What is Medigap (Medicare Supplement)?
Key Takeaways
- Private insurance companies offer Medigap Medicare Supplement insurance 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 Medigap Medicare Supplement plan directly through a private insurance carrier or through a marketplace that will let you review options from multiple insurance carriers.
Medigap Medicare Supplement is a type of insurance plan sold by private insurance carriers to help with the gaps between your needs and what’s covered by Original Medicare.
For example, you pay coinsurance or copayments out-of-pocket when you receive most services. Medigap Medicare Supplement helps with these costs.
Medigap Medicare Supplement plans feature a range of different coverage levels. In most states, each type of plan, identified with a letter from “A” to “N,” provides a standardized selection benefits.
Medigap Medicare Supplement Insurance is only available to those enrolled in Original Medicare; you can’t get Medigap Medicare Supplement coverage if you’re already enrolled in a Medicare Advantage plan.
Read on to learn more about how Medigap Medicare Supplement 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.
A Medigap plan covers some of the costs Original Medicare doesn’t.
Medicare Supplement Insurance 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 some plans are no longer sold.
- The same coverage across most states and insurance carriers.
Medigap plans can be priced using an attained age model or issue age model.
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 Supplement insurance plans must cover:
- 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 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
As of January 1, 2020, Medigap plans cannot cover the Part B deductible. Plans C and F, which included that benefit, are not available to new enrollees joining Medicare on or after that date. Enrollees who were eligible for Medicare before January 1, 2020 but have not yet enrolled, may still be able to buy Plan C or F.
Customers who are new to Medicare and want a comprehensive plan similar to Plans C and F may consider Medicare Plan G coverage because it pays for most copayments and coinsurance.
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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
| Medigap Plan Benefits | Plan A | Plan B | Plan D | Plan G | Plan K | Plan L | Plan M | Plan N |
| Part A coinsurance and hospital costs | 100% | 100% | 100% | 100% | 100% | 100% | 100% | 100% |
| Part B copays and coinsurance | 100% | 100% | 100% | 100% | 50% | 75% | 100% | 100% |
| Part A deductible | Not covered | 100% | 100% | 100% | 50% | 75% | 50% | 100% |
| Blood (first three pints) | 100% | 100% | 100% | 100% | 50% | 75% | 100% | 100% |
| Part A hospice | 100% | 100% | 100% | 100% | 50% | 75% | 100% | 100% |
| Skilled nursing facility | Not covered | Not covered | 100% | 100% | 50% | 75% | 100% | 100% |
| Part B excess charges | Not covered | Not covered | Not covered | 100% | Not covered | Not covered | Not covered | Not covered |
| Foreign travel emergency | Not covered | Not covered | 80% | 80% | Not covered | Not covered | 80% | 80% |
Note: Plan G offers a high deductible plan in some states. Different standardized plan options are available in Massachusetts, Wisconsin, and Minnesota.
Medigap Plans C and F are only available to Medicare enrollees who became eligible before January 1, 2020. Plan F is available as a high deductible plan in some states.
| Medigap Plan Benefits | Plan C | Plan F |
| Part A coinsurance and hospital costs | 100% | 100% |
| Part B copays and coinsurance | 100% | 100% |
| Part A deductible | 100% | 100% |
| Part B deductible | 100% | 100% |
| Blood (first three pints) | 100% | 100% |
| Part A hospice | 100% | 100% |
| Skilled nursing facility | 100% | 100% |
| Part B excess charges | Not covered | 100% |
| Foreign travel emergency | 80% | 80% |
- 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 2025, the Part B deductible is $257.
- 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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Am I Eligible for Medigap?
To be eligibleSome health plans require you to meet minimum requirements before you can enroll. , you must enroll in Original Medicare (Parts A and B). Most individuals are automatically enrolled in Medicare Part AMedicare Part A is hospital insurance, which covers the care you receive while admitted to a hospital, skilled nursing facility, or other inpatient facility. Medicare Part A is part of Original Medicare. by their 65 birthday if they’re already receiving Social Security benefits. If you have questions about enrollment into Medicare parts A or B call your local Social Security office.
When Can I Enroll in Medigap?
The Medicare Supplement open enrollmentThe Medicare Open Enrollment Period (OEP), also known as the Annual Enrollment Period, runs from October 15 to December 7 each year and allows you to make multiple Medicare-related changes. In addition, Affordable Care Act Open Enrollment allows changes to non-Medicare coverage from November 1 to December 15. period lasts for six months. This window begins the month you turn 65 and enroll in Medicare Part B. You must meet both qualifications to be eligible for Medigap’s open enrollment period.
For example, if you turn 65 in January, but your Part B enrollment begins in February, your eligibility begins on Feb. 1 and runs through the end of July.
What Are Guaranteed Issue Rights?
During your initial Medigap open enrollment period, you have guaranteed issueIf you have guaranteed issue rights, insurance companies are required to sell you a Medigap (Medicare Supplement) policy without any additional conditions. rights. Insurers can’t charge higher premiumsA premium is a fee you pay to your insurance company for health plan coverage. This is usually a monthly cost. because of pre-existing conditions or health status. Insurers are required to accept your application for coverage during the open enrollment period. Plus, your coverage is guaranteed renewable if you purchase it at this time, which means it can’t be canceled by the insurer as long as you pay your monthly premium.
You can still purchase Medigap after your open enrollment period, but you may not get the same pricing or coverage levels. Insurers also are allowed to charge more or limit your coverage for pre-existing conditions if you sign up outside of the initial Medigap open enrollment period.
There are a few exceptions, including if you move or must purchase new Medigap coverage. Many states recognize certain life events and may grant Guaranteed Issue Rights to:
- Medicare recipients who lose supplemental coverage through no fault of their own
- Retirees whose former employers cancel their coverage
- Medicare beneficiaries that move to a new state and can’t keep their supplemental coverage
- Beneficiaries who left a Medigap plan to go into a Medicare Advantage plan, but want to return to the Medigap within 12 months of switching
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 coverage with additional benefits.
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.
Does Medigap cover my spouse?
Medigap policies only cover the policyholder, not spouses. If you and your spouse both need Medigap coverage, you will need to sign up separately and purchase individual policies.
Does Medigap cover prescription drugs?
No. However, prescription drugs can be covered by a Medicare Part D Prescription Drug Plan. Medicare Part D is sold separately from Parts A and B. Medicare Advantage plans often include Part D coverage.
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.