What Is Medigap?
Medigap is private health insurance you buy from insurance companies to help pay costs that Original Medicare doesn't cover. It works only with Original Medicare (Medicare Part A and Part B). It does not work with Medicare Advantage.
When you have both Original Medicare and a Medigap policy, Medicare pays first. Then Medigap pays its share of what's left. This reduces what comes out of your pocket for:
- Deductibles (the amount you must pay before Medicare covers services)
- Coinsurance (your percentage share of costs after you meet the deductible)
- Copayments (fixed amounts you pay per service)
Medigap does not cover prescription drugs, long-term care, dental, vision, or hearing aids. These are covered by other programs.
Medigap vs. Medicare Advantage: A Critical Difference
Medigap and Medicare Advantage are two very different ways to get extra coverage:
Medigap
- Works with: Original Medicare only
- Pays: Your out-of-pocket costs (deductibles, coinsurance, copays)
- Network: Accepted anywhere Medicare is accepted
- Enrollment: Separate from Medicare
Medicare Advantage (Part C)
- Replaces: Original Medicare entirely
- Includes: Part A, Part B, and usually Part D (drugs)
- Network: Limited to plan's network providers
- Enrollment: Replaces Original Medicare
You cannot have both Medigap and Medicare Advantage at the same time. If you want Medigap, you must be in Original Medicare. You cannot be in a Medicare Advantage plan.
Standardized Medigap Plans: A–N
Medigap plans are named by letter. Plan G from any insurance company covers the same benefits as Plan G from any other company. The only differences are the price and how good the customer service is.
The standardized plans are: A, B, C, D, F, G, K, L, M, and N. Each offers a different combination of benefits at different price levels.
Plans C and F: Closed to New Beneficiaries
If you first became eligible for Medicare on January 1, 2020 or later, you cannot enroll in Plans C or F. These plans closed to new people.
If you became eligible for Medicare before January 1, 2020, you can still enroll in or keep Plan C or F. But if you switch to a different plan, you generally cannot switch back to it later.
Massachusetts, Minnesota, and Wisconsin
Massachusetts, Minnesota, and Wisconsin have different rules. Medigap plans in these states may have different names and benefits. Call your state's insurance office or your insurance company to learn about plans where you live.
Medigap Standardized Benefits Comparison
Use this chart to see what each plan covers. A checkmark or percentage means the plan pays that cost. A dash (—) means it doesn't. Plans K and L cover less of each bill but have a yearly cap on what you pay out of your pocket. That makes them cheaper.
| Medigap Benefit | Plan A | Plan B | Plan C | Plan D | Plan F | Plan G | Plan K | Plan L | Plan M | Plan N |
|---|---|---|---|---|---|---|---|---|---|---|
| Part A Coinsurance & Hospital Costs (days 61–90, days 91–150 lifetime reserve) | Yes | Yes | Yes | Yes | Yes | Yes | 50% | 75% | Yes | Yes |
| Part A Hospice Coinsurance or Copayment | Yes | Yes | Yes | Yes | Yes | Yes | 50% | 75% | Yes | Yes |
| Part B Coinsurance or Copayment | Yes | — | Yes | Yes | Yes | Yes | 50% | 75% | Yes | Copay |
| Part B Excess Charges (charges above Medicare's approved amount) | — | — | — | — | Yes | Yes | — | — | — | — |
| Part A Deductible | — | Yes | Yes | Yes | Yes | Yes | 50% | 75% | Yes | Yes |
| Part B Deductible | — | — | Yes | — | Yes | — | — | — | — | — |
| Skilled Nursing Facility (SNF) Coinsurance (days 21–100) | Yes | Yes | Yes | Yes | Yes | Yes | 50% | 75% | Yes | Yes |
| Blood (first 3 pints per year) | Yes | Yes | Yes | Yes | Yes | Yes | 50% | 75% | Yes | Yes |
| Foreign Travel Emergency (up to plan limits) | — | — | Yes | Yes | Yes | Yes | — | — | Yes | Yes |
| Out-of-Pocket Limit (annual maximum you pay) | — | — | — | — | — | — | Yes (annual limit) | Yes (annual limit) | — | — |
Understanding the Medigap Open Enrollment Period
The Medigap Open Enrollment Period is a six-month window. During this time, insurance companies must sell you Medigap. They cannot say no or charge you more because of your health. This is your best chance to get Medigap without any medical questions.
When Does It Start?
Your six-month period starts on the first day of the month when you turn 65 and enroll in Medicare Part B.
Example: If you turn 65 on March 15 and enroll in Part B, your period starts March 1 and ends August 31.
What Does It Mean?
During this period:
- Insurance companies cannot check your health history. They cannot say no or charge you extra.
- Companies must accept you. This is called guaranteed issue.
- You can choose any Medigap plan the company offers in your state.
After the Open Enrollment Period Ends
If you apply for Medigap after this window ends, the insurance company may:
- Ask detailed health questions.
- Say no to covering problems you had before.
- Charge you extra money because of your health.
- Refuse to sell you a policy at all.
There are some exceptions (like if you leave a Medicare Advantage plan, you might get a second chance), but your first Open Enrollment Period is your best opportunity to enroll without any problems.
Choosing a Medigap Plan
All Plans With the Same Letter Are Identical
When you compare Medigap plans, remember that all Plan G policies cover the same things, all Plan N policies cover the same things, and so on. The insurance company does not matter for benefits—it only matters for price and how good their customer service is.
If you want Plan G, look for the cheapest Plan G with good customer reviews. There's no point in paying more for the same coverage.
Price Varies by Insurer, Age, and Location
Benefits are the same everywhere, but prices are not. The same Plan G costs different amounts at different companies. Insurers also charge in different ways:
- Age-based (attained age): Your monthly cost goes up as you get older.
- Issue-age: Your monthly cost is locked in at your age when you enroll and doesn't change.
- Community-rated: Everyone in your area pays the same amount, no matter their age.
Prices also vary by state and neighborhood. The key point: get quotes from several companies for the same plan letter.
Use Medicare's Medigap Finder
Medicare has a free online tool to compare Medigap plans and prices in your area. Go to Medicare's Medigap page to search for plans, read details, and see ratings.
When to Enroll and When You Can Switch
The best time to enroll in Medigap is during your Open Enrollment Period (the six-month window when you turn 65 and enroll in Part B). This way you won't have medical underwriting (health checks).
If you apply after that window, the company may ask health questions. You might pay more or even be turned down. In some cases, you may get a second chance (like if you leave a Medicare Advantage plan), but this is rare.
You can switch from one Medigap plan to another. But if you switch to a plan that covers less, you usually cannot go back to the plan you left. This is called the step-down rule. You can switch to a plan with more coverage. Ask your state insurance office about the current rules.
Getting Help With Medigap
Medigap is confusing. Free help is out there:
Getting Help Paying
Overview of assistance programs and counseling services for Medicare costs, including Medigap guidance.
SHIP Directory
Find your state's SHIP (State Health Insurance Assistance Program) for free, personalized Medigap counseling.
State Insurance Departments
Contact your state's insurance commissioner or department for Medigap-specific complaints, questions, and regulations.
Related Topics
To understand Medigap better, read about the programs it works with:
- Medicare Part A (Hospital Insurance)
- Medicare Part B (Medical Insurance)
- Choosing Your Medicare Coverage
- Medicare Advantage (Part C) — see why you can't combine it with Medigap