Medigap Explained

If you’ve been researching Medicare Supplement plans, also referred to as Medigap, it’s easy to feel like you’re getting pulled in different directions.

Most people we meet aren’t looking for the “perfect” plan. They just want to make sure that when they need coverage, it’s there for them. We get that.  

We have broken this article into two parts. First, we will share what plan most people in our agency select. Later, we will go over a high-level explanation of all 10 plans.

Original Medicare

Before we dive into Medigap explanation, let’s quickly review the parts of Medicare you need to qualify for a supplement. Part A generally helps with hospital-related care, while Part B covers doctor visits, outpatient services, and routine medical care. Enrollment in both Medicare Part A and B is required to purchase a Medigap plan.

Supplements (Medigap) are made to cover the coinsurance not covered by Parts A and B.  

One important note: Medicare Supplement plans do not include prescription drug coverage, so a separate Part D plan is needed.

Sams/Hockaday & Associates

Here at our local Decatur agency, Michael Sams comments that most of the supplements he sells are Plan G. Why? Because Plan G covers everything that Original Medicare does not, after the $283 Part B deductible (2026) has been met.

Why Supplements Are Right for Some People

For many retirees, the appeal of a Medicare Supplement plan comes down to predictability. A supplement can help reduce that uncertainty by covering portions of those remaining costs.

Another factor is flexibility. In most cases, Medicare Supplement plans allow you to visit any provider nationwide who accepts Medicare, without the need for referrals or network restrictions.

Making Sense of the Medigap Plan Letters

There are 10 Medicare Supplement (Medigap) Plans, labeled A through N. While that may sound complicated, the key point is that the government standardizes what each letter covers. That means Plan G offers the same medical benefits regardless of which insurance company provides it. However, the premium and underwriting requirements may vary from carrier to carrier.

Here is a brief overview of each Medigap plan. Please note, this content is for educational purposes only and does not represent all plan options available. Benefits and availability may vary by carrier and location.

Medicare Supplement Plan A
Plan A is the most basic Medicare Supplement and is offered by every company that sells Medigap. It covers core items like hospital and doctor coinsurance but does not cover deductibles, skilled nursing care, or foreign travel emergencies.

Medicare Supplement Plan B
Plan B includes everything in Plan A, with the added benefit of covering the Medicare Part A hospital deductible. It still does not cover skilled nursing facility care or foreign travel emergencies.

Medicare Supplement Plan C
Plan C provides broad coverage, including both Part A and Part B deductibles, skilled nursing coinsurance, and limited foreign travel emergency care. It is only available to individuals who were eligible for Medicare before January 1, 2020.

Medicare Supplement Plan D
Plan D closely mirrors Plan C but does not cover the Part B deductible. It still includes coverage for skilled nursing coinsurance and foreign travel emergencies.

Medicare Supplement Plan F
Plan F offers the most comprehensive coverage, paying nearly all Medicare-approved costs, including deductibles, copays, and excess charges. It is only available to individuals eligible for Medicare Part A before January 1, 2020.

Medicare Supplement Plan G
Plan G is a widely used option that covers most Medicare costs except the Part B deductible, which you pay out of pocket. After that deductible is met, it covers nearly all remaining Medicare-approved expenses.

Medicare Supplement Plan K
Plan K covers a portion (generally 50%) of many Medicare costs and includes an annual out-of-pocket limit. Once that limit is reached, the plan pays 100% of covered services for the remainder of the year.

Medicare Supplement Plan L
Plan L works similarly to Plan K but covers a larger share (typically 75%) of many costs and has a lower out-of-pocket maximum. It balances cost sharing with added financial protection.

Medicare Supplement Plan M
Plan M lowers monthly premiums by sharing the Part A hospital deductible, covering 50% of it while paying many other Medicare gaps. It does not cover the Part B deductible or excess charges.

Medicare Supplement Plan N
Plan N offers lower premiums in exchange for some cost sharing, including small copays for certain doctor and emergency room visits. It does not cover Part B excess charges but still provides strong overall coverage.

Conclusion

If you’re feeling unsure, you’re not alone. Many people selecting a Medigap plan simply want a clear explanation from someone who will take the time to walk them through it. That’s where any agent at Sams/Hockaday can help you choose the plan that’s best for you.

We’ll help you understand how Medicare Supplement plans work, what your options could look like, and how to think about your costs now and into the future. Just as importantly, we’re here as an ongoing resource, so you’re not left figuring it out on your own after you enroll.

Note: This content is for educational purposes only and does not represent all plan options available. Benefits and availability may vary by carrier and location.