic benefits as a Plan G from another company. This makes it much easier to compare plans based on what they cover.

While the benefits are standardized, the price is not. The monthly premium you pay can vary significantly from one insurance company to the next, even for the same exact plan. That’s why it’s so important to shop around. The key is to first figure out which plan letter has the benefits that fit your health needs and budget, and then find the company that offers that plan at the best price. This approach helps you get the right coverage without overpaying.

A Quick Look at Plans A-N

Each of the 10 Medigap plans offers a different combination of benefits to help pay for costs not covered by Original Medicare. While the mix of coverage varies, all plans provide certain core benefits. For instance, every single Medigap plan covers your Medicare Part A coinsurance and hospital costs for up to an additional 365 days after your Medicare benefits are used up.

Beyond that, the plans start to differ. Most plans will fully cover your Part B coinsurance or copayments, but some may only cover a percentage. Other benefits, like the Part A deductible or skilled nursing facility care coinsurance, are covered by some plans but not others. You can compare plan benefits side-by-side using official charts to see exactly what each lettered plan includes.

What About High-Deductible Plans?

If you’re generally healthy and prefer a lower monthly premium, a high-deductible Medigap plan might be a good fit. Currently, Plans F and G are available as high-deductible options. With these plans, you are responsible for paying all of your Medicare-covered costs—like copayments and deductibles—up to a certain amount each year.

For 2025, that deductible is $2,870. Once you’ve met that deductible, your Medigap plan kicks in and starts paying for your covered services for the rest of the year. This trade-off means you’ll pay less each month for your premium, but you’ll have higher out-of-pocket costs if you need medical care. It’s a practical choice for those who want a safety net for major health issues but can handle smaller costs themselves.

Which Plans Are Most Popular?

For years, Plans C and F were the most popular choices because they offered the most comprehensive coverage. However, a change in federal law means that if you became eligible for Medicare on or after January 1, 2020, you can no longer buy Plan C or Plan F. If you were eligible for Medicare before that date, you might still be able to buy one of these plans.

Because of this change, Plan G has become the go-to option for many new Medicare beneficiaries. It offers nearly the same level of comprehensive coverage as the old Plan F—the only difference is that you have to pay the annual Medicare Part B deductible yourself. After you’ve met that deductible, Plan G covers the gaps just like Plan F did, making it an excellent choice for predictable, robust coverage.

Do You Qualify for a Medigap Plan?

Thinking about a Medigap plan is a great step toward managing your healthcare costs with more predictability. But before you start comparing the different lettered plans, you need to make sure you qualify. The requirements might seem simple at first, but timing plays a surprisingly huge role. Your eligibility isn’t just about having Original Medicare; it’s also about when you apply. This is because certain windows of time give you special protections that make it much easier to get the plan you want, regardless of your health history.

Missing this window can mean that insurance companies can ask you detailed health questions and potentially deny you coverage or charge you more based on your answers. This is why understanding the rules from the start is so important. It’s the key to getting the right coverage without any surprises or roadblocks. Let’s walk through the basics of eligibility, why your initial enrollment period is the best time to act, and what special rights you have as a Medicare beneficiary. Knowing this information will put you in control of your Medigap decision.

Check Your Basic Eligibility

First things first, to be eligible for any Medigap plan, you must be enrolled in Medicare Part A and Part B. Think of it this way: Medigap is a supplement, so you need to have the original policy first for it to supplement. It’s designed specifically to fill the “gaps” in your Original Medicare coverage, like deductibles and coinsurance. If you only have Part A or are enrolled in a Medicare Advantage plan instead of Original Medicare, you won’t be able to purchase a Medigap policy. This foundational step is non-negotiable, so confirming your enrollment in both Part A and B is your starting point.

Why Your Open Enrollment Period Is So Important

This is the most critical piece of the puzzle. Your Medigap Open Enrollment Period is a one-time, six-month window that begins on the first day of the month you’re 65 or older and enrolled in Part B. During this golden window, you have what are called “guaranteed issue rights.” This means any insurance company offering Medigap plans in your state must sell you any plan they offer, and they can’t use medical underwriting. They can’t ask about your health history or charge you more because of pre-existing conditions. Missing this period means you lose these federal protections, and getting a policy later could be more difficult and expensive.

What Are Guaranteed Issue Rights?

Guaranteed issue rights are special protections that ensure you can purchase a Medigap policy under certain circumstances, even if your six-month Open Enrollment Period has passed. These rights apply in specific situations, such as if you lose other health coverage. For example, if your employer-sponsored plan ends or you move out of your Medicare Advantage plan’s service area, you may get a special window to buy a Medigap plan. During this time, insurance companies must sell you a policy without considering your health status. Understanding these guaranteed issue protections is crucial because they provide a safety net, ensuring you can still get coverage when life changes unexpectedly.

When Should You Enroll in Medigap?

Timing is one of the most critical factors when buying a Medigap plan. While you can technically apply for a policy at any time, there is a specific, one-time window when you have special protections. Enrolling during this period ensures you can get any plan you want, regardless of your health history. Missing this window can make it much harder—and more expensive—to get coverage later on.

Think of it as a golden ticket for Medigap. This initial enrollment period is your best opportunity to secure a plan that fits your needs without facing health-related hurdles. Let’s walk through when this period occurs and why it’s so important to act during that time. Understanding these rules will help you make a confident decision and avoid potential pitfalls down the road.

The Best Time to Apply

The ideal time to buy a Medigap policy is during your six-month Medigap Open Enrollment Period. This is a one-time window that automatically starts on the first day of the month you are both 65 or older and enrolled in Medicare Part B. During these six months, an insurance company cannot use your health history to make decisions about your policy. This means they must sell you any Medigap plan they offer, cannot charge you more because of health problems, and cannot make you wait for coverage to start. It’s a powerful protection that makes getting the right coverage straightforward.

What to Expect from Medical Underwriting

If you apply for a Medigap plan outside of your Open Enrollment Period, insurance companies can generally require medical underwriting. This is a process where the insurer reviews your health history, including pre-existing conditions, to assess their risk in covering you. Based on this review, they can legally charge you a higher premium than someone with a clean bill of health. In some cases, they can even deny your application for coverage altogether. This is why your initial six-month window is so valuable—it allows you to bypass this entire process and get the plan you want without any health questions asked.

What Happens If You Apply Later?

Waiting to enroll can have significant consequences. Once your six-month Medigap Open Enrollment Period ends, so do your federal protections. These guaranteed issue protections are what ensure you can buy any plan sold in your state. If you miss this window, you lose that guarantee. You may find that your plan options are limited, the premiums are much higher, or you are unable to purchase a Medigap policy at all. While some situations grant you special enrollment rights later, relying on them is risky. Taking action during your initial window is the surest way to secure your coverage.

How to Choose the Right Medigap Plan

Choosing a Medigap plan feels like a big decision because it is. The right plan for you will depend on your personal health needs, your budget, and how much financial risk you’re comfortable with. While there are ten different options to consider, breaking the process down into a few simple steps can make it much more manageable. By thinking through your needs, comparing your options, and researching the companies behind the plans, you can find coverage that gives you peace of mind for years to come.

Assess Your Healthcare Needs

First, take a realistic look at your health. It’s easy to focus on how you feel today, but it’s wise to plan for the unexpected. As you evaluate your healthcare needs, think about your current health status, any chronic conditions you manage, and your family’s medical history. Do you anticipate needing more medical care in the future? Also, consider your financial situation. Would a surprise medical bill be a major setback? Some people prefer a higher monthly premium for more predictable costs, while others are comfortable with a lower premium and potentially paying more out-of-pocket if they need care. This is about finding the right balance for your health and your wallet.

Compare Plan Benefits Side-by-Side

Once you have a good idea of your needs, it’s time to see how the plans stack up. The great thing about Medigap is that the plans are standardized. That means 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 your options. The best way to do this is with a side-by-side chart. You can compare Medigap plan benefits to see exactly what each one covers, from the Part A deductible to skilled nursing facility care. This visual layout helps you quickly identify which plans offer the level of coverage you’re looking for.

Research Insurance Company Reputations

After you’ve narrowed down your choices to one or two lettered plans, the final step is to look at the insurance companies offering them. Since the benefits are the same, your decision will likely come down to price and service. It’s important to compare costs from different insurance companies to find the best price for the plan you want. But don’t stop at the premium. Look into the company’s reputation for customer service and its history of rate increases. Some companies are known for more stable pricing over time. Reading reviews and checking financial strength ratings can give you a clearer picture of the company you’ll be working with.

How Much Do Medigap Plans Cost?

Let’s talk about the bottom line: what will a Medigap plan actually cost you? The price isn’t one-size-fits-all. Think of it like shopping for car insurance—the final number depends on the coverage you choose, the company you go with, and even where you live. While two different companies might offer the exact same Plan G benefits, their monthly premiums can be surprisingly different.

Understanding these moving parts is the first step to finding a plan that fits your budget without sacrificing the coverage you need. We’ll walk through what influences your premium, how to account for all your costs, and the best way to find a more affordable rate.

What Affects Your Monthly Premium?

The cost of Medigap policies can vary quite a bit, even for identical plans. Insurance companies set their own prices, so you’ll see different premiums for the same lettered plan. The main factors that influence what you’ll pay each month are the insurance company’s pricing structure, the specific plan you choose (for example, Plan G versus Plan N), and your location. A plan in a major city might cost more than the same plan in a rural area. It’s a good idea to compare costs from several companies to see what the range looks like in your state.

Plan for Out-of-Pocket Costs

When you’re mapping out your retirement budget, it’s important to remember that your Medigap premium is a separate expense. You will pay this monthly premium directly to your private insurance company, and it’s in addition to the monthly Part B premium you pay to Medicare. These two costs together form the foundation of your healthcare expenses under Original Medicare with a Medigap plan. Factoring both into your financial planning helps prevent surprises down the road and ensures your healthcare coverage remains affordable and predictable. This approach allows you to fully appreciate the peace of mind your Medigap plan provides.

How to Find a More Affordable Premium

The single best way to secure a good price is to shop for your plan during your Medigap Open Enrollment Period. This six-month window starts the month you’re 65 or older and enrolled in Part B. During this time, insurance companies cannot use medical underwriting. That means they can’t refuse to sell you a plan or charge you more because of pre-existing health conditions. This is your golden ticket to getting any plan sold in your state at the best possible price. Comparing quotes from different insurance companies during this period is the key to finding a more affordable premium.

How Medigap Fits with Your Other Coverage

Understanding how a Medigap plan fits into your overall health coverage is a crucial step. You might have Original Medicare, be thinking about drug coverage, or even still have a plan from your employer. It’s not always clear how these different pieces work together. The key is knowing that Medigap is designed to work with Original Medicare, but it doesn’t replace other types of insurance you might need. Let’s walk through how Medigap interacts with other common coverage options so you can see the full picture.

Medigap vs. Medicare Advantage: Key Differences

One of the most common points of confusion is the difference between Medigap and Medicare Advantage. Think of it this way: you can have one or the other, but not both. A Medigap policy is a true supplement—it works alongside your Original Medicare (Part A and Part B) to help pay for out-of-pocket costs like deductibles and coinsurance. On the other hand, a Medicare Advantage plan is an alternative way to get your Medicare benefits. It replaces Original Medicare, bundling your Part A and B coverage into a single plan offered by a private insurance company.

Do You Still Need a Part D Plan?

This is a question I hear all the time, and the answer is a clear “yes.” If you take any prescription medications, you will need a separate prescription drug plan, also known as Part D. Medigap plans sold today do not cover prescription drugs. Their job is to help with the costs of your medical services under Part A and Part B, not your medications from the pharmacy. To get that coverage and avoid a potential late enrollment penalty, you’ll need to sign up for a standalone Part D plan. This ensures you have comprehensive coverage for both your doctor visits and your prescriptions.

Using Medigap with Employer Insurance

If you’re still working past 65 and have health coverage through your job, you might wonder if Medigap makes sense. It can. In this situation, your employer plan is typically the “primary payer,” meaning it pays your health claims first. After your employer plan pays its share, Medicare pays second. A Medigap policy could then step in to cover costs that are left over, like deductibles and copays. It’s important to figure out if the monthly Medigap premium is worth the extra coverage you’d get. Understanding how Medicare works with other insurance is the first step to deciding if this strategy is right for you.

Avoid These Common Medigap Mistakes

Medigap can feel like a puzzle, but it doesn’t have to be. Once you understand the basics, the pieces start to fit together. A big part of getting it right is knowing what to watch out for. Let’s walk through a few common trip-ups so you can feel confident in your decision and choose a plan that truly works for you.

Myth: Medigap Covers Prescriptions

This is one of the most frequent points of confusion. While it seems like a “supplement” plan would cover everything, Medigap policies sold today do not include prescription drug coverage. Original Medicare (Parts A and B) doesn’t cover most prescriptions you take at home, and Medigap is designed to fill the gaps in Original Medicare—not add new benefits. To get help with your medication costs, you’ll need to enroll in a separate Medicare Part D plan. Think of it as a separate but essential piece of your overall healthcare coverage.

Mistake: Missing Your Best Enrollment Window

Timing is everything when it comes to Medigap. You have a golden opportunity to enroll, and it’s called your Medigap Open Enrollment Period. This six-month window starts on the first day of the month you’re 65 or older and enrolled in Medicare Part B. During this time, insurance companies can’t use your health history to charge you more or deny you coverage. It’s your one-time pass to get any plan you want. If you miss this window, you may have to answer health questions, and companies could refuse to sell you a policy.

Mistake: Choosing a Plan Based on Price Alone

It’s tempting to just pick the plan with the lowest monthly premium, but that can be a shortsighted move. Here’s why: Medigap plans are standardized. That means a Plan G from one company has the exact same benefits as a Plan G from another. However, the prices they charge can be wildly different. It’s smart to compare costs, but you should also look at the company’s history of rate increases and its reputation for customer service. A super-low introductory rate might not stay low for long. Your goal is to find a plan that offers stable, long-term value from a company you can trust.

Where to Get Help with Your Medigap Decision

Choosing a Medigap plan is a significant decision, and you don’t have to make it alone. Sorting through the different plans, rules, and insurance companies can feel like a full-time job. The good news is that there are several reliable resources available to provide clarity and personalized guidance. Whether you prefer to do your own research with official tools or talk through your options with an expert, help is available. Taking the time to find the right support can give you confidence that you’re selecting a plan that truly fits your life.

Use Official Medicare Resources

The best place to start your research is often with the source itself. Medicare provides official, unbiased information to help you understand your options. You can use Medicare’s comparison tool to explore and compare the plans available in your area. It’s a straightforward way to see which benefits are included in each standardized plan, helping you find the coverage that best fits your needs. The annual “Medicare & You” handbook is another excellent resource that breaks down how Medigap works with Original Medicare. These government-provided tools are free to use and can give you a solid foundation of knowledge before you make a final decision.

Find Your State’s Assistance Program

Every state has a State Health Insurance Assistance Program, or SHIP, that offers free and impartial counseling to people with Medicare. SHIP counselors are highly trained volunteers who can answer your specific questions about Medigap policies, enrollment periods, and your rights. They can help you understand complex rules, like the guaranteed issue protections you have during your one-time, six-month Medigap open enrollment period. Because SHIPs are not affiliated with any insurance company, you can trust that their advice is completely unbiased. You can find your local SHIP office to schedule a phone or in-person appointment.

Talk with an Independent Insurance Agent

If you’d like more personalized guidance, speaking with an independent insurance agent can be incredibly helpful. Unlike agents who work for a single company, independent agents can offer plans from multiple insurance carriers. This gives you a much broader view of your options. You can buy a Medigap policy from any insurance company that’s licensed in your state, and a good agent will help you compare the costs and reputations of those companies. They will take the time to understand your health needs and budget to help you find the right fit. This one-on-one support can simplify the entire process and ensure all your questions are answered.

Frequently Asked Questions

What’s the real difference between a Medigap plan and a Medicare Advantage plan? Think of it this way: a Medigap plan works with your Original Medicare as a partner, while a Medicare Advantage plan is an alternative that replaces it. Medigap helps pay for the out-of-pocket costs that Original Medicare leaves behind, like deductibles and coinsurance. A Medicare Advantage plan bundles your Part A and Part B benefits into a single plan run by a private insurer, often with its own network of doctors and hospitals. You can have one or the other, but you can’t have both at the same time.

I’m healthy. Do I really need to buy a Medigap plan right when I turn 65? This is a great question, and the timing is more important than you might think. Your six-month Medigap Open Enrollment Period when you first get Part B is your one-time golden ticket. During this window, insurance companies can’t ask you about your health history or charge you more for pre-existing conditions. If you wait, you lose that protection. While you might be healthy now, applying later means you’ll likely have to go through medical underwriting, which could lead to higher premiums or even being denied coverage.

If all the plans with the same letter are identical, should I just pick the one with the lowest price? While it’s tempting to go for the lowest monthly premium, price shouldn’t be the only factor. It’s true that a Plan G from one company has the same basic benefits as a Plan G from another. However, the companies themselves are different. It’s wise to also look at a company’s history of rate increases and its reputation for customer service. A plan with a very low introductory rate might see larger price hikes down the road, so finding a stable, reputable company can provide better long-term value.

Will my Medigap plan cover my prescription drugs? No, this is a common point of confusion. Medigap plans sold today are designed to fill the gaps in your medical coverage under Original Medicare Parts A and B, not your pharmacy costs. To get coverage for your medications, you will need to enroll in a separate Medicare Part D prescription drug plan. Think of your Part D plan as another essential piece of your complete healthcare coverage.

I missed my initial six-month enrollment window. Can I still get a Medigap plan? It is possible, but it’s not guaranteed. Once your Open Enrollment Period ends, insurance companies can generally require you to answer health questions and go through medical underwriting. Based on your health history, they can charge you a higher premium or deny your application. There are some specific situations, like losing employer coverage, that grant you “guaranteed issue rights” to buy a plan later. However, relying on these exceptions is risky, which is why enrolling during your initial window is always the best approach.