What it is
Medigap is supplemental insurance sold by private companies. It helps pay some of the costs that Original Medicare leaves behind, such as certain coinsurance, copayments and deductibles.
Medigap plans are standardized by letter. 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 Plan H is no longer an option. Massachusetts, Minnesota and Wisconsin standardize Medigap differently.
Because Medigap is built around filling gaps in Original Medicare's medical coverage, it does not include a drug benefit. Prescription coverage comes from a stand-alone Part D prescription drug plan, which is also sold by private insurers. 1-800-MEDIGAP is an independent, privately run educational site. It is not Medicare.gov, CMS, Social Security or any government agency.
How it’s traditionally been approached
People who choose Medigap have traditionally paired it with a separate Part D plan. They keep Original Medicare and Medigap for doctor and hospital costs, and add Part D for medications.
Part D plans differ in which drugs they list, how those drugs are tiered, and which pharmacies they use. Because of this, many people review their medication list against a plan's formulary each year.
Medicare Advantage is another way people approach coverage. Many of those plans include drug coverage, often along with extras, an annual out-of-pocket maximum and sometimes lower premiums. They also use networks and may require prior authorization or copays. Medigap offers the freedom to see any provider nationwide who accepts Medicare, with no network or referrals, and predictable cost-sharing. Its trade-offs are generally higher monthly premiums, possible medical underwriting outside open enrollment or guaranteed issue, a separate Part D plan, and no routine dental, vision or hearing. Neither path is right for everyone.
How the right licensed agent may help
A Medigap agent may help you look at medical coverage and drug coverage together. That can make it easier to see how a Medigap plan, such as Plan G, and a Part D plan might work side by side.
A conversation is usually relaxed and informational. An agent will generally ask which medications you take, which pharmacies you use, which doctors you want to keep and what matters most to you. It helps to bring your medication list and your Medicare card.
Good questions to ask include: Is my medication on this plan's formulary? Which pharmacies are in the network? How might my coverage change if my prescriptions change? What are the enrollment timing rules in my state? Call 1-800-MEDIGAP for more information.
The bigger picture
Worrying about medication costs can weigh on your peace of mind. Knowing which part of your coverage handles drugs and which handles hospital and doctor bills may make the whole picture feel less overwhelming.
Taking your time, asking questions and reviewing your options each year can support both your finances and your wellbeing. If you are also looking for care providers, Providers.plus may be a helpful resource.
Keep in mind
- Medigap does not include prescription drug coverage. A separate Part D plan is needed for that.
- Medigap also does not typically cover routine dental, vision or hearing care.
- Enrollment timing, open enrollment, guaranteed issue and under-65 access vary by state and change over time. Confirm current rules with Medicare.gov, your State Health Insurance Assistance Program (SHIP) or a licensed agent.
- This page is educational only and is not insurance, legal, tax or medical advice. Official information is at Medicare.gov.
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
Does Medigap cover prescriptions?
No. Medigap plans do not cover outpatient prescription drugs. You would need a separate Medicare Part D prescription drug plan for medication coverage. A Medigap agent may help you understand how the two work together.
Does Medigap Plan G cover prescription drugs?
No. Plan G helps with certain Medicare-covered medical costs, but it does not include drug coverage. People who choose Plan G usually add a stand-alone Part D plan.
Do I need Part D if I have Medigap?
If you want prescription drug coverage, you generally need a Part D plan. Going without it can have consequences when you enroll later, so confirm current rules with Medicare.gov, your SHIP or a licensed agent.
Can I buy a Medigap plan that includes drug coverage?
Not today. Older Medigap plans that included drug coverage, such as Plan H, were discontinued and are not sold now. Current Medigap plans do not include a drug benefit.
Does Medicare Advantage cover prescriptions?
Many Medicare Advantage plans include drug coverage, though not all do. These plans may also offer extras and an out-of-pocket maximum, but they use networks and may require prior authorization or copays. Medigap and Medicare Advantage each have strengths and trade-offs.
Does Medigap cover dental, vision or hearing?
Medigap plans generally do not cover routine dental, vision or hearing care. Some people look into separate stand-alone coverage for those needs. 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.