What it is
Medigap plans, also called Medicare Supplement plans, are sold by private insurance companies. They are designed to help pay some out-of-pocket costs in Original Medicare, such as certain coinsurance and deductibles. Which costs a plan helps with depends on its letter.
Many people ask what medigap plans leave out. Prescription drug coverage is the big one. Medigap plans sold today do not include drug coverage, so people who want it generally add a separate Medicare Part D plan. Routine dental, vision and hearing care are also typically not part of Medigap.
Some extras do appear in certain plans. Some plans help with Part B excess charges, which can apply when a provider does not accept Medicare's approved amount. Some plans also include limited emergency care during foreign travel. Which plans offer these varies, so it helps to compare the standardized plan benefits. Massachusetts, Minnesota and Wisconsin standardize Medigap differently.
How it’s traditionally been approached
Traditionally, people have paired Original Medicare and a Medigap plan with a stand-alone Part D plan. The Part D plan is chosen separately, with its own list of covered drugs, pharmacies and costs. Many people review it each year because plans can change.
Timing matters with Part D. People who go without drug coverage that is considered creditable after they are first eligible may face a late enrollment penalty, which can last as long as they have Part D. Rules and exceptions exist, so it is wise to confirm the details with Medicare.gov, a State Health Insurance Assistance Program (SHIP), or a licensed agent.
For dental, vision and hearing, people have approached it in different ways. Some buy a separate stand-alone dental or vision policy. Others pay out of pocket, use discount programs, or choose Medicare Advantage, which often includes some of these extras. Medicare Advantage also has trade-offs, such as networks, prior authorization and copays, while Medigap offers the freedom to see any provider nationwide who accepts Medicare, with generally higher monthly premiums and a separate drug plan.
How the right licensed agent may help
A Medigap agent may help you see how all these pieces fit together. A conversation is usually a friendly review of your doctors, your medications, your travel habits and your budget. There is no obligation, and an agent cannot promise a particular outcome.
Questions you might ask include: Which plan letters are available to me? Does this plan help with Part B excess charges? Does it include foreign travel emergency coverage? How would a separate Part D plan work with it? An agent may also explain how Medigap and Medicare Advantage compare so you can weigh both fairly.
Plan availability also depends on your situation. Plans C and F are only for people who became eligible for Medicare before January 1, 2020. Plans E, H, I and J were discontinued and are not sold today, which matters because people still search for Plan H. Call 1-800-MEDIGAP for more information.
The bigger picture
Coverage decisions can touch your sense of calm as much as your wallet. Wondering whether a prescription, a hearing aid or a trip abroad will be covered can be stressful. Putting the pieces in order may help you feel more prepared and less rushed.
Whole-person wellbeing includes dental, vision and hearing, since they affect eating, reading, conversation and independence. If you are also looking for care providers, Providers.plus may be a helpful resource. Every person's needs differ, and no single approach is right for everyone.
Keep in mind
- This site is educational only and is not insurance, legal, tax or medical advice.
- 1-800-MEDIGAP is independent and privately run. It is not Medicare.gov, CMS, Social Security or any government agency. Official information is at Medicare.gov.
- Open enrollment, guaranteed issue and other rules vary by state and change over time, so confirm current rules with Medicare.gov, your SHIP, or a licensed agent.
- Acceptance, savings and coverage are never guaranteed, and no plan is best for everyone.
Take the next step
- Talk with a Medigap agent ↗Jeff Cline on contacts.plus — a person, not a call center.
Guides in this topic
Licensed agent types
Call 1-800-MEDIGAP for more information
Frequently asked questions
Does Medigap cover prescriptions?
No, Medigap plans sold today do not include prescription drug coverage. Most people who want drug coverage add a separate Medicare Part D plan. A Medigap agent may help explain how the two can work together.
Can I use Medicare Part D with Medigap?
Yes, Medicare Part D with Medigap is a common pairing. Medigap helps with certain Original Medicare costs, while Part D plans help with prescription drugs. You choose and enroll in each separately.
What is the Part D late enrollment penalty?
The Part D late enrollment penalty is an added cost that may apply if you go without creditable drug coverage after you are first eligible. It can continue as long as you have Part D. Confirm how it applies to you with Medicare.gov, your SHIP, or a licensed agent.
What are Medicare Part B excess charges?
Part B excess charges are amounts a provider may bill above Medicare's approved amount when the provider does not accept assignment. Some Medigap plans help cover them, and others do not. Rules vary by state, so check with a licensed agent.
Does Medigap cover foreign travel emergencies?
Some Medigap plans include limited emergency care when you travel outside the U.S., but not all do. Terms and limits depend on the plan. A Medigap agent can explain which plans offer it.
Does Medigap cover dental and vision?
Generally, no. Medigap plans do not include routine dental, vision or hearing care. People often use separate stand-alone policies, pay out of pocket, or consider Medicare Advantage, which may include some of these extras.
Educational resource. 1-800-MEDIGAP shares general information and connects people with independent licensed agents. It is not professional advice. Talk with a qualified professional about your own situation.