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What is a Medigap Plan?

A Medigap plan, also known as Medicare Supplement Insurance, is a type of private health insurance designed to complement Original Medicare (Part A and Part B). Medigap plans are offered by private insurance companies and are regulated by both federal and state laws to provide standardized coverage. Medigap plans work alongside Original Medicare, providing an additional layer of coverage. It’s important to note that Medigap plans cannot be used with Medicare Advantage plans (Part C).

Benefits of Medigap Plans

Additional Coverage

Medigap plans are intended to fill the “gaps” in coverage left by Original Medicare. They help pay for certain out-of-pocket costs that you would otherwise incur, such as deductibles, copayments, and coinsurance. Original Medicare has a fee schedule for covered services, if a healthcare provider charges more than the Medicare-approved amount, beneficiaries may be responsible for paying the excess charges. Medigap plans can help cover these excess charges.

Standard Plans

Medigap plans are standardized and labeled by letters (A, B, C, D, F, G, K, L, M, and N). Each standardized plan offers the same basic set of benefits, regardless of the insurance company offering it.

Freedom to Choose Healthcare Providers

People with a Medigap plan have the flexibility to visit any doctor or hospital that accepts Medicare patients. There are no network restrictions, providing a broad choice of healthcare providers.

Guaranteed Renewal

Medigap plans are guaranteed renewable, meaning as long as you pay the premiums, the insurance company cannot cancel the plan. This ensures continued coverage, regardless of your health conditions.

Foreign Travel

Original Medicare provides limited coverage for emergency medical care outside of the United States. This means that if you require healthcare services while traveling abroad, you may face significant out-of-pocket costs. Some Medigap plans offer coverage for emergency medical care during foreign travel.

2024 Medigap Plan Options

  Plan A Plan B Plan C Plan D Plan F Plan G Plan K Plan L Plan M Plan N
Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up ​Yes ​Yes ​Yes ​Yes ​Yes ​Yes ​Yes ​Yes ​Yes ​Yes
Part B coinsurance or copayment ​Yes ​Yes ​Yes ​Yes ​Yes ​Yes ​50% ​75% ​Yes ​Yes
Blood (first 3 pints) ​Yes ​Yes ​Yes ​Yes ​Yes ​Yes ​50% ​75% ​Yes ​Yes
Part A hospice care coinsurance or copayment ​Yes ​Yes ​Yes ​Yes ​Yes ​Yes ​50% ​75% ​Yes ​Yes
Skilled nursing facility care coinsurance No No ​Yes ​Yes ​Yes ​Yes ​50% ​75% ​Yes ​Yes
Part A deductible ​No ​Yes ​Yes ​Yes ​Yes ​Yes ​50% ​75% 50% ​Yes
Part B deductible ​No ​No ​Yes ​No ​Yes ​No No ​No No ​No
Part B Excess charge ​No No No No ​Yes ​Yes No No No No
Foreign travel exchange (up to plan limits) No ​No ​80% ​80% ​80% ​80% No No 80% ​80%
Out-of-pocket limit ​N/A ​N/A ​N/A ​N/A N/A N/A ​$7060 ​$3530 ​N/A ​N/A

Plan C & Plan F aren’t available if you turned 65 on or after January 1, 2020, and to some people under age 65. You might be able to get these plans if you were eligible for Medicare before January 1, 2020, but not yet enrolled.

Plans F & G offer a high deductible plan in some states.

Plans K & L show how much they’ll pay for approved services before you meet your out-of-pocket yearly limit and Part B deductible. After you meet them, the plan will pay 100% for approved services.

Plan N pays 100% of the costs of Part B services, except for copayments for some office visits and some emergency room visits.

Medigap Enrollment

You get a 6 month “Medigap Open Enrollment” period, which starts the first month you have Medicare Part B and you’re 65 or older. During this time, you can enroll in any Medigap policy and the insurance company can’t deny you coverage due to pre-existing health problems. After this period, you may not be able to buy a Medigap policy, or it may cost more.

Here at the J G Petit Insurance Agency we can guide you through the entire Medicare application process and help you decide if you need a Medigap plan or a Medicare Advantage Plan. Call us today on (855) 509-0001 to speak to a Licensed Insurance Agent or book an appointment to get help with your Medicare Insurance.

Not affiliated with or endorsed by the government or Federal Medicare Program.

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John Petit

John has a degree in Finance, a Master’s degree in Management, and is licensed to offer insurance products, financial products such as mutual funds and retirement plans.

Published January 19, 2024. Updated April 2, 2024

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