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Medigap —Filling the Gaps in Original Medicare

Original Medicare pays a significant portion of your healthcare costs — but not all of it. Medigap plans pay some or all of the remaining costs, providing financial predictability and freedom to see any provider that accepts Medicare.

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Coverage

What Medigap Covers

Original Medicare covers about 80 percent of approved medical costs but leaves beneficiaries responsible for deductibles, copays, and 20 percent coinsurance with no out-of-pocket maximum. Medigap fills those gaps.

Part A hospital costs. Part A has a deductible per benefit period and daily coinsurance for extended hospital stays. Medigap plans cover these costs.

Part B coinsurance. Original Medicare pays 80 percent of approved outpatient costs; you pay the remaining 20 percent with no cap. Most Medigap plans cover it entirely.

Any provider that accepts Medicare. Unlike Medicare Advantage, Medigap lets you see any doctor, specialist or hospital that accepts Medicare anywhere in the country. No networks, no referrals.

Guaranteed renewable. As long as you pay your premium, your plan cannot be canceled and benefits cannot be reduced.

Medigap vs. Medicare Advantage

  • Medigap: any Medicare provider nationwide
  • Medigap: no networks or referrals
  • Medigap: predictable costs, higher premium
  • Advantage: network-based, lower premium
  • Advantage: extra dental and vision benefits
  • Advantage: prior authorization requirements
Plan Options

Medigap Plan Letters Explained

Benefits are standardized. Every Plan G from every carrier covers exactly the same things. The difference between carriers is price, financial strength and service.

Most Comprehensive

Plan G

The most comprehensive plan currently available to new Medicare enrollees. Covers Part A deductible, Part A coinsurance, Part B coinsurance at 100%, skilled nursing coinsurance and foreign travel emergency. The only gap is the Part B deductible.

Plan N

Similar to Plan G but with copays for some office and ER visits, and typically a lower premium. Copays run up to $20 for office visits and up to $50 for ER visits that do not result in admission.

Plan K, L and High-Deductible G

Lower-premium options with more cost-sharing. Plan K covers 50 percent of most costs and Plan L covers 75 percent, both with annual out-of-pocket limits. High-deductible Plan G gives full benefits once the deductible is met.

Legacy Only

Plan F (Pre-2020 Only)

Plan F covered the Part B deductible in addition to everything Plan G covers. No longer available to people who became eligible for Medicare on or after January 1, 2020, but still available to those enrolled before that date.

Enrollment Timing

When to Enroll in Medigap

Open Enrollment Period. The 6-month period beginning the month you turn 65 and are enrolled in Part B. During this window you can buy any Medigap plan regardless of health history, at the best available rate. This is the most important window.

Guaranteed issue rights. Outside Open Enrollment, insurance companies can use medical underwriting to deny coverage or charge higher premiums based on your health history. Certain situations trigger guaranteed issue rights that provide access without underwriting.

Switching plans later. Switching after your open enrollment period typically requires medical underwriting. If you develop health conditions you may not be able to switch plan or carrier.

Guaranteed issue situations

  • Turning 65 and enrolling in Part B
  • Losing employer or union coverage
  • Medicare Advantage plan leaving your area
  • Moving out of your plan's service area
  • Certain other qualifying situations

Frequently Asked Questions

What is the difference between Plan G and Plan N?
Plan G covers Part B coinsurance at 100 percent with no copays. Plan N covers it with a copay of up to $20 for office visits and up to $50 for ER visits that do not result in inpatient admission, and typically has a lower monthly premium. If you visit doctors infrequently, Plan N may cost less overall.
Can I use any doctor with Medigap?
Yes. Medigap works with Original Medicare, so you can see any doctor, specialist or hospital that accepts Medicare anywhere in the United States. No network restrictions and no referrals required.
Does Medigap include prescription drug coverage?
No. You need a separate Part D plan. Medicare Advantage plans typically include Part D, while Medigap requires a separate enrollment.
Why do premiums vary by carrier for the same plan letter?
Benefits are standardized federally, so a Plan G from any carrier covers the same things. Carriers differ in how they price them — community rating, issue-age rating, or attained-age rating which increases as you age. We compare pricing and rate increase history.
Can I switch plans to get a lower premium?
You can apply, but outside your open enrollment period the new carrier can use medical underwriting. If you have developed health conditions you may not qualify or may be charged more.

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1–800–MEDICARE to get information on all of your options.

Fill the gaps in Original Medicare.

We compare plan letters and carrier pricing to find the right coverage at the right price.

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