Medicare & senior health
Medicare Supplement (Medigap)
A Medigap policy pays the deductibles and coinsurance Original Medicare leaves on your side of the ledger. No network, no referrals, no surprises at the point of care — you pay a monthly premium instead.
Worth considering if
- You want to see any provider in the United States who accepts Medicare
- You travel, split the year between states, or want out-of-state specialists
- You would rather pay a known monthly premium than variable copays
- You have a chronic condition and want predictable costs in a heavy-use year
- You are inside your six-month Medigap Open Enrollment Period
Watch out for
- Premiums rise with age, inflation and claims experience — budget for increases
- Prescription coverage is not included; you buy a Part D plan alongside it
- Dental, vision and hearing are not included either
- Outside your open enrollment window, carriers can medically underwrite and decline you
- Plan letters are standardised, but prices for the identical plan vary widely by carrier
Why Medigap exists at all
Original Medicare is good insurance with a hole in it. Part A carries an inpatient deductible per benefit period. Part B carries an annual deductible and then pays 80 percent of the approved amount, leaving you the other 20 percent — with no annual limit on what that 20 percent can add up to. A long hospitalisation, a course of infusions or a serious diagnosis can turn an unlimited 20 percent into a genuinely frightening number.
A Medigap policy closes that hole. You pay a monthly premium and the policy picks up the deductibles and coinsurance according to a standardised benefit chart set by federal law. Because the benefits are standardised, Plan G from one carrier pays exactly what Plan G from another carrier pays. The only real differences are price, rate-increase history and service.
The three plans most people actually choose
| Plan G | High-deductible G | Plan N | |
|---|---|---|---|
| Part A deductible | Paid in full | Paid after you meet the plan deductible | Paid in full |
| Part B coinsurance | Paid in full | Paid after you meet the plan deductible | Paid, minus small copays |
| Part B deductible | You pay it | You pay it | You pay it |
| Office visit copay | None | None after deductible | Up to $20 |
| Emergency room copay | None | None after deductible | Up to $50 if not admitted |
| Part B excess charges | Covered | Covered after deductible | Not covered |
| Monthly premium | Highest of the three | Lowest | Middle |
| Suits you if | You want no bills at all | You are healthy and want the lowest premium | You accept small copays for a lower premium |
The enrollment window that decides everything
Your Medigap Open Enrollment Period is six months long and starts the month your Part B coverage begins, provided you are 65 or older. Inside that window a carrier must sell you any Medigap plan it offers, at its best available rate, regardless of your health history. It cannot ask about your conditions, and it cannot decline you.
Once that window closes, in most states the rules change completely. A carrier can require a health questionnaire, rate you up, impose a waiting period for pre-existing conditions, or simply decline the application. This is why the Medigap decision is not really reversible for many people, and why it deserves more thought at 65 than at any point afterwards.
A handful of states — Massachusetts among them — apply additional consumer protections and different rating rules. If you live in one of them, the picture is friendlier than the national default, and it is worth an actual conversation rather than a rule of thumb.
Identical benefits, very different prices
Because Plan G is standardised, the shopping question is not “which plan” but “which carrier, at what price, with what rate history.” Two carriers can quote materially different premiums for a policy that pays out identically. A third can quote the lowest premium of all and have a pattern of steep annual increases that makes it the most expensive option by year five.
We look at the current rate, the rating method — attained-age, issue-age or community-rated — and the carrier’s increase history, and we tell you which one we would put a family member on. That is the whole value of using a broker here: the product is a commodity, so the only thing left to get right is the purchase.
Frequently asked questions
Does a Medigap plan include prescription drug coverage?
No. Medigap policies sold today do not include Part D drug coverage. You buy a standalone Part D prescription drug plan alongside your supplement. We quote both together so you see the true combined monthly cost, not just the supplement premium.
Is Plan G better than Plan N?
Neither is better in the abstract. Plan G leaves you with essentially nothing to pay after the Part B deductible. Plan N costs less each month but leaves small copays for office and emergency-room visits and does not cover Part B excess charges. If you see doctors often, Plan G frequently wins on total cost. If you rarely do, Plan N usually does.
Can I be turned down for a Medigap policy?
Inside your six-month Medigap Open Enrollment Period, no — the carrier must issue. Outside it, in most states yes: the carrier can underwrite your health history and decline. Some states, including Massachusetts, provide additional guaranteed-issue rights. Tell us your state and we will tell you exactly which rules apply to you.
Do Medigap premiums go up?
Yes, essentially always. Increases come from general medical inflation, the carrier’s claims experience and, on attained-age policies, your age. Budgeting for annual increases is part of choosing this route. What you can control is starting with a carrier that has a disciplined rate history rather than the cheapest first-year quote.
Can I switch from Medicare Advantage to Medigap later?
You can leave a Medicare Advantage plan at the usual times, but getting a Medigap policy afterwards may require medical underwriting unless a guaranteed-issue right applies — for example, if your plan left your service area, or if you are inside the trial-right window during your first year on Advantage. This asymmetry is why the first decision matters more than people expect.
On the figures above. Figures reflect published Medicare amounts for the plan year shown and are provided for orientation only. Carrier premiums, deductibles and networks vary by county and change annually — confirm current numbers before you enroll.
How we help
The services that go with this.
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Insurance plan comparison
Every realistic option in your county, compared against your own doctors and drugs.
How it works -
Medicare enrollment assistance
Step-by-step help getting enrolled in the right Medicare arrangement, at no cost to you.
How it works -
Turning 65 consultations
A clear roadmap for your Initial Enrollment Period, starting six months out.
How it works
Related coverage
Worth reading next.
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Medicare Advantage (Part C)
A private, all-in-one alternative to Original Medicare — often with a $0 premium, usually with drug coverage built in, always with a network.
Read the guide -
Part D prescription drug plans
Drug coverage is the part of Medicare people get wrong most often, because the plan with the lowest premium is almost never the plan with the lowest total cost.
Read the guide -
Dental, vision & hearing
Original Medicare covers almost none of it — not cleanings, not fillings, not dentures, not glasses, not hearing aids.
Read the guide -
Hospital indemnity
A cash benefit paid directly to you for each day of a covered hospital stay.
Read the guide