What it is
Medigap is private insurance that may help pay some costs Original Medicare does not pay, such as certain copayments, coinsurance and deductibles. It is sold by private insurance companies and works alongside Original Medicare (Part A and Part B). It is not the same as Medicare Advantage.
Medigap plans are labeled with letters. Only Plans A, B, D, G, K, L, M and N (and high-deductible Plan G) are sold to people newly eligible for Medicare. Plans C and F (and high-deductible F) are available only to people who became eligible before January 1, 2020. Plans E, H, I and J were discontinued and are not sold today, so if you see Plan H in a search or an old letter, that is why. Massachusetts, Minnesota and Wisconsin standardize Medigap differently.
Medigap does not usually include prescription drug coverage, which is typically a separate Part D plan. It also does not generally cover routine dental, vision or hearing. Official information is available at Medicare.gov, and 1-800-MEDIGAP is not connected with or endorsed by the U.S. government or the federal Medicare program.
How it’s traditionally been approached
Many families have approached this by gathering the parent's Medicare card, current coverage papers and medication list, then comparing the two main paths: Original Medicare with a Medigap plan and a Part D plan, or a Medicare Advantage plan. Some families also call their State Health Insurance Assistance Program (SHIP) for free, local counseling.
Medigap has real strengths. It generally lets a person see any provider nationwide that accepts Medicare, with no network or referrals, and its cost-sharing tends to be predictable. The trade-offs are that monthly premiums are generally higher, medical underwriting may apply outside open enrollment or guaranteed issue, and drugs need a separate Part D plan.
Medicare Advantage has strengths too. Premiums are often lower, there is an annual out-of-pocket maximum, many plans include extra benefits and drug coverage. Its trade-offs can include provider networks, prior authorization and copays. Neither path is right for everyone, and the choice often depends on your parent's health, doctors, budget and preferences.
How the right licensed agent may help
A licensed Medigap agent may help you make sense of the paperwork so you are not guessing. A visit or call is generally a conversation about your parent's doctors, medications, budget and travel habits. It may also cover where they are in their enrollment timeline, such as turning 65 or switching coverage.
Helpful questions to ask include: Which plan letters are available to my parent? Do open enrollment or guaranteed issue rules apply to them in their state? Will health questions be asked? How might a Part D plan fit alongside this? How could I compare this fairly with Medicare Advantage?
An agent may also explain who needs to be present to authorize decisions and how to keep records organized. Rules vary by state and change over time, so confirm current details with Medicare.gov, your SHIP, or a licensed agent. Call 1-800-MEDIGAP for more information.
The bigger picture
Helping a parent with health coverage can feel heavy. You may worry about getting it wrong, about cost, or about whether your parent will be able to see the doctors they trust. Taking it one step at a time, and asking for help, may ease some of that stress.
A clear plan can bring peace of mind to both of you, and it can free up your time and energy to simply be present with your parent. If you are also looking for care providers, Providers.plus may be a place to start.
Keep in mind
- This page is education only, not insurance, legal, tax or medical advice.
- Enrollment windows, guaranteed issue and birthday or anniversary rules vary by state and can change, so confirm them before deciding.
- Acceptance into a plan is not guaranteed, and no plan is best for everyone.
- 1-800-MEDIGAP is independent and privately run; for official information, visit Medicare.gov.
Licensed agents who often help
Get matched privatelyCall 1-800-MEDIGAP for more information
Frequently asked questions
What are medigap plans?
Medigap plans are private insurance policies that may help pay some out-of-pocket costs left by Original Medicare, such as copayments, coinsurance and deductibles. They are sold by private companies and are labeled by letter. They are separate from Medicare Advantage.
Can I help my parent choose a Medigap plan?
Yes, many adult children help with research and paperwork. Your parent will usually need to be involved in the application and give any required permission. A licensed agent may explain what is needed.
Which Medigap plan letters can my parent get?
It depends on when they became eligible for Medicare. People newly eligible can generally choose Plans A, B, D, G, K, L, M and N, plus high-deductible Plan G. Plans C and F are only for those eligible before January 1, 2020. Plan H and Plans E, I and J are discontinued.
Does Medigap include prescription drug coverage?
No, Medigap generally does not include drug coverage. A separate Part D prescription drug plan is typically used for medications. An agent may help compare Part D options based on your parent's prescriptions.
Is Medigap better than Medicare Advantage?
Neither is better for everyone. Medigap offers nationwide provider choice and predictable cost-sharing but generally has higher premiums. Medicare Advantage often has lower premiums, an out-of-pocket maximum and extra benefits, but may use networks and prior authorization.
Where can I get help understanding my parent's Medicare paperwork?
You can start with Medicare.gov, your State Health Insurance Assistance Program (SHIP), or a licensed agent. Call 1-800-MEDIGAP for more information about independent resources and agents.
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.