What is Medigap, and Why Do I Need Supplemental Insurance?

Reviewed by: Selah Lee, Licensed Insurance Agent
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).
You may need to add Medicare Supplement Insurance to fill costly “gaps” in coverage. Private insurance companies provide Medigap plans with different levels of coverage.
Medigap coverage can help you eliminate cost gaps. It’s important to know what you need and compare plans to determine which Medigap plan is right for you.
You can apply directly through a private Medigap provider, or through Marketplaces like GoHealth.
There’s nothing more personal than your health or finances; balancing both can be tricky. Original Medicare costs can add up quickly. By purchasing a Medigap policy, you are able to offset some of those costs. Continue reading to learn how Medigap works alongside Original Medicare.
Find a local Medicare plan that fits your needs
What is Medigap Insurance?
Original Medicare (Part A and Part B) requires beneficiaries to still pay copays, deductibles, and coinsurance. Medicare Supplement Insurance, or Medigap policies, help you cover some of the costs Original Medicare doesn’t. Frequent hospital or doctor visits can be expensive without the right coverage.
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.” It’s important to note 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.
The terms “standard benefits” and “basic coverage” mean that Medigap plan “A” in one state is the same as plan “A” in a different state. However, there are exceptions to this rule with a few states. We discuss these states below.
What Do Medigap Plans Cover?
Medicare Supplement plans cover some costs not covered by Original Medicare. For example, a 20% coinsurance bill for a doctor visit could be covered with a Medigap plan. All Medicare Supplemental insurance plans must cover standard services. Additional benefits are available with specific plans.
All Medicare Supplemental insurance plans must cover:
- Medicare Part A coinsurance costs up to an additional 365 days after Medicare benefits run out; coinsurance or copayments for hospice care
- Medicare Part B coinsurance or copayments
- Up to three pints of blood
Other services covered depending on the plan:
- Skilled nursing facility care coinsurance
- Part A deductible
- Part B deductible (no longer covered for new Medicare beneficiaries)
- Part B excess charges
- Foreign travel emergency care
Medicare Supplement plans generally don’t cover:
- Prescription drugs
- Vision
- Dental
- Long-term care
- Hearing aids
Do you have more questions about Medicare Supplement coverage? Learn more.
Are you eligible for cost-saving Medicare subsidies?
Compare Medicare Supplement Plans
With ten different plan options, it can be challenging to understand what each plan offers and whether it’s right for you.
We’ve created a chart for a side-by-side comparison of each plan. Any percentage less than 100% requires you to pay the remaining cost.
Necessary coverage Medigap policies are not the same if you live in Massachusetts , Minnesota or Wisconsin.
Medicare Supplement Plans Comparison Chart 2022
Benefits: Plan A
Medicare Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits run out
- 100%
Medicare Part B coinsurance or copayment
- 100%
Blood (first three pints) for a medical procedure
- 100%
Part A hospice care coinsurance or copayment
- 100%
Skilled nursing facility care coinsurance
- –
Part A deductible
- –
Part B deductible
- –
Part B excess charges
- –
Foreign travel emergency up to plan limits
- –
The out-of-pocket limit in 2022
- N/A
Benefits: Plan B
Medicare Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits run out
- 100%
Medicare Part B coinsurance or copayment
- 100%
Blood (first three pints) for a medical procedure
- 100%
Part A hospice care coinsurance or copayment
- 100%
Skilled nursing facility care coinsurance
- –
Part A deductible
- 100%
Part B deductible
- –
Part B excess charges
- –
Foreign travel emergency up to plan limits
- –
The out-of-pocket limit in 2022
- N/A
Benefits: Plan C*
Medicare Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits run out
- 100%
Medicare Part B coinsurance or copayment
- 100%
Blood (first three pints) for a medical procedure
- 100%
Part A hospice care coinsurance or copayment
- 100%
Skilled nursing facility care coinsurance
- 100%
Part A deductible
- 100%
Part B deductible
- 100%
Part B excess charges
- –
Foreign travel emergency up to plan limits
- 80%
The out-of-pocket limit in 2022
- N/A
Benefits: Plan D
Medicare Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits run out
- 100%
Medicare Part B coinsurance or copayment
- 100%
Blood (first three pints) for a medical procedure
- 100%
Part A hospice care coinsurance or copayment
- 100%
Skilled nursing facility care coinsurance
- 100%
Part A deductible
- 100%
Part B deductible
- –
Part B excess charges
- –
Foreign travel emergency up to plan limits
- 80%
The out-of-pocket limit in 2022
- N/A
Benefits: Plan F*
Medicare Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits run out
- 100%
Medicare Part B coinsurance or copayment
- 100%
Blood (first three pints) for a medical procedure
- 100%
Part A hospice care coinsurance or copayment
- 100%
Skilled nursing facility care coinsurance
- 100%
Part A deductible
- 100%
Part B deductible
- 100%
Part B excess charges
- 100%
Foreign travel emergency up to plan limits
- 80%
The out-of-pocket limit in 2022
- N/A
Benefits: Plan G
Medicare Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits run out
- 100%
Medicare Part B coinsurance or copayment
- 100%
Blood (first three pints) for a medical procedure
- 100%
Part A hospice care coinsurance or copayment
- 100%
Skilled nursing facility care coinsurance
- 100%
Part A deductible
- 100%
Part B deductible
- –
Part B excess charges
- 100%
Foreign travel emergency up to plan limits
- 80%
The out-of-pocket limit in 2022
- N/A
Benefits: Plan K*
Medicare Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits run out
- 100%
Medicare Part B coinsurance or copayment
- 50%
Blood (first three pints) for a medical procedure
- 50%
Part A hospice care coinsurance or copayment
- 50%
Skilled nursing facility care coinsurance
- 50%
Part A deductible
- 50%
Part B deductible
- –
Part B excess charges
- –
Foreign travel emergency up to plan limits
- –
The out-of-pocket limit in 2022
- $6,620
Benefits: Plan L*
Medicare Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits run out
- 100%
Medicare Part B coinsurance or copayment
- 75%
Blood (first three pints) for a medical procedure
- 75%
Part A hospice care coinsurance or copayment
- 75%
Skilled nursing facility care coinsurance
- 75%
Part A deductible
- 75%
Part B deductible
- –
Part B excess charges
- –
Foreign travel emergency up to plan limits
- –
The out-of-pocket limit in 2022
- $3,310
Benefits: Plan M
Medicare Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits run out
- 100%
Medicare Part B coinsurance or copayment
- 100%
Blood (first three pints) for a medical procedure
- 100%
Part A hospice care coinsurance or copayment
- 100%
Skilled nursing facility care coinsurance
- 100%
Part A deductible
- 50%
Part B deductible
- –
Part B excess charges
- –
Foreign travel emergency up to plan limits
- 80%
The out-of-pocket limit in 2022
- N/A
Benefits: Plan N*
Medicare Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits run out
- 100%
Medicare Part B coinsurance or copayment
- 100%
Blood (first three pints) for a medical procedure
- 100%
Part A hospice care coinsurance or copayment
- 100%
Skilled nursing facility care coinsurance
- 100%
Part A deductible
- 100%
Part B deductible
- –
Part B excess charges
- –
Foreign travel emergency up to plan limits
- 80%
The out-of-pocket limit in 2022
- N/A
There are a few important changes and variations of the plan that you should know before choosing.
- Medicare Supplement Plan F and Plan G also offer a plan with a high deductible in some states. In 2022, you must pay $2,490 in shared costs before regular Medicare 80/20 policy begins.
- 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 Plans K and 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 2022, the Part B deductible is $233.
- 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.
What extra benefits and savings do you qualify for?
Choosing a Medicare Supplement (Medigap) Policy
Is Medigap the right decision for you? Selecting a health insurance plan can be challenging. It’s important to compare each plan for your lifestyle because every Medicare Supplement plan is different.
Another option to consider is Medicare Advantage Plans (Part C). Those policies help with your Medicare costs and can add more benefits.
FAQs
You can enroll in a Medigap policy or Medicare Advantage plan, but you cannot have both at the same time.
- Medicare Advantage is an alternative to Original Medicare. It combines Parts A, B and sometimes D. Medicare Advantage plans may also offer additional benefits such as dental, vision, hearing and more.
- Medicare Supplement (Medigap) plans help cover gaps in Original Medicare. Common gaps are out-of-pocket expenses, including copays, coinsurance and deductibles. Private health insurance companies provide Medigap plans under state and federal regulations.
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. Many people enroll in a Medigap plan to cover the “gaps,” and a standalone Part D plan to cover prescription drug costs.
Choosing Medicare Advantage combines both Parts A and B and usually includes 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.
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.