Works with Original Medicare
Medicare pays first
When you receive a Medicare-covered service, Original Medicare processes the claim and pays its share of the Medicare-approved amount.
Skip to content A Medigap plan, also called Medicare Supplement Insurance, is private insurance that works with Original Medicare to help pay some of your share of Medicare-covered costs, such as copayments, coinsurance, and deductibles.
Original Medicare pays its share of approved health care costs first. Your Medigap policy can then pay some or all of the remaining Medicare cost-sharing covered by your specific policy. The exact amount depends on which standardized Medigap plan you buy.
In most states, Medigap plans are standardized by letter. That means the core benefits of a Plan G are the same regardless of which insurance company sells it. Premiums, pricing methods, discounts, service, and company experience can still differ.
Medigap is designed to supplement Original Medicare, not replace it.
When you receive a Medicare-covered service, Original Medicare processes the claim and pays its share of the Medicare-approved amount.
Your Medigap insurer can then pay the eligible cost-sharing covered by your policy, such as certain deductibles, coinsurance, or copayments.
In most states, plans are standardized as A, B, C, D, F, G, K, L, M, and N. Massachusetts, Minnesota, and Wisconsin standardize Medigap differently.
The payment process is usually straightforward once your Medicare and Medigap coverage are in place.
Generally, you must have Original Medicare Part A and Part B before you can buy a Medigap policy.
Your doctor or other provider submits the Medicare-covered claim to Medicare for processing.
Medicare pays according to Original Medicare rules and the Medicare-approved amount for the covered service.
Your Medigap policy can pay the covered portion of the remaining cost-sharing. You are responsible for anything your policy does not cover.
Coverage depends on the standardized plan letter, but Medigap is primarily designed to reduce your share of costs for services covered by Original Medicare.
All standardized Medigap plans provide at least some coverage for certain Part A and Part B cost-sharing. Plans K and L use partial cost-sharing for several benefits.
Some Medigap plans cover the Part A deductible. Plans C and F can cover the Part B deductible only for people who meet the eligibility rules for those plans.
Plans C, D, F, G, M, and N include 80% foreign travel emergency coverage up to plan limits.
A Medigap policy is not designed to cover every health care expense.
Medigap generally does not cover routine dental care, routine vision care, glasses, or hearing aids.
Medigap does not generally pay for long-term custodial care in a nursing home or assisted living setting.
Medigap policies sold after 2005 do not include prescription drug coverage. You can generally add a separate Medicare Part D plan.
These are fundamentally different ways to structure Medicare coverage.
For new Medigap buyers, prescription drug coverage is separate.
These policies do not include outpatient prescription drug coverage. A Medigap plan and Part D serve different purposes.
If you want prescription drug coverage, you can generally enroll in a separate Medicare Part D plan and review its formulary, pharmacies, premium, deductible, and drug costs.
These amounts apply to the standardized plan comparison below and can change each year.
The chart shows the standard benefits for Medigap plans in most states. Massachusetts, Minnesota, and Wisconsin use different standardization systems.
On a phone or tablet, swipe the table left and right to compare plans.
| Medigap Benefit | 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 | 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 benefit (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 emergency (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 | $8,000 | $4,000 | N/A | N/A |
Yes means the plan covers 100% of that benefit. A percentage means the plan pays that percentage and you are responsible for the rest. N/A means not applicable.
Plan C and Plan F: These plans are not available to people who became newly eligible for Medicare on or after January 1, 2020. People eligible for Medicare before that date may still be able to buy them if otherwise eligible.
*High deductible Plans F and G: In 2026, the high deductible amount is $2,950 before the policy begins paying covered Medicare cost-sharing under the high deductible plan.
**Plans K and L: After you meet the 2026 out-of-pocket limit and the yearly Part B deductible of $283, the plan pays 100% of covered services for the rest of the calendar year.
***Plan N: Plan N pays 100% of Part B services except for copayments for some office visits and some emergency room visits. Plan N does not cover Part B excess charges.
Your one-time Medigap Open Enrollment Period is one of the most important timing rules to understand.
Your Medigap Open Enrollment Period generally starts the first month you have Medicare Part B and are age 65 or older. It lasts for six months.
During this period, you can generally buy any Medigap policy sold in your state, and the insurance company cannot deny coverage because of pre-existing health conditions.
After your Medigap Open Enrollment Period ends, you may have fewer options, may have to answer health questions, or may pay more unless you qualify for a guaranteed issue right or another protection under federal or state law.
State rules can provide additional rights, so your options may depend on where you live.
Standardized Medigap policies are generally guaranteed renewable as long as you continue to meet the policy requirements.
According to Medicare, standardized Medigap policies are automatically renewed every year even if you have health problems. An insurer can generally drop you only if you stop paying premiums, were not truthful on the application, or the insurance company becomes bankrupt or goes out of business.
Yes. Medigap is the common name for Medicare Supplement Insurance. It is private insurance designed to work with Original Medicare and help pay certain out-of-pocket costs.
Generally, yes. Medicare states that you generally must have Original Medicare Part A and Part B to buy a Medigap policy.
No. A Medigap policy covers one person. If both spouses want Medigap coverage, each generally needs a separate policy.
Medigap is designed to work with Original Medicare, not Medicare Advantage. You cannot use a Medigap policy to pay Medicare Advantage copayments, deductibles, or premiums. An insurer generally cannot sell you Medigap while you are enrolled in Medicare Advantage unless you are switching back to Original Medicare.
Medigap policies sold after 2005 do not include outpatient prescription drug coverage. If you want drug coverage, you can generally enroll in a separate Medicare Part D plan.
In most states, the standardized core benefits of Plan G are the same regardless of the company selling the policy. Premiums, pricing methods, discounts, underwriting rules when applicable, customer service, and company experience can differ.
Standardized Medigap policies are generally automatically renewed each year even if your health changes. Medicare lists limited reasons an insurer can drop coverage, including nonpayment of premiums, material application misrepresentation, or the insurer going bankrupt or out of business.
Both are standardized Medicare Supplement plans, but Plan G covers Part B excess charges while Plan N does not. Plan N can also require copayments for some office and emergency room visits. See our Plan G vs Plan N comparison.
Medigap rules, benefits, and annual dollar amounts can change. These Medicare.gov resources are the primary references for this page.
Compare standardized benefits, premiums, underwriting rules when applicable, household discounts, Part D options, and how each choice fits your doctors, travel needs, budget, and comfort with out-of-pocket costs.
Request Medicare Plan InformationSenior Healthcare Planning is an independent insurance agency that provides education, guidance, and enrollment assistance for Medicare-related insurance products, including Medicare Advantage, Medicare Supplement, and Prescription Drug Plans. Senior Healthcare Planning is not connected with or endorsed by the United States government or the federal Medicare program. Medigap availability, premiums, underwriting requirements, guaranteed issue rights, discounts, and state-specific rules vary and can change. Not all plans are available in all areas.
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