Understanding Medicare Supplement Plans (Medigap): A Simple Guide

If you’re turning 65 or already enrolled in Medicare, you’ve likely heard about Medicare Supplement Plans, also known as Medigap. These plans are designed to work alongside Original Medicare to help cover the “gaps” in coverage—things like copayments, coinsurance, and deductibles.
This post is here to gently walk you through what Medigap is, what it covers, who it’s for, and how it can provide peace of mind. Our goal is to give you clear, helpful information—without pressure—so you can make decisions that feel right for you.

What Is a Medicare Supplement (Medigap) Plan?

A Medigap plan is health insurance offered by private companies to help pay some of the costs that Original Medicare (Parts A and B) doesn’t cover. These are things like:
  • Hospital deductibles
  • Doctor visit coinsurance
  • Skilled nursing facility coinsurance
  • Emergency care during foreign travel
Medigap plans don’t replace Medicare—they supplement it. You must be enrolled in both Medicare Part A and Part B to buy a Medigap policy.

What Does a Medigap Plan Cover?

The benefits of Medigap plans are standardized by the federal government. That means a Plan G from one company covers the same benefits as Plan G from another —only the premium may differ.
Common Medigap plans include:
  • Plan G: Covers nearly all out-of-pocket costs except the Part B deductible
  • Plan N: Lower premiums than Plan G but may have small copays and doesn’t cover Part B excess charges.
  • These are just a few of the eligible plans available. Your cost share and monthly premium will vary depending upon the plan.
Medigap plans do not include prescription drug coverage —you’ll need a separate Part D plan for medications.

Who Should Consider a Medigap Plan?

Medigap may be a good fit for people who:
  • Want predictable healthcare costs with minimal surprises
  • Travel frequently and need nationwide provider access
  • Prefer flexibility in choosing doctors and hospitals (no networks)
  • Have health conditions requiring frequent outpatient care or specialist visits

How Much Do Medigap Plans Cost?

Costs vary by:
  • Plan type (e.g., Plan G vs. Plan N)
  • Your age and location
  • Insurance company
  • Enrollment timing
Premiums will vary depending on the plan and your area. Remember, Medigap helps reduce what you pay when you use healthcare, so many find the monthly premium worth the peace of mind .

When Should You Enroll in a Medigap Plan?

The best time to buy a Medigap policy is during your Medigap Open Enrollment Period :
  • Starts the month you are both 65 or older and enrolled in Medicare Part B
  • Lasts for 6 months
During this window:
  • You have guaranteed issue rights , meaning you can’t be denied or charged more due to health conditions.
After this period, you may be subject to medical underwriting and could be denied coverage or charged a higher rate. However, some states such as New York do not have Medical Underwriting and therefore Guarantee Issue at all times.

How Is Medigap Different from Medicare Advantage?

It’s easy to confuse Medigap with Medicare Advantage (Part C), but they are very different :
Feature Medigap Medicare Advantage
Works with Original Medicare Yes No (Works in lieu of)
Includes Part D (Rx coverage) No Often yes
Uses provider networks No (any provider who accepts Medicare) Yes (HMO/PPO plans)
Monthly premiums Higher Lower or $0 plans available
Out-of-pocket predictability High Varies by plan

Final Thoughts: Is a Medigap Plan Right for You?

Medigap plans offer a layer of financial protection and peace of mind for those who want comprehensive coverage and provider flexibility. While premiums may be higher than other options, many people value the reduced out-of-pocket costs and freedom to see any doctor that accepts Medicare.
If you’re approaching Medicare eligibility, it’s a good idea to:
  • Learn about your Medigap enrollment window
  • Compare plans based on your budget and health needs
  • Consider pairing Medigap with a Part D drug plan
And if you need help, you’re not alone—speak with a licensed Medicare advisor, check out Medicare.gov, or reach out to your State Health Insurance Assistance Program (SHIP) for free, unbiased guidance.
Do Medicare Supplement Plans(Medigap) offer Dental and Vision?
No, Medicare Supplement Plans only help pay cost sharing associated with your Medicare Card.
No- your Primary Payer is still Medicare so a stand alone Part D plan will still have to be added.
Your doctors only need to accept Medicare.

Mike Miligi- Owner

For over 10 years, Mike has been assisting Seniors and other Medicare-eligible individuals in understanding the ins and outs of Medicare and Medicare Health Insurance options, including Medicare Advantage Plans(Part C), Medicare Supplement Plans(Medigap), Prescription Drug Plans(PartD), and Dental and Vision programs.
Mike is Licensed in seven States and Certified with 11 Insurance Carriers. He has helped thousands of individuals decide on the best course of action for their particular Health Insurance needs. Because Mike is an Independent Medicare Health Insurance Broker, he works for the client, not the Insurance Carriers, and is able to provide his clients with accurate and unbiased Health Insurance options.
Mike recertifies with CMS(The Centers for Medicare and Medicaid Services) annually, regularly completes Continuing Education Courses required by individual State Insurance Departments, and keeps abreast of industry trends and standards to offer his clients the most up-to-date information.

Choosing the Right Medicare Coverage

Selecting the best Medicare coverage depends on factors like your healthcare needs, budget, and preferred providers. You can choose between:
  • Original Medicare (Parts A & B): Allows you to see any doctor or
    hospital that accepts Medicare but does not include prescription drug
    coverage (Part D) or additional benefits.
  • Medicare Advantage (Part C): Offers bundled coverage with
    potential extra benefits but may require using a network of providers.
  • Medigap (Medicare Supplement Insurance): Helps cover
    out-of-pocket costs not covered by Original Medicare, such as
    copayments and deductibles.

Key Medicare Enrollment Periods

It is crucial to enroll in Medicare at the right time to avoid penalties and ensure continuous coverage:
  • Initial Enrollment Period (IEP): A seven-month window starting
    three months before your 65th birthday month.
  • General Enrollment Period (GEP): From January 1 to March 31
    each year for those who missed their IEP.
  • Annual Election Period (AEP): From October 15 to December 7,
    allowing you to switch or enroll in Medicare Advantage and Part D
    plans.
  • Open Enrollment Period(OEP): From January 1 to March 31 for
    those who missed AEP and want to make certain changes.
  • Special Enrollment Period(SEP): Can be used anytime during the
    calendar year for those that meet certain criteria such as moving to a
    new service area.

Finding Help with Medicare

Understanding Medicare can be complex, but you don’t have to do it alone. Licensed Insurance Brokers, Medicare.gov, and state health assistance programs can provide guidance tailored to your specific needs.
By taking the time to explore your Medicare options, you can make informed decisions that ensure you receive the healthcare coverage that best suits your lifestyle and budget.
Do I have to sign up for Medicare?
It depends upon your current coverage. If you are employed and your employer has over 20 employees then you can delay signing up for Medicare and avoid penalties.
No, You will have to enroll in a stand alone Part D plan or a Medicare Advantage Plan(Part C) to get coverage.
There are no networks with Medicare and most doctors and hospitals accept it. However, Medicare does not cover 100% of services so a Medicare Supplement or Medicare Advantage plans is advisable.

Mike Miligi- Owner

For over 10 years, Mike has been assisting Seniors and other Medicare-eligible individuals in understanding the ins and outs of Medicare and Medicare Health Insurance options, including Medicare Advantage Plans(Part C), Medicare Supplement Plans(Medigap), Prescription Drug Plans(PartD), and Dental and Vision programs.
Mike is Licensed in seven States and Certified with 11 Insurance Carriers. He has helped thousands of individuals decide on the best course of action for their particular Health Insurance needs. Because Mike is an Independent Medicare Health Insurance Broker, he works for the client, not the Insurance Carriers, and is able to provide his clients with accurate and unbiased Health Insurance options.
Mike recertifies with CMS(The Centers for Medicare and Medicaid Services) annually, regularly completes Continuing Education Courses required by individual State Insurance Departments, and keeps abreast of industry trends and standards to offer his clients the most up-to-date information.
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