Medicare
What Is Medigap (Medicare Supplement Insurance), and Who Is Eligible for It?
A Medigap plan — or a Medicare supplement policy — helps cover your share of healthcare costs that original Medicare (Part A and B) doesn’t cover. This can include deductibles, copays, and coinsurance.
Anyone enrolled in Medicare Parts A and B can buy Medigap, but signing up at age 65 during your initial enrollment period gives you the best coverage and pricing.
There are 10 standardized Medigap plans in most states, each offering different levels of coverage, from basic benefits in Plan A to more comprehensive options like Plan G.
Medigap is a Medicare supplement policy that helps fill the gaps in your original Medicare coverage. You might be surprised to learn that even with original Medicare (Parts A and B) coverage, you may still be responsible for out-of-pocket costs. That’s why many people buy a Medicare supplement policy.
Medigap plans differ in what they cover. And with 10 different plans available in most states, finding the right one takes careful research. Familiarizing yourself with Medigap’s different plans and enrollment periods can help you manage your coverage and healthcare costs.
A Medigap plan, also known as a Medicare supplement policy, is insurance that pays for out-of-pocket costs that original Medicare doesn’t cover, like deductibles, copays, and coinsurance.
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These private insurance policies work alongside your Medicare coverage, stepping in to pay some or all of these expenses when you receive care. Different Medigap plans cover different costs: Some might pay your Part A hospital deductible and Part B medical coinsurance, while others also include coverage for emergency care abroad.
Whether you need a Medigap plan depends on your health needs and financial situation. If you’re in good health, you may not spend much on Medicare deductibles and coinsurance. But healthcare needs can change suddenly, and costs can add up quickly. For example, just one hospital stay can leave you paying the Medicare Part A deductible ($1,676 per benefit period in 2025). Even outpatient care can drive up your costs. For Part B, you may need to first meet its deductible ($257 in 2025) and then 20% coinsurance.
To be eligible for a Medigap policy, you must be enrolled in Medicare Parts A and B. These policies are sold individually. This means each person — whether single or married — must buy their own separate Medigap policy.
If you qualify for Medicare before age 65 because of a disability or end-stage renal disease, your Medigap options may be limited. This is because federal law doesn’t require insurance companies to sell Medigap policies to people under 65. But some states have rules that allow it. Your state’s insurance department can explain what options are available if you need Medigap before age 65.
Medicare Advantage (MA) plan members generally can’t buy Medigap unless they’re using their trial right. A trial right gives you up to 12 months to switch back to original Medicare and buy a Medigap plan if you’re not satisfied with the MA plan. But you can only use your trial right the first time you join an MA plan.
To maintain your Medigap policy, you must:
Continue paying your Medigap monthly premium
Continue paying your Medicare Part B monthly premium
Yes, some Medigap plans cover gym memberships. Find out what types of programs are included and if it’s worth it.
Facing Medigap underwriting? Here are some things to help make answering underwriting questions easier, plus tips on what to do if you’re denied coverage.
Plan G is a popular Medigap policy and the most comprehensive plan. But it has disadvantages and is not the right option for everyone.
If you have questions about Medigap plans or need help understanding your options, you can get free assistance from the State Health Insurance Assistance Program, a nonprofit network of benefits counselors who help people who are eligible for Medicare and their caregivers.
The best time to buy a Medigap policy is during your Medigap open enrollment period. This period starts the month you turn 65 and enroll in Medicare Part B, or when you leave employer-based health insurance and enroll in Part B. During this one-time enrollment period, you’ll typically find better Medigap pricing options than you will outside this window.
Your open enrollment period offers important protections because insurance companies can’t use medical underwriting (health testing). This means they can’t deny you coverage or charge you more due to health conditions. You have what’s called guaranteed issue rights. This means you can buy any Medigap policy offered in your state, and all your preexisting health conditions must be covered. Once you buy a Medigap plan, it automatically renews every year, provided you pay the premiums.
If you wait to sign up for Medigap after your open enrollment period ends, things can get more complicated. Insurance companies may:
Require medical underwriting
Deny you coverage
Charge higher premiums
In certain situations you may have additional opportunities to switch Medigap plans with guaranteed issue rights. These special circumstances might include losing your coverage through no fault of your own or moving out of your plan’s service area.
Some states also offer more flexible enrollment rules. In Connecticut, Massachusetts, and New York, you can switch Medigap plans anytime during the year, regardless of your health. Maine offers a 1-month window each year to switch to Plan A. Other states have “birthday rules” that let you change plans around your birthday. For example, California and Oregon give you 30 days after your birthday to switch to a different Medigap plan without medical underwriting, as long as the new plan offers the same or less coverage than your current one.
Medigap offers 10 standardized plans. They are labeled A, B, C, D, F, G, K, L, M, and N in most states. Each plan provides a different level of coverage, but they all work alongside Medicare Parts A and B to help with out-of-pocket costs.
The benefits of standardized plans are the same across insurance companies. For example, Plan G covers the same benefits whether you buy it from United HealthCare, Blue Cross Blue Shield, or Mutual of Omaha. But not all companies offer every plan, and the monthly premiums for the same plan can vary widely among insurers. This makes it important to shop around to find the best value.
All Medigap plans provide basic benefits, like covering Medicare Part A coinsurance and hospital costs (up to an additional 365 days after Medicare benefits are used up). But they differ in how much they cover for other services. For instance, most plans fully cover Part B coinsurance, but Plans K and L offer partial coverage. Only Plans F and G cover Medicare Part B excess charges, which are noncovered costs from healthcare professionals who don’t accept the Medicare-approved amount for their services.
Let’s see how coverage varies by standardized Medigap plan:
Medigap plan | Coverage overview |
|---|---|
Plan A | Offers the minimum coverage required: Part A coinsurance, Part B coinsurance, first 3 pints of blood, and hospice care. |
Plan B | Includes all of Plan A’s coverage, plus covers Part A deductible. |
Plan C | (No longer available to new Medicare enrollees) Includes all of Plan B’s coverage, plus Part B deductible and 80% of foreign travel emergencies, but does not cover Part B excess charges. |
Plan D | Similar to Plan C but without Part B deductible coverage. |
Plan F | (No longer available to new Medicare enrollees) Most comprehensive: Covers all deductibles, coinsurance, and excess charges, plus covers 80% of foreign travel emergencies. |
Plan G | The most comprehensive option for those new to Medicare: Includes everything in Plan F, except doesn’t cover Part B deductible. A high-deductible version of Plan G is offered in certain states. |
Plan K | Provides 50% coverage for most benefits, with an annual out-of-pocket limit of $7,220 in 2025, but no coverage for Part B excess charges or foreign travel emergencies. This plan often has a low premium. |
Plan L | Offers 75% coverage for most benefits, with an annual out-of-pocket limit of $3,610 in 2025, but no coverage for Part B excess charges or foreign travel emergencies. |
Plan M | Offers 100% coverage for most benefits but no coverage for Part B excess charges. It covers only 50% of the Part A deductible. |
Plan N | Similar to Plan M, but covers 100% of the Part A deductible. It has some copays for office visits and emergency care. |
Because of a change in federal law, Medicare plans can no longer cover the Part B deductible for new enrollees. That’s why Plans C and F were discontinued for people who became eligible for Medicare after January 1, 2020. But this discontinuation does not apply to people who were already enrolled in these plans before that date.
Medigap Plans B, C, D, F, G, and N pay the Part A deductible in full. Plans C and F aren’t available to newly eligible Medicare enrollees.
Medigap Plans K and M pay 50% of the Part A deductible, while Plan L pays 75%.
For people who travel internationally, 6 of the 10 nationally standardized Medigap plans (C, D, F, G, M, and N) offer limited benefits for emergency healthcare while traveling abroad.
Legacy Medigap Plans E, H, I, and J also offer foreign travel emergency healthcare coverage, but these older plans are not available to new buyers. The same is true for Plans C and F. But if you are already enrolled in one of these plans, you can continue to use it.
Only two Medigap Plans, K and L, have out-of-pocket limits. These plans initially cover less than other Medigap policies, but their spending caps can help protect you from high healthcare costs. Once you’ve paid your Medicare Part B deductible and reached your plan’s out-of-pocket limit ($7,220 for Plan K or $3,610 for Plan L), both plans will cover 100% of your approved Medicare costs for the rest of the year.
Medigap premiums vary widely based on several factors, including your location, age, gender, and insurance company. Here are 2025 monthly premium examples for a 65-year-old nonsmoking man in Charlotte, North Carolina, and a 65-year-old non-smoking woman in New York City:
Plan | North Carolina (man, 65, nonsmoker) | New York (woman, 65, nonsmoker) |
|---|---|---|
Plan A | $106-$335 | $195-$414 |
Plan B | $154-$271 | $253-$624 |
Plan D | $138-$393 | $324-$502 |
Plan G | $94-$394 | $298-$776 |
Plan G High deductible | $34-$61 | $68-$109 |
Plan K | $61-$114 | $99-$225 |
Plan L | $103-$173 | $206-$322 |
Plan M | $81-$126 | $297-$524 |
Plan N | $85-$341 | $220-$483 |
Note: For North Carolina, we used zip code 28201, and for New York City, we used zip code 10001 in the Medicare search tool to generate the premium rates.
Medigap plans offer standardized coverage across most states, but their costs vary significantly. Insurance companies set their own prices and use different methods to calculate premiums. Before you choose a plan, it’s important to understand how your insurer prices its policies, since this can affect your costs.
Insurance companies use three main pricing methods:
Everyone is charged the same amount for the same Medigap policy, regardless of age. Premiums can increase due to inflation, smoking status, and other factors. For example, a 65-year-old and an 85-year-old would pay the same premium for Plan G from the same insurer.
This pricing plan determines your premium based on your age when you buy the policy. That means the older you are when you purchase it, the higher your premium will be. As with community rated, premiums can increase due to a few factors, but the increase will be the same for all policyholders.
Premiums increase as you get older. These policies might seem more affordable at first, but they can become the most expensive option over time. Premiums rise with age and because of other factors, such as inflation and smoking status.
If you live in Massachusetts, Minnesota, or Wisconsin, your Medigap plan options are different from those in other states.
Massachusetts has its own Medigap system: a Core Plan and Supplement 1A (Supplement 1 is no longer available to new enrollees). These plans cover Medicare Parts A and B costs, as standard Medigap plans do. But they also have some extra benefits, such as Pap tests and mammograms coverage. Supplement 1A offers additional benefits, including coverage for up to 120 days per year in mental health hospitals and emergency care when traveling abroad.
Minnesota offers versions of Plans K, L, M, and N. It also offers two unique plans: the Basic Plan and the Extended Basic Plan. Each of these offers different percentages of cost coverage than the plans offered in other states, along with state-mandated benefits, such as coverage for equipment and supplies for diabetes care.
Wisconsin offers its own Basic Plan, with different percentages of coverage than what is offered in the standardized plans. It includes coverage for 40 more home healthcare visits than what Medicare pays, as well as additional inpatient mental health coverage. Wisconsin also offers riders, or additional insurance — such as for a foreign travel emergency or the Part A deductible — beyond what the Basic Plan offers, for an extra charge. It also offers modified versions of the standard K and L plans.
Buying a Medigap or Medicare Advantage plan allows you to expand your Medicare coverage. Medigap coverage supplements original Medicare by covering out-of-pocket expenses like copayments and deductibles, but Medicare Advantage is an alternative to original Medicare.
MA plans provide the same coverage as Medicare Parts A and B. But they package the parts together and often offer extra benefits, such as routine dental and vision care. Medicare Advantage plans are sold by Medicare-approved private companies and. Unlike Medigap plans, MA plans typically include prescription medication coverage.
Unlike original Medicare, MA plans have an annual cap on out-of-pocket spending. You can choose a Medicare Advantage plan or a Medigap plan to go with original Medicare, but you can’t have MA and Medigap at the same time.
Medigap plans can be costly, with premiums that may increase over time on top of what you pay for Medicare Part B. These plans don’t cover prescription medications, so you’ll need to buy a separate Medicare Part D plan for medication coverage. Medicare supplement policies typically don’t include extra benefits like dental, vision, or hearing coverage. Also, if you miss your initial enrollment period and try to buy a plan later, insurance companies can deny you coverage or charge you more based on your health conditions.
In some cases, your Medigap premium can increase with age, but it depends on the insurer’s pricing. With attained-age policies, your premium increases as you get older. Issue-age policies base your premium on your age when you first buy the plan, though costs may still rise with inflation. Community-rated plans charge everyone the same premium regardless of age, though these rates can also increase due to inflation and other factors.
Medigap premiums typically are not deducted from Social Security benefits. Instead, you pay your Medigap premiums directly to the private insurance company that provides your policy. Some insurers might offer automatic deductions as an option. But your Medicare Part B premium, which is separate from Medigap, is generally deducted from your Social Security benefits.
Medigap plans can be costly, with premiums that may increase over time on top of what you pay for Medicare Part B. These plans don’t cover prescription medications, so you’ll need to buy a separate Medicare Part D plan for medication coverage. Medicare supplement policies typically don’t include extra benefits like dental, vision, or hearing coverage. Also, if you miss your initial enrollment period and try to buy a plan later, insurance companies can deny you coverage or charge you more based on your health conditions.
In some cases, your Medigap premium can increase with age, but it depends on the insurer’s pricing. With attained-age policies, your premium increases as you get older. Issue-age policies base your premium on your age when you first buy the plan, though costs may still rise with inflation. Community-rated plans charge everyone the same premium regardless of age, though these rates can also increase due to inflation and other factors.
Medigap premiums typically are not deducted from Social Security benefits. Instead, you pay your Medigap premiums directly to the private insurance company that provides your policy. Some insurers might offer automatic deductions as an option. But your Medicare Part B premium, which is separate from Medigap, is generally deducted from your Social Security benefits.
Medigap plans are Medicare supplement policies that help cover out-of-pocket costs for people enrolled in original Medicare (Parts A and B). If you’re new to Medicare and considering Medigap, your best option is to buy a Medigap plan during your open enrollment period rather than doing so later. Waiting until later may mean that insurers can review your health history, potentially deny coverage, charge more, or delay your coverage. Since different insurance companies can charge different premiums for the same coverage, take time to compare plans, ask about pricing methods, and get quotes from multiple insurers before enrolling in a Medigap plan.
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