What is Medigap Insurance and What Does it Cover?
Medigap, also called Medicare Supplement, covers things like your Medicare Part A and B deductibles and coinsurance so you pay less overall for medical care.
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There are 10 different Medicare Supplement plans to choose from, each with its own level of coverage. With some of the higher-coverage plans, you might not have to pay much, if anything, when you go to the doctor or hospital.
What is Medigap insurance?
Medigap is an extra insurance plan you can buy to cover some of the costs you have to pay when you have Original Medicare (Parts A and B).
Also called Medicare Supplement, Medigap plans help you cover Medicare costs like your deductible, copays and coinsurance. Medigap plans help you lower or even eliminate what you pay for most medical care.
Medicare Supplement plans come from insurance companies, not from the government. But the government sets standard coverage limits for each plan letter. That means you get the same coverage with Plan G no matter which company you buy it from. Once you decide which plan letter is right for you, you can compare companies based on price and customer service reputation.
You cannot buy a Medicare Supplement plan if you have Medicare Advantage.
You can only get Medigap if you have Original Medicare, which means Part A and Part B from the government. However, you can have a Part D plan for prescription drug coverage. This is usually a good idea, because Medigap doesn't have any coverage for prescription medications.
What does Medigap cover?
Medigap pays for some of the costs that Original Medicare (Parts A and B) won't cover.
That often includes your Parts A and B deductibles and coinsurance, but the exact coverage depends on your plan.
For example, when you have Medicare and you go into the hospital, you have to pay a deductible and a daily amount depending on how many days you have to stay. If you have a Medigap plan, you might not have to pay anything.
Most popular plans
Other plans
Average costs are for a 65-year-old female nonsmoker. Rates vary by location, age, gender and other factors.
Most popular plans
Average costs are for a 65-year-old female nonsmoker. Rates vary by location, age, gender and other factors.
Other plans
Plan B | Plan C | Plan D | Plan L | Plan M | |||
|---|---|---|---|---|---|---|---|
| Monthly cost | $151 | $196 | $222 | $178 | $83 | $126 | $143 |
| Part A coinsurance | |||||||
| Part B coinsurance | 50% | 75% | |||||
| Blood (3 pints) | 50% | 75% | |||||
| Part A hospice care | 50% | 75% | |||||
| Skilled nursing facility | 50% | 75% | |||||
| Part A deductible | 50% | 75% | 50% | ||||
| Part B deductible | |||||||
| Part B excess charges | |||||||
| Foreign travel emergency | 80% | 80% | 80% |
Average costs are for a 65-year-old female nonsmoker. Rates vary by location, age, gender and other factors.
= 100%
Plans F, G and N make up more than 80% of all Medicare Supplement policies sold. These plans all provide high levels of coverage.
- Plan G is the best option for most people. It has the highest level of coverage for people who are new to Medicare.
- Plan F has the most coverage, but you can only get it if you could get Medicare before Jan. 1, 2020.
- Plan N has a good balance of coverage and cost. It has coverage that's almost as good as Plan G but a lower monthly rate.
What does Medigap not pay for?
Medigap doesn't pay for the bulk of your medical bills.
Medigap plans are not regular health insurance. They're a type of supplemental insurance designed to help you pay for the costs not covered by Original Medicare. That means Medicare Parts A and B still pay for most of your medical bills, and your Medigap plan helps pay for what's left over.
Medigap plans also don't include coverage for vision or dental care. Although Medicare covers some vision and dental procedures, you're better off buying a separate plan for each to get the best coverage.
Not covered by Medicare Supplement plans
- Dental
- Vision
- Hearing
- Prescription drugs
- Transportation
Some states have "innovative" Medigap plans that bundle extra benefits onto your regular Medigap plan. These plans might include dental, hearing or vision coverage as well as access to a fitness program and other perks. However, these plans are not common or widespread.
Many Medigap companies sell separate supplemental insurance like vision, dental and hearing policies. This can be a good way to get coverage while keeping all your policies with one company for convenience.
Medicare Supplement plan cost
The most popular Medigap plans — F, G and N — cost between $121 and $199 per month.
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Plans with more coverage typically have higher prices.For example, Plan F policies typically cost more than Plan K policies since Plan F offers significantly more coverage than Plan K.
Other factors like your age, health status and when you buy your Medigap plan also affect how much you pay.
Medigap plan costs
Plan letter | Monthly rate |
|---|---|
| High-deductible Plan G | $49 |
| High-deductible Plan F | $54 |
| Plan K | $83 |
| Plan N | $121 |
| Plan L | $126 |
Prices are for a 65-year-old woman who doesn't smoke.
You should buy your Medigap plan when you become eligible for Medicare, during what's called your " initial enrollment period, " to get the best price on your Medigap policy. During this period, your health can't be used to set your monthly rate. It's the best time to get a Medigap policy because it helps you pay less overall.
Insurance companies set prices for Medicare Supplement policies in three different ways. Some states require Medigap companies to set prices in one of those ways, while other states let companies choose.
- Community-rated: Age doesn't impact your price.
- Issue-age-rated: Your rate is based on the age you are when you first get a policy, but you don't pay more just because you get older.
- Attained-age-rated: Your Medicare Supplement plan gets more expensive every year, as you age.
Each option has pros and cons. For example, plans that take age into account may be cheaper when you first enroll, but they can grow unaffordable over time. Plans that don't use age at all might be more expensive at first, but your rate stays steady over time.
Frequently asked questions
What does Medigap typically cover?
Medigap plans cover some of what you still have to pay for medical care even when you have Medicare Part A and B. Some plans also pay for up to 80% of emergency medical costs you get while traveling.
What does Medigap not pay for?
Medigap doesn't pay for vision, dental or hearing care unless you have an "Innovative" plan, which isn't common. Medicare Supplement plans also don't pay for the majority of your medical bills. Original Medicare (Parts A and B) will always pay first, and Medigap will pay some or all of what's left over.
What are the disadvantages of a Medigap plan?
Medigap plans can be expensive, especially if you buy a plan with a high level of coverage. It can be hard to get a Medigap plan if you don't buy one when you're first eligible, because rates can be higher. You also should buy a separate Part D plan for medication coverage, because Medicare Supplement plans don't cover prescriptions.
Methodology and sources
ValuePenguin sourced Medicare Supplement rates from private insurance companies. Rates are for a 65-year-old woman who does not smoke and who signed up for Medigap when she was first eligible. Rates don't include Select plans or plans in Massachusetts, Minnesota or Wisconsin, which have their own Medigap systems.
Plan popularity info is from AHIP.
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