Medigap (Medicare Supplement)
Medigap fills the “gaps” in Original Medicare—covering some or most of your deductibles, coinsurance, and copays. Use it with Parts A & B (not with Medicare Advantage).
Why people pick Medigap
- Predictable costs: Lower surprise bills vs. 20% coinsurance under Original Medicare alone.
- No networks: See any provider nationwide who accepts Medicare.
- Travel-friendly: Some plans include limited foreign travel emergency coverage.
- Simplicity: Keep Original Medicare freedom + a supplement; add a separate Part D for drugs.
What Medigap does not include
- Prescription drugs (Part D is separate).
- Dental, vision, or hearing benefits (unless you add separate coverage).
- It does not work with Medicare Advantage—you can’t have both at the same time.
Plans by letter (standardized)
- Plan G: Most comprehensive option available to newer beneficiaries (doesn’t cover Part B deductible).
- Plan N: Lower premiums; office/ER copays; does not cover Part B excess charges.
- High-deductible G: Lower monthly premium; you pay more upfront each year before benefits kick in.
- Plans K/L: Partial cost-sharing up to an annual limit (then plan pays 100%).
- Plans C/F: Generally only for people first eligible for Medicare before 1/1/2020.
Note: Massachusetts, Minnesota, and Wisconsin standardize Medigap differently.
Plan G vs Plan N (quick take)
| Feature |
Plan G |
Plan N |
| Monthly premium |
Higher |
Lower |
| Part A/B cost gaps |
Covers most gaps (except Part B deductible) |
Similar core coverage; adds small copays |
| Office/ER copays |
None (after deductibles/coinsurance rules) |
Yes (typical small copays) |
| Part B excess charges |
Covered |
Not covered (check if your state/providers bill them) |
Costs: what affects your premium
- Plan letter: G vs N vs high-deductible G, etc.
- Rating method: community-rated, issue-age, or attained-age (varies by insurer/state).
- Zip code & tobacco use: pricing factors vary.
- Household discounts: some carriers offer them.
When to enroll
- Medigap Open Enrollment: your 6-month window starting the month you’re 65+ and enrolled in Part B (no medical underwriting in most cases).
- Guaranteed-Issue rights: certain situations (e.g., losing other coverage) give you a limited window to buy specific plans without underwriting.
- After these windows: you can apply anytime, but approval may require health questions/underwriting.
See enrollment windows
How to choose (fast checklist)
- Decide if you want maximum coverage (Plan G) or lower premium (Plan N or high-deductible G).
- Confirm whether your state/providers bill Part B excess charges (matters for Plan N).
- Estimate typical care (office visits, tests, therapy) to weigh copays vs premium.
- Add a Part D plan for prescriptions.
- Get quotes from multiple carriers (benefits are standardized; price and service differ).
FAQ
- Do I keep Original Medicare? Yes—Medigap works with Parts A & B. Your red/white/blue card stays primary.
- Networks? None. Any provider nationwide who accepts Medicare.
- Can I switch later? You can apply anytime; approval may require underwriting unless you have a special right.
- Drug coverage? Get a separate Part D plan to avoid late penalties and cover meds.
- Can I have Medigap with Advantage? No—choose one or the other.
Want precise quotes and plan comparisons? Call Rachel Carroll at (575) 545-0056. We’ll compare carriers, explain rating methods, and pair you with a Part D plan for your medications.
