What it is
A Medicare supplement, also called Medigap, is private insurance you can buy to work alongside Original Medicare (Part A and Part B). It may help pay some out-of-pocket costs that Original Medicare leaves to you, such as deductibles, coinsurance and copayments.
Medigap is sold in standardized plan 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.
Medigap is not required. It also is not the same as Medicare Advantage (Part C), and the two generally are not used together. Medigap does not usually include drug coverage, so people often add a separate Part D plan. It also does not typically cover routine dental, vision or hearing. Official Medicare information is at Medicare.gov.
How it’s traditionally been approached
Many people who stay with Original Medicare look at Medigap because Original Medicare does not cover every cost. Without other coverage, a person may be responsible for a share of many medical bills. Some people like having a plan that helps make those costs more predictable.
Others choose Medicare Advantage instead. These plans often have lower monthly premiums, an annual out-of-pocket maximum, extra benefits and, in many cases, drug coverage. The trade-offs can include provider networks, prior authorization and copays.
Medigap has its own strengths and trade-offs. Its strengths include the ability to see any provider nationwide that accepts Medicare, no network or referrals, and predictable cost-sharing. Its trade-offs 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. Some people go without either and rely on Original Medicare alone. Each path can fit a different person.
How the right licensed agent may help
A Medigap agent is a licensed professional who may help you sort through your options. A first conversation is usually a relaxed Q&A. The agent may ask about your doctors, how often you use care, your budget comfort and when you became eligible for Medicare.
Questions you might bring: Do I have an open enrollment window or guaranteed issue rights? How do Plan G and Plan N generally differ? Which plans are sold where I live? Will I need a separate Part D plan? What might happen to my premium over time? Which carriers are available in my state?
An agent may also explain timing, which matters a great deal for people turning 65 or enrolling for the first time. Rules vary by state and change over time, so confirm current rules with Medicare.gov, your State Health Insurance Assistance Program (SHIP), or a licensed agent. Call 1-800-MEDIGAP for more information.
The bigger picture
Health coverage choices touch more than money. Worrying about a surprise bill can weigh on sleep, stress and even whether someone seeks care. For some people, knowing how their costs are likely to work brings real peace of mind. Others feel more comfortable with a lower monthly premium and a different structure.
Take your time and include people you trust. Your health, budget and comfort with uncertainty all matter. If you are also looking for care providers, Providers.plus may be a helpful place to start. No single approach is right for everyone.
Keep in mind
- Medigap is optional, and whether you need it depends on your health, budget and preferences.
- Enrollment timing can affect your choices, including whether a company may review your health history. Rules vary by state.
- 1-800-MEDIGAP is an independent educational directory. It is not Medicare.gov, CMS, Social Security or any government agency, and it is not connected with or endorsed by the U.S. government or the federal Medicare program.
- This page is education only, not insurance, legal, tax or medical advice. A Medigap agent may help, but no outcome is promised.
Take the next step
- Talk with a Medigap agent ↗Jeff Cline on contacts.plus — a person, not a call center.
Not sure where to start? Answer a few gentle questions and choose who you’d like to hear from.
Call 1-800-MEDIGAP for more information
Frequently asked questions
Do I need a Medicare supplement?
No, a Medicare supplement is not required. It is optional insurance that may help with some costs Original Medicare does not pay. Whether it fits you depends on your health needs, budget and comfort with out-of-pocket costs.
What happens if I don't get a Medicare supplement?
You would generally be responsible for the costs Original Medicare does not cover, unless you have other coverage such as an employer or retiree plan. Some people choose Medicare Advantage instead. A Medigap agent or your SHIP counselor can help you compare.
Is a Medicare supplement the same as Medicare Advantage?
No, they are different. Medigap works with Original Medicare, while Medicare Advantage replaces it with a private plan that often has a network. Each has strengths and trade-offs, and neither is right for everyone.
When can I buy a Medicare supplement?
Many people first look when they turn 65 and enroll in Part B, which often starts a Medigap open enrollment period. Outside that window, companies may review your health history in some cases. Rules vary by state, so confirm current rules with Medicare.gov, your SHIP or a licensed agent.
Does a Medicare supplement cover prescription drugs?
Generally no. Medigap plans sold today do not include drug coverage, so people often add a separate Part D plan. Medigap also typically does not cover routine dental, vision or hearing.
Which Medigap plans can a new Medicare enrollee buy?
Newly eligible people can buy Plans A, B, D, G, K, L, M and N, plus high-deductible Plan G. Plans C and F are available only to people who became eligible before January 1, 2020. Massachusetts, Minnesota and Wisconsin work differently. Call 1-800-MEDIGAP for more information.
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.