What is Medigap, and Why Do I Need Supplemental Insurance?
Key Takeaways
- Private insurance companies offer Medicare Supplement insurance (Medigap) to help cover some of the healthcare costs not covered by Original Medicare (Part A and B).Original Medicare is a fee-for-service health insurance program available to Americans aged 65 and older and some individuals with disabilities. Original Medicare is provided by the federal government and is made up of two parts: Part A (hospital insurance) and Part B (medical insurance).
- You can choose between several standardized Medigap options. Consider your coverage needs and budget to decide which one is right for you.
- You can apply for Medicare Supplement plan directly through a private insurance carrier or through a marketplace that will let you review options from multiple insurance carriers.
There’s nothing more personal than your health or finances; balancing the two can be tricky. Original Medicare costs can add up quickly. By purchasing a Medigap policy, you are able to offset some of those costs, but you will need to pay more in monthly premiums. Continue reading to learn how Medigap works alongside Original Medicare.
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What Is Medigap Insurance?
Original Medicare (Part A and Part B) covers a wide range of hospital and medical services. However, beneficiaries are still responsible for a copay or coinsurance when they use most services, and they must reach an annual deductibles before the insurance starts to pay. As a result, even with Medicare, frequent hospital or doctor visits can be expensive.
Medicare Supplement insurance, also referred to as Medigap, cover some of the costs Original Medicare doesn’t.
A Medicare Supplement insurance plan offers:
- Different coverage levels with standard benefits for each plan.
- A range of services and plans, each assigned a letter from “A” to “N.” Note that plans “E”, “H”, “I” and “J” are no longer sold.
- Basic Medigap coverage is the same across most states and insurance companies.
- Each Medigap plan follows federal and state laws to protect you and your policy.
- Medigap plans can be priced using an attained age model or issue age model.
For the most part, Medigap Plan A in one state provides the same coverage as Plan A in a different state. However, there are exceptions to this rule with a few states. We discuss these exceptions below.
What Do Medigap Plans Cover?
Medicare Supplement plans cover some costs not provided for by Original Medicare, such as the 20% coinsurance charged for most doctor’s visits. All Medicare Supplemental insurance plans must cover these standard services:
- Medicare Part A coinsurance costs for inpatient care, up to an additional 365 days after Medicare benefits run out
- Coinsurance or copaymentsA copayment is the fixed amount you pay directly to your provider for medical services or prescription drugs covered in your plan. For example: If your plan includes a copayment of $20 for office visits, you’ll pay $20 to your doctor whenever you have an appointment. for hospice care
- Medicare Part B coinsurance or copayments
- Up to three pints of blood
Specific Medigap plans provide additional coverage like:
- Skilled nursing facility careSkilled nursing facilities provide in-patient extended care with trained medical professionals to recover from injury or illness and activities of daily living. These facilities provide physical and occupational therapists, speech pathologists and medical professionals assist with medications, tube feedings and wound care. Skilled nursing stays are usually covered under Medicare Part A. coinsurance
- Part A deductible
- Part B deductible (no longer covered for new Medicare beneficiaries)
- Part B excess charges (additional charges that certain doctors may decide to add on top of the Medicare-recommended amount for a service)
- Emergency care during foreign travel
Medicare Supplement plans don’t cover:
- Prescription drugs
- Vision
- Dental
- Long-term care
- Hearing aids
Find the Medicare Plan that works for you.
Compare Medicare Supplement Plans
It can be challenging to understand what each Medigap policy offers and whether it’s right for you.
We’ve created a chart for a side-by-side comparison. Any percentage less than 100% requires you to pay the remaining cost.
Medigap policies are standardized differently if you live in Massachusetts, Minnesota, or Wisconsin. Otherwise, these coverage details are the same for plans across the country.
Medicare Supplement Plans Comparison Chart 2025
- Medicare Supplement Plan F and Plan G each also offer a variation with a high deductible in some states. In 2025, you must pay $2,870 in shared costs before your supplemental coverage begins. These options charge lower monthly premiums, so they can help you save in years when you have lower healthcare expenses.
- Medigap Plan D offers some of the most comprehensive benefits of all Medigap options.
- As of January 1, 2020, new Medicare enrollees are not eligible for Plan C or Plan F. If you were eligible for Medicare before January 1, 2020 but did not enroll, you may still be eligible.
- Medigap Plan K and Plan L pay 100% of covered services after you reach the annual out-of-pocket limit and pay the yearly Part B deductible. Your annual out-of-pocket limit and Part B deductible reset each calendar year. In 2024, the Part B deductible is $240.
- Medicare Supplement Plan N pays 100% of the Part B coinsurance with certain exceptions. For example, an office visit copay of $20 or $50 copay for emergency room visits that don’t include inpatient admission.
Learn more about Medigap plan costs and how to enroll.
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Choosing a Medicare Supplement (Medigap) Policy
Is Medigap the right decision for you? Consider your choices carefully and contact a licensed insurance agent for guidance.
You may also want to consider Medicare Advantage (Part C) plans. Those policies can offer lower Medicare costs while providing additional benefits like coverage for prescription drugs, vision, dental, and hearing.
What’s the difference between Medicare Supplement (Medigap) and Medicare Advantage?
Medicare Supplement (Medigap) plans are offered by private insurance carriers to cover gaps in Original Medicare, paying for out-of-pocket expenses like copays, coinsurance and deductibles. The coverage for most Medigap plans is standardized across the U.S.
Medicare Advantage is an alternative to Original Medicare. These plans from private insurance carriers substitute for Part A and B coverage, and most include Part D prescription drug coverage. Medicare Advantage plans may also offer additional benefits such as dental, vision, hearing and more. The availability of Medicare Advantage plans depends on where you live, and many plans require you to see doctors in a healthcare provider network to take full advantage of your benefits.
Can I enroll in a Medigap plan while on a Medicare Advantage plan?
You cannot be enrolled in both a Medigap plan and a Medicare Advantage policy. When choosing which plan is right for you, consider that Original Medicare covers about 80% of your costs for most medical and hospital care. Many people enroll in a Medicare Supplement plan to cover the gaps, and a standalone Part D plan to cover prescription drug costs.
Medicare Advantage plans match the coverage from Parts A and B and usually include Part D coverage for prescription drug costs.
If you’re not sure which plan is right for you, contact a GoHealth licensed insurance agent. They will take time to explain your options.
When should I enroll in a Medigap policy?
The best time to apply for a Medigap policy is during your Medigap Open Enrollment Period. The period starts on the first day of the month that you are 65 years or older and enrolled in Part B. This period is open for six months. You can’t be denied coverage based on any pre-existing conditions.
While you can still apply for a Medigap policy after you’re 65, there may be fewer options and your premium may go up. Insurance companies can use medical underwriting outside of your Medigap Open Enrollment Period to determine your health status and how much your policy costs. There’s also a chance your application won’t be accepted if you don’t meet the minimum health requirements.
How do Medigap plans work in each state?
Sources
- How to compare Medigap policies. Medicare.gov.
This website is operated by GoHealth, LLC., a licensed health insurance company. The website and its contents are for informational and educational purposes; helping people understand Medicare in a simple way. The purpose of this website is the solicitation of insurance. Contact will be made by a licensed insurance agent/producer or insurance company. Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. Our mission is to help every American get better health insurance and save money.
Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.