Medigap Plans: Cost-Sharing Plans K, L, M and Basic Plans A, B, D

Medigap plans are private supplement policies that may help pay some costs Original Medicare does not, such as certain coinsurance and deductibles. They are standardized by letter, so a plan with the same letter generally offers the same core benefits from one carrier to the next. Massachusetts, Minnesota and Wisconsin standardize Medigap differently.

Plans K, L and M are cost-sharing plans. That means you and the plan split some costs rather than the plan covering nearly everything. Plans K and L also include an annual out-of-pocket limit, which is why people search for out-of-pocket limit plans. Plan M is a different design, with a split of certain costs. Details vary, so confirm each plan's benefits before deciding.

Plans A, B and D are more basic options. Plan A is the core set of benefits. Plans B and D add some benefits to that core. 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 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 Plan H is not available to buy.

Many people have looked at Medigap as a way to add predictability to Original Medicare. They pick a plan letter, compare carriers, and decide how much cost they want to share and how much they want the plan to handle.

Cost-sharing plans like K, L and M have often drawn people who want to weigh monthly premiums against what they might pay when they use care. Basic plans like A, B and D have often been considered by people who want a simpler set of benefits. Neither approach is right for everyone.

Medigap is often compared with Medicare Advantage. Medigap may let you see any provider nationwide that accepts Medicare, with no network or referrals, and its cost-sharing can be predictable. Trade-offs can include generally higher monthly premiums, possible medical underwriting outside open enrollment or guaranteed issue, 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.

A Medigap agent is a licensed professional who may help you understand how these plan letters compare. Many agents work with several carriers, which may let you see more than one option in a single conversation. An agent is not a government representative, and this is not a promise of any result.

A conversation is generally relaxed. An agent may ask about your health needs, the doctors you see, how you like to handle costs, and your Medicare start date. They may explain which plans are sold where you live and whether any enrollment rules apply to you.

Good questions to ask include: Which of these plans are available to me? How does the cost-sharing work if I need care? What could I owe in a year? How might my rates change over time? Will I need a separate drug plan? Call 1-800-MEDIGAP for more information.