Medigap Plans Explained: Your Medicare Supplement Guide

Medigap, also known as Medicare Supplement Insurance, helps fill the "gaps" in Original Medicare coverage. This guide explains how Medigap works, compares available plans, and helps you decide if a supplement policy is right for you.

!An umbrella, representing the supplemental protection a Medigap policy provides

What Is Medigap?

> About 41.9% of Original Medicare beneficiaries carry a Medigap (Supplement) policy. (Source: AHIP, The State of Medicare Supplement Coverage, 2023.)

Medigap policies are private insurance plans that help pay some of the out-of-pocket costs that Original Medicare doesn't cover:

• Part A coinsurance and hospital costs
• Part B coinsurance or copayments
• Part A hospice care coinsurance
• Blood (first 3 pints)
• Part B deductible (on some plans)
• Skilled nursing facility coinsurance
• Foreign travel emergency coverage

Important: Medigap only works with Original Medicare. You cannot use a Medigap policy with Medicare Advantage.

How Medigap Works

Here's the basic structure:

1. You pay your Medicare Part B premium 2. You pay your Medigap monthly premium 3. When you receive Medicare-covered services: - Medicare pays its share (80% of Part B services) - Medigap pays some or all of the remaining 20%

Available Medigap Plans in 2026

Insurance companies can only sell standardized Medigap plans, labeled with letters. Each lettered plan offers the same benefits regardless of which company sells it.

Plan Comparison Chart

| Benefit | Plan A | Plan B | Plan C | Plan D | Plan F | Plan G | Plan K | Plan L | Plan M | Plan N | |---------|--------|--------|---------|--------|---------|--------|--------|--------|--------|--------| | Part A coinsurance | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | 50% | 75% | ✓ | ✓ | | Part B coinsurance | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | 50% | 75% | ✓ | ✓** | | Blood (first 3 pints) | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | 50% | 75% | ✓ | ✓ | | Part A hospice | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | 50% | 75% | ✓ | ✓ | | Skilled nursing | ✗ | ✗ | ✓ | ✓ | ✓ | ✓ | 50% | 75% | ✓ | ✓ | | Part A deductible | ✗ | ✓ | ✓ | ✓ | ✓ | ✓ | 50% | 75% | 50% | ✓ | | Part B deductible | ✗ | ✗ | ✓ | ✗ | ✓ | ✗ | ✗ | ✗ | ✗ | ✗ | | Part B excess | ✗ | ✗ | ✗ | ✗ | ✓ | ✓ | ✗ | ✗ | ✗ | ✗ | | Foreign travel | ✗ | ✗ | 80% | 80% | 80% | 80% | ✗ | ✗ | 80% | 80% |

*Plans C and F are only available if you became Medicare-eligible before January 1, 2020 **Plan N requires copays: up to $20 for office visits, up to $50 for ER visits not resulting in admission

Most Popular Plans in 2026

Plan G: The New Standard

Plan G has become the most popular Medigap plan because:

• Covers everything Plan F covered except the Part B deductible
• Lower premiums than Plan F
• The Part B deductible is only $257 in 2026
• Available to everyone regardless of when they became Medicare-eligible

Best for: Most people choosing Medigap who want comprehensive coverage

Average Florida monthly premium: $140-$250

Plan N: The Budget Option

Plan N offers strong coverage at lower premiums:

• Slightly lower premiums than Plan G
• Requires small copays ($20 for office visits, $50 for ER)
• Doesn't cover Part B excess charges
• Good for people who don't see doctors frequently

Best for: Healthy individuals who want lower monthly costs

Average Florida monthly premium: $100-$180

High-Deductible Plan G

This option features:

• Very low monthly premiums
• $2,870 annual deductible (2026)
• Full Plan G benefits after meeting deductible

Best for: Healthy individuals with savings who rarely use healthcare services

Average Florida monthly premium: $30-$60

Medigap Pricing Methods

Insurance companies use three pricing methods:

Community-Rated (No-Age-Rated)

• Same premium for everyone regardless of age
• Your premium won't increase just because you get older
• May start higher but grows more slowly

Issue-Age-Rated

• Premium based on your age when you buy the policy
• Premium doesn't increase due to aging (but can increase for other reasons)
• Buying younger means lower lifetime premiums

Attained-Age-Rated

• Premium based on your current age
• Increases as you get older
• Usually starts lowest but can become expensive over time

Recommendation: Look for community-rated or issue-age-rated policies for more predictable costs over time.

The Medigap Open Enrollment Period

Your Medigap Open Enrollment Period is crucial:

• When: Starts the first day of the month you're 65 or older AND enrolled in Part B
• Duration: 6 months
• Benefit: During this time, insurers cannot:

- Deny you coverage - Charge more due to health conditions - Make you wait for pre-existing conditions

Warning: After your Medigap OEP ends, insurers can:

• Deny your application
• Charge higher premiums based on health
• Exclude coverage for pre-existing conditions

Medigap vs Medicare Advantage

| Factor | Medigap | Medicare Advantage | |--------|---------|-------------------| | Monthly premium | Higher | Usually lower/$0 | | Out-of-pocket costs | Lower/predictable | Higher/variable | | Doctor choice | Any Medicare doctor | Network restrictions | | Extra benefits | None | Dental, vision, etc. | | Prescription drugs | Need separate Part D | Usually included | | Best for | Travelers, specialists | Budget-conscious, local care |

Florida Medigap Considerations

Competitive Market

Florida's large senior population means:

• Many insurance companies compete for business
• Rates tend to be competitive
• More plan options available

Birthday Rule

Florida has a "birthday rule" that allows you to switch to a comparable Medigap plan from another insurer within 30 days of your birthday without medical underwriting.

Household Discounts

Many Florida insurers offer discounts if:

• You and your spouse both have Medigap policies
• You're a non-smoker
• You pay premiums annually

When to Buy Medigap

The best times to purchase Medigap:

1. During your Medigap OEP (best option): Guaranteed acceptance 2. During your birthday month (Florida): Can switch plans without underwriting 3. When leaving employer coverage: May have guaranteed issue rights 4. When dropping Medicare Advantage: Within 12 months of joining, you have guaranteed rights

Questions to Ask Before Buying

1. What is the monthly premium? 2. How does the company price policies (community, issue-age, or attained-age)? 3. What discounts are available? 4. What is the company's history of rate increases? 5. How financially stable is the insurance company? 6. What is the claims process like?

Get Personalized Help

Choosing a Medigap plan involves comparing prices from multiple insurers. A licensed Medicare advisor can:

• Compare rates from all major carriers
• Find available discounts
• Help you understand your options
• Assist with enrollment at no cost

Schedule a free consultation to find the right Medigap plan for your needs.

Next steps: Take our 2-minute Medicare plan quiz, book a free Medicare review, or see our Medigap Plan G guide.

We do not offer every plan available in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.