What it is
Medigap is also called Medicare Supplement Insurance. It is sold by private insurance companies. It works alongside Original Medicare (Part A and Part B).
Original Medicare does not pay everything. Medigap plans may help with some of the costs Original Medicare leaves behind. Plans are labeled with letters, and the benefits for each letter are standardized in most states.
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.
How it’s traditionally been approached
People who like Medigap often point to its flexibility. You may see any provider nationwide that accepts Medicare. There is generally no network and no referral requirement. Cost-sharing is also fairly predictable from one year to the next.
Medigap also has trade-offs. Monthly premiums are generally higher than with many Medicare Advantage plans. Outside open enrollment or guaranteed issue situations, you may face medical underwriting. Medigap does not include drug coverage, so you would add a separate Part D plan. It also does not cover routine dental, vision or hearing.
Medicare Advantage is a different path, and it has real strengths. Premiums are often lower. There is an annual out-of-pocket maximum. Many plans include extra benefits and drug coverage. The trade-offs can include provider networks, prior authorization and copays. Neither choice is right for everyone.
How the right licensed agent may help
A Medigap agent is a licensed professional who may help you sort through these trade-offs. An agent can explain how the plan letters differ and how Medigap compares with Medicare Advantage. A good agent may also help you think about your own doctors, budget and comfort with risk.
A conversation is usually relaxed. You may be asked about your current coverage, your doctors, your prescriptions and when you became eligible for Medicare. Agents may also ask about your state, since enrollment rules vary.
Good questions to ask include: Which plan letters can I buy right now? Will I face medical underwriting? Do I have a guaranteed issue right? How would a separate drug plan fit in? Call 1-800-MEDIGAP for more information.
The bigger picture
Choosing coverage is about more than numbers. For many people, knowing they can see the doctors they trust brings peace of mind. Others feel better with a lower monthly cost and extra benefits. Both feelings are valid.
Stress about health costs can affect sleep, mood and well-being. Taking time to understand your options, and asking for help, may ease that worry. If you are also looking for care providers, Providers.plus may be a helpful place to explore.
Keep in mind
- This page is education only. It is not insurance, legal, tax or medical advice.
- Open enrollment, guaranteed issue, birthday or anniversary rules 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.
- 1-800-MEDIGAP is not connected with or endorsed by the U.S. government or the federal Medicare program. Official information is at Medicare.gov.
- No plan is guaranteed to be best for everyone, and acceptance or savings are never 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
What are the pros and cons of Medigap?
The main pros are freedom to use any provider nationwide that accepts Medicare, no networks or referrals, and predictable cost-sharing. The main cons are generally higher monthly premiums, possible medical underwriting, a separate Part D plan for drugs, and no routine dental, vision or hearing. Your own needs decide how these weigh.
Is Medigap better than Medicare Advantage?
Neither is better for everyone. Medigap offers flexibility and predictability, while Medicare Advantage often has lower premiums, an out-of-pocket maximum and extra benefits. Advantage plans may use networks and prior authorization. A Medigap agent can help you compare them for your situation.
Does Medigap cover prescription drugs?
No. Medigap plans sold today do not include drug coverage. You would generally add a separate Medicare Part D plan. Medicare Advantage plans often include drug coverage, which is one point people weigh when comparing.
Can I be turned down for Medigap?
Possibly, in some situations. Outside open enrollment or a guaranteed issue right, insurers in many states may use medical underwriting. Rules vary by state and change over time, so confirm them with Medicare.gov, your SHIP, or a licensed agent.
Which Medigap plans can I buy if I am new to Medicare?
Plans A, B, D, G, K, L, M and N, plus high-deductible Plan G, are sold to people newly eligible. Plans C and F are only for people eligible before January 1, 2020. Plan H and other plans E, I and J are discontinued. Massachusetts, Minnesota and Wisconsin work differently.
Does Medigap cover dental, vision and hearing?
No, Medigap generally does not cover routine dental, vision or hearing care. Some Medicare Advantage plans include these extras. 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.