What it is
Medigap is private insurance that helps pay some costs Original Medicare does not, such as certain deductibles, copayments and coinsurance. It works alongside Original Medicare (Part A and Part B). It is not a replacement for Medicare.
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, even though people still search for Plan H. Massachusetts, Minnesota and Wisconsin standardize Medigap differently.
Medigap does not usually include prescription drug coverage, so many people add a separate Part D plan. It also does not generally cover routine dental, vision or hearing care. Official information is available at Medicare.gov.
How it’s traditionally been approached
People who choose Medigap often value its predictability. It lets you see any provider nationwide that accepts Medicare, with no network and generally no referrals. Many like knowing their cost-sharing is more settled from one year to the next.
Medigap has trade-offs too. Monthly premiums are generally higher than with many Medicare Advantage plans. Outside open enrollment or guaranteed issue situations, insurers in many states may use medical underwriting. You also need a separate Part D plan for drugs.
Medicare Advantage is another well-established path. It often has lower premiums, an annual out-of-pocket maximum, extra benefits and drug coverage in many plans. Its trade-offs can include provider networks, prior authorization and copays. Neither approach is right for everyone, and both are reasonable choices.
How the right licensed agent may help
A Medigap agent may help you sort through the question of whether Medigap is worth it for your situation. Licensed independent agents can often explain how different plan letters compare, such as Plan G and Plan N, and how carriers may differ.
A conversation is generally a chance to talk about your doctors, how often you use care, your comfort with unexpected costs and your budget. You might ask: Which plan letters are available to me? Do I have an open enrollment or guaranteed issue right? How might premiums change over time? What would I need for drug coverage?
If you already have a policy, an agent may also review whether your current premium and plan still fit your needs. Rules vary by state and change over time, so confirm current details with Medicare.gov, your State Health Insurance Assistance Program (SHIP), or a licensed agent. Call 1-800-MEDIGAP for more information.
The bigger picture
Choosing coverage is about more than numbers. For many people, knowing what to expect from medical bills supports peace of mind and lets them focus on health and family. For others, a lower monthly premium eases today's budget, and that matters just as much.
Think about how you feel when care is needed: do you prefer fewer surprises, or more flexibility in your monthly budget? If you are also looking for care providers, Providers.plus may be one place to explore. Either way, take your time and ask questions.
Keep in mind
- Whether Medigap is worth it is personal. It depends on your health, budget, doctors and comfort with risk.
- Medigap and Medicare Advantage each have real strengths and trade-offs, and neither is best for everyone.
- Enrollment timing, underwriting and guaranteed issue rules vary by state and can change, so confirm them before deciding.
- This page is education only, not insurance, legal, tax or medical advice, and acceptance or savings are never guaranteed.
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
Is Medigap worth it?
It can be, depending on your needs. Medigap may suit people who value seeing any Medicare-accepting provider and having more predictable cost-sharing. People who prefer lower premiums or extra benefits may lean toward Medicare Advantage. A Medigap agent may help you compare.
Is Medigap worth it if I am healthy?
It depends on your priorities. Some healthy people choose Medigap to protect against unexpected costs, while others prefer a lower premium and accept more cost-sharing. Think about how you would feel if a major health event happened.
Is Medigap worth the higher premium?
Medigap premiums are generally higher than many Medicare Advantage premiums, but the plans work differently. The extra cost buys broader provider access and more predictable cost-sharing. Whether that is worth it is a personal decision about budget and peace of mind.
Are medigap plans worth it compared with Medicare Advantage?
Neither is better for everyone. Medigap offers nationwide provider choice with no network, while Medicare Advantage often offers lower premiums, an out-of-pocket maximum and extra benefits, with networks and prior authorization. Your doctors, health and budget usually guide the choice.
Is Plan G or Plan N worth it?
Both are popular among newly eligible people, and they differ in how cost-sharing is arranged. Plan N generally involves some copays, while Plan G is typically more comprehensive. A Medigap agent may help you compare how each fits your situation.
Can I switch Medigap plans if it no longer feels worth it?
Possibly, but it depends on your state and situation. Some people may face medical underwriting when switching, and certain states have special rules. Confirm current rules with Medicare.gov, your SHIP, or a licensed agent. 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.