Does Medicare Leave Gaps in Your Healthcare Coverage? Here’s the Fix
Let’s face it—healthcare costs can be confusing (and expensive!). While Original Medicare (Parts A & B) covers many medical services, it doesn’t pay for everything. That’s where Medicare Supplement Insurance (Medigap) comes in.
If you’ve ever been surprised by a medical bill, this guide is for you. We’ll break down:
✅ What Medicare Supplement Insurance is
✅ How it works with Original Medicare
✅ Who needs it (and who doesn’t)
✅ Key benefits & costs
By the end, you’ll know whether a Medigap plan could save you money and stress. Let’s dive in!
What Is Medicare Supplement Insurance (Medigap)?
Medigap is private health insurance that helps cover costs Original Medicare doesn’t pay, such as:
✔ Copayments & coinsurance (your share of doctor/hospital bills)
✔ Deductibles (what you pay before Medicare kicks in)
✔ Emergency care abroad (Original Medicare doesn’t cover international travel)
✔ Excess charges (when doctors charge more than Medicare’s approved amount)
Think of it like a safety net—it fills the “gaps” in Medicare so you pay less out of pocket.
How Does Medigap Work with Original Medicare?
Here’s the simple breakdown:
1️⃣ You must have Medicare Part A & Part B to buy a Medigap plan.
2️⃣ Medigap pays after Medicare—Medicare covers its share first, then your supplement plan pays part (or all) of the rest.
3️⃣ You pay a monthly premium for your Medigap policy (on top of your Part B premium).
Example:
- You get a $200 doctor bill.
- Medicare pays 80% ($160).
- Without Medigap, you pay $40.
- With Medigap, your plan might cover all or part of that $40.
Who Needs Medicare Supplement Insurance?
Medigap isn’t for everyone. Consider it if you:
✅ Want predictable healthcare costs (no surprise bills)
✅ Travel outside the U.S. (some plans cover foreign emergencies)
✅ Frequently need medical care (saves money long-term)
✅ Don’t have other coverage (like employer insurance or Medicaid)
Who Might Not Need It?
❌ If you have Medicare Advantage (Part C) (you can’t use both).
❌ If you qualify for Medicaid (it already covers costs).
❌ If you’re low-risk and rarely see a doctor (may not be worth the premium).
Types of Medigap Plans (Standardized Options)
Medigap plans are labeled A, B, C, D, F, G, K, L, M, & N. All plans with the same letter offer identical coverage (no matter the insurance company).
Most Popular Plans in 2025:
- Plan G – Covers almost all gaps (except Part B deductible).
- Plan N – Lower premiums but has small copays for some services.
⚠️ Note: Plan F (full coverage) is only for those eligible before 2020.
How Much Does Medigap Cost?
Prices vary by plan type, location, age, & insurer, but expect:
💲 Premiums: 100–100–300/month (on top of Part B’s 174.70/monthin2024).💲∗∗Deductibles:∗∗SomeplanscoverPartA’s174.70/monthin2024).💲∗∗Deductibles:∗∗SomeplanscoverPartA’s1,632 deductible (2024).
💲 Out-of-pocket max: Certain plans (K & L) cap annual costs.
Money-Saving Tip:
Compare insurers! Same plan = same coverage, but prices differ.
When Can You Enroll in Medigap?
The best time is during your 6-month Medigap Open Enrollment Period:
📅 Starts when you’re 65+ and enrolled in Part B.
📅 No medical exams—insurers can’t deny you or charge more for pre-existing conditions.
After this window, getting Medigap may cost more or be harder (unless you qualify for special cases).
Medigap vs. Medicare Advantage: Key Differences
| Feature | Medigap | Medicare Advantage (Part C) |
|---|---|---|
| Works with Original Medicare | ✅ Yes | ❌ Replaces it |
| Covers travel abroad | ✅ Some plans | ❌ Rarely |
| Network restrictions | ❌ No (any doctor who accepts Medicare) | ✅ Yes (HMO/PPO networks) |
| Prescription coverage | ❌ No (need Part D) | ✅ Usually included |
Final Verdict: Is Medigap Worth It?
👍 Pros:
✔ Fewer surprise medical bills
✔ More provider choices (no networks)
✔ Stable costs long-term
👎 Cons:
✖ Monthly premiums add up
✖ Doesn’t cover prescriptions (need Part D)
Good for: Those who want max flexibility and can afford extra premiums.
Key Takeaways
🔹 Medigap fills Medicare’s coverage gaps.
🔹 Plans are standardized by letter (e.g., Plan G).
🔹 Enroll early to avoid higher costs/denials.
🔹 Compare prices—same plan ≠ same premium!
Need More Help? Explore These:
🔗 Medigap vs. Medicare Advantage: Which Is Better?
🔗 How to Compare Medigap Plans in Your State
🔗 2025 Medicare Changes You Should Know
Official Resources
📌 Medicare.gov’s Medigap Guide
📌 State Health Insurance Assistance Program (SHIP)