Medigap Plans Review for Current Policyholders

A Medigap policy, also called Medicare Supplement insurance, is sold by private insurance companies. It may help pay some costs that Original Medicare does not, such as certain deductibles, copays and coinsurance. Medigap plans are identified by 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 are searching for Plan H, you will not find it for sale. Massachusetts, Minnesota and Wisconsin standardize Medigap differently.

A policyholder review is simply a fresh look at the plan you already have. People often do one after a premium goes up, after a health or budget change, or when they wonder whether another plan or approach might fit better today.

Many people keep the same Medigap policy for years and look at it again only when something changes, such as a notice of a rate increase. Premiums can change over time for many reasons, and the way a company sets them can vary by state and by carrier.

Some policyholders compare their current plan with other plans that offer the same standardized letter benefits from different companies. Because plans with the same letter generally cover the same basic benefits, the comparison often centers on the company, how it prices its policies and how it treats existing customers.

Others consider switching to a different plan letter, or to Medicare Advantage. Medigap is known for allowing any provider nationwide that accepts Medicare, with no network or referrals, and for predictable cost-sharing. Trade-offs can include generally higher monthly premiums, a separate Part D plan for drugs, no routine dental, vision or hearing, and possible medical underwriting outside open enrollment or guaranteed issue. Medicare Advantage often has lower premiums, an annual out-of-pocket maximum, extra benefits and drug coverage in many plans, but it can bring networks, prior authorization and copays.

The right Medigap agent may help you read your rate notice, confirm which plan letter you have and explain what it covers. A conversation is generally relaxed. You can bring your policy, your Medicare card and a list of your doctors and prescriptions.

An agent may also explain whether switching is possible where you live. Rules about open enrollment, guaranteed issue, birthday or anniversary windows and underwriting vary by state and change over time, so it helps to confirm current rules with Medicare.gov, your State Health Insurance Assistance Program (SHIP) or a licensed agent. If you have Plan C or F, an agent may explain what staying or changing could mean.

Useful questions to ask: What does my plan cover today? How has this company handled rate changes? Would changing risk losing coverage or require health questions? What would I give up and gain with another option? Call 1-800-MEDIGAP for more information.