Medigap Plans for People Under 65 on Medicare

Medigap, also called Medicare Supplement insurance, is private insurance that may help pay some costs Original Medicare does not cover. These can include certain deductibles, copayments and coinsurance. It works alongside Original Medicare (Part A and Part B).

Most people get Medicare at 65. But some people qualify earlier, through disability or certain conditions. Being under 65 on Medicare is common enough that many people search for supplement options. Whether medigap plans are offered to you, and on what terms, depends on your state and the carrier.

Medigap plans use standard 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. Massachusetts, Minnesota and Wisconsin standardize Medigap differently.

Federal law does not require insurers to sell medigap plans to people under 65. Some states require it, and some do not. In states that do, the choices of plans or carriers may differ from what is offered at 65.

Many people have traditionally looked at the timing of their enrollment. A Medigap open enrollment period may apply, and in some states it works differently for people under 65. Outside open enrollment or guaranteed issue, a carrier may use medical underwriting, which means it can review health history. Rules change over time, so confirm current details with Medicare.gov, your State Health Insurance Assistance Program (SHIP), or a licensed agent.

Some people compare Medigap with Medicare Advantage. Medigap may offer the freedom to see any provider nationwide that accepts Medicare, with no network or referrals, and more predictable cost-sharing. Trade-offs can include generally higher monthly premiums, possible underwriting, a separate Part D plan for drugs, and no routine dental, vision or hearing. Medicare Advantage often has lower premiums, an annual out-of-pocket maximum, extra benefits, and drug coverage in many plans. Its trade-offs can include networks, prior authorization and copays. Neither is right for everyone.

A Medigap agent is a licensed professional who may help you understand what is offered in your state. A conversation is generally a chance to talk through your situation, your doctors, your medications and your budget. It is education and guidance, not a promise of any particular outcome.

Helpful questions may include: Does my state require insurers to offer medigap plans to people under 65? Which plan letters are available to me? Am I in an open enrollment period or guaranteed issue situation? Could cost-sharing plans like K, L or M, or Plans A, B and D, fit my needs? How would a Part D prescription drug plan work with my choice?

If you already have a plan, an agent may also explain how switching plans works and when guaranteed issue could apply. Ask about timing, whether health questions may be involved, and what happens to your current coverage. Call 1-800-MEDIGAP for more information.