What is a Medigap (Medicare Supplement) policy?

Medigap — also called Medicare Supplement insurance — is a private insurance policy that pays your share of Original Medicare costs: deductibles, coinsurance, and copays. It only works alongside Original Medicare (Parts A and B). It does not work with Medicare Advantage.

Medigap policies are standardized by federal law in most states, labeled by letter (A, B, C, D, F, G, K, L, M, N). A Plan G is a Plan G no matter who sells it — the benefits are identical. What can vary is the premium and the company's customer service. Massachusetts, Minnesota, and Wisconsin have their own standardized plan designs.

The Medigap Open Enrollment Period is a one-time, 6-month window that starts on the first day of the month you're 65 or older AND have Medicare Part B in effect. During those 6 months, insurers cannot deny you a Medigap policy or charge more based on your health — it's guaranteed issue.

Outside the Medigap OEP, in most states, insurers can ask health questions, rate you up, or deny coverage. The OEP doesn't reopen.

No. It is illegal under federal law for an insurer to sell you a Medigap policy if you're enrolled in a Medicare Advantage plan. The two products are designed for different paths.

Medicare Advantage replaces Original Medicare with a private plan. Medigap supplements Original Medicare. You're either on the Original Medicare path (with optional Medigap and a separate Part D plan) or the Medicare Advantage path. Pick one. Switching paths later is possible but not always easy.

Plan G covers nearly everything Original Medicare leaves you with after the annual Part B deductible — hospital coinsurance, the Part A deductible, Part B coinsurance, the first three pints of blood, skilled nursing facility coinsurance, and Part B excess charges.

Plan N covers most of the same items but with three differences: you pay up to a $20 copay for certain office visits, up to a $50 copay for ER visits that don't lead to admission, and Part N does not cover Part B excess charges. In exchange, Plan N usually has a lower monthly premium than Plan G.

Plan F (and high-deductible Plan F) closed to people new to Medicare on January 1, 2020. The closure came from the Medicare Access and CHIP Reauthorization Act of 2015 — MACRA. The law prohibited the sale of Medigap policies that cover the Part B deductible to anyone newly eligible for Medicare on or after that date.

If you were eligible for Medicare before January 1, 2020, you can still buy Plan F. If you became eligible on or after that date, Plan G is the most-comprehensive option available to you.

No. Only Plans C, D, F, G, M, and N include the foreign travel emergency benefit. Plans A, B, K, and L do not.

The benefit covers 80% of billed charges for medically necessary emergency care during the first 60 days of a trip outside the U.S., after a $250 annual deductible, up to a $50,000 lifetime maximum. It is not full travel insurance — it covers emergencies only, has a hard lifetime cap, and only the first 60 days of any trip.

High-deductible Plan G is a version of Plan G with a substantially lower monthly premium in exchange for a high annual deductible you pay before benefits kick in. The deductible adjusts annually under CMS guidance.

It's worth considering if you're relatively healthy, have savings to cover the deductible if a major event happens, and want a low monthly premium. It's worth avoiding if you have ongoing high medical costs — you'll hit the deductible every year and may end up paying more total than standard Plan G.

Yes — dramatically. Medigap premiums vary by state, by zip code within a state, by your age in some pricing methods, and by the insurer.

There are three pricing methods. Community-rated: everyone in the area pays the same regardless of age. Issue-age-rated: premium is based on your age when you bought the policy and stays tied to that. Attained-age-rated: premium starts low and rises as you get older. Each method has tradeoffs depending on how long you'll hold the policy and how the company adjusts premiums over time.

They're separate. Medigap does not include prescription drug coverage. If you're on Original Medicare plus Medigap, you also need a separate Medicare Part D plan to get drug coverage — and to avoid a permanent late-enrollment penalty.

The one exception: a small number of pre-2006 Medigap plans (the older Plans H, I, and J) included drug benefits. Those plans were closed to new enrollment when Part D started in 2006. If you have one of those grandfathered policies, you may already have drug coverage; everyone else needs Part D separately.

Hang up. Unsolicited cold-call sales of Medicare-related products — including Medigap — are prohibited under CMS marketing rules and federal Do Not Call rules. Real licensed advisors don't cold-call seniors at home.

Never give your Medicare number, Social Security number, or banking information to a caller you didn't initiate contact with. Report cold-call Medicare solicitations to 1-800-MEDICARE and to the FTC. If you want a real comparison, call SHIP at 1-877-839-2675 or a licensed Chapter advisor at (352) 841-0632 — both are free, and you control the call.