What Is Medigap?

If you’re new to Medicare, you’ve probably heard the term Medigap and wondered exactly what it means.

Medigap is another name for Medicare Supplement insurance. These plans are sold by private insurance companies and are designed to help pay many of the out-of-pocket costs that Original Medicare doesn’t cover.

Although Medicare provides excellent health insurance for millions of Americans, it does not pay 100% of your medical expenses. Depending on the services you receive, you may still be responsible for deductibles, coinsurance, and copayments.

A Medigap plan helps fill many of those “gaps” in Original Medicare coverage—hence the name Medigap.

For many people, a Medigap policy provides greater financial predictability and the freedom to see any doctor nationwide who accepts Medicare.

How Does Medigap Work?

Medigap plans work alongside Original Medicare (Part A and Part B).

Here’s what typically happens when you receive medical care:

You visit a doctor or hospital that accepts Medicare.
Medicare pays its share of the approved charges.
Your Medigap plan pays some or all of the remaining approved costs, depending on the plan you chose.

Instead of replacing Medicare, a Medigap policy simply works with it.

Because of this, you’ll continue using your red, white, and blue Medicare card. Your Medicare Supplement insurance simply pays after Medicare processes the claim.

What Does Medigap Cover?

Coverage depends on which standardized Medigap plan you purchase, but many plans help pay for expenses such as:

Medicare Part A hospital coinsurance
Medicare Part B coinsurance
Blood (first three pints)
Skilled nursing facility coinsurance
Hospice coinsurance
Medicare Part A deductible (certain plans)
Foreign travel emergency benefits (certain plans)

Some plans provide nearly complete protection against Medicare-approved medical expenses, while others require you to pay small copayments in exchange for lower monthly premiums.

What Doesn’t Medigap Cover?

One of the biggest misconceptions is that Medigap covers everything.

It doesn’t.

Most Medigap plans do not cover:

Prescription drugs
Routine dental care
Routine vision exams
Hearing aids
Long-term custodial nursing home care
Routine physicals beyond what Medicare covers

If you need prescription drug coverage, you’ll generally enroll in a separate Medicare Part D prescription drug plan.

Who Can Buy a Medigap Plan?

Generally, you’re eligible to purchase a Medigap policy if:

You’re enrolled in Medicare Part A.
You’re enrolled in Medicare Part B.
You remain on Original Medicare.

The best time to enroll is during your Medigap Open Enrollment Period, which begins when you’re both age 65 or older and enrolled in Medicare Part B.

During this six-month window, insurance companies generally cannot deny coverage or charge higher premiums because of pre-existing health conditions.

After this enrollment period ends, you may have to answer health questions unless you qualify for a guaranteed issue right.

Are All Medigap Plans the Same?

This is one of the most confusing parts of Medicare.

Every Medigap plan is standardized by the federal government.

That means a Plan G from one insurance company provides the exact same medical benefits as a Plan G from another company.

The differences are generally:

Monthly premium
Company reputation
Rate increase history
Customer service
Household discounts
Value-added extras offered by some companies

Because the benefits are standardized, many people compare insurance companies based primarily on price and long-term value rather than differences in medical coverage.

Why Do So Many People Choose Medigap?

Many Medicare beneficiaries choose Medigap because they appreciate:

Predictable medical costs
Freedom to see nearly any Medicare provider nationwide
No referral requirements
Excellent nationwide portability
Protection from large medical bills
Simple coordination with Original Medicare

For people who travel frequently or simply want flexibility in choosing doctors and hospitals, Medicare Supplement insurance remains one of the most popular options.

Medigap vs. Medicare Advantage

One of the most common questions people ask is whether they should choose a Medigap plan or a Medicare Advantage plan.

Although both options are ways to receive Medicare benefits, they work very differently.

Medigap

With a Medigap plan, you remain enrolled in Original Medicare. Medicare pays first, and your Medigap policy helps pay many of the remaining out-of-pocket costs.

Many people like Medigap because it offers:

Freedom to see any doctor or hospital in the United States that accepts Medicare
No provider networks
No referrals to see specialists
Predictable out-of-pocket costs
Excellent coverage while traveling throughout the country

Medicare Advantage

Medicare Advantage plans replace Original Medicare with a private insurance plan.

Depending on the plan, you may have:

Provider networks
Copayments for most services
Prior authorization requirements
Referrals for specialists (on some plans)
Annual out-of-pocket maximums

While Medicare Advantage plans can have lower monthly premiums, your costs generally depend on how often you use healthcare services.

Neither option is automatically better for everyone. The right choice depends on your health, budget, travel habits, preferred doctors, and personal priorities.

What Medigap Plans Are Available?

Although there are several standardized Medigap plans, most new Medicare beneficiaries today focus on just a few options.

Plan G

Plan G has become one of the most popular Medicare Supplement plans available.

It covers nearly all Medicare-approved out-of-pocket costs except the annual Medicare Part B deductible.

Once you’ve met the Part B deductible for the year, Plan G typically pays the remaining Medicare-approved costs.

Plan N

Plan N has also become increasingly popular because it generally offers lower monthly premiums than Plan G.

In exchange, you may pay:

A small copayment for certain doctor visits
A small copayment for emergency room visits (if not admitted)
Potential Part B excess charges in states where they’re allowed

For many healthy Medicare beneficiaries, Plan N offers an excellent balance between monthly premium and out-of-pocket costs.

Other Plans

Depending on your eligibility and enrollment date, you may also hear about:

Plan A
Plan B
Plan D
Plan K
Plan L
Plan M

Some people who became eligible for Medicare before January 1, 2020, may still have or qualify for Plan F.

How Much Does Medigap Cost?

There isn’t one price for every Medigap policy.

Your premium depends on several factors, including:

Your age
Your ZIP code
Gender (in some states)
Tobacco use
Household discounts
Insurance company
The plan you choose

For example, Plan G typically costs more than Plan N because it provides more comprehensive coverage.

Since benefits are standardized, comparing prices among insurance companies can potentially save hundreds of dollars each year.

Can You Switch Medigap Companies Later?

Yes.

Many people change Medicare Supplement companies after several years if another insurer offers comparable coverage at a lower premium.

However, in most states—including Pennsylvania—you’ll generally have to answer health questions if you’re applying outside of a guaranteed issue period.

Approval depends on your health at the time you apply.

Because of this, it’s important to choose your initial company carefully and review your options periodically as rates change.

Does Medigap Cover You Anywhere in the United States?

One of the biggest advantages of Medigap is nationwide access.

As long as a doctor or hospital accepts Medicare patients, your Medigap coverage generally travels with you anywhere in the United States.

This makes Medicare Supplement plans especially attractive for:

Snowbirds
RV travelers
Frequent travelers
People with children living in other states
Anyone who wants flexibility when choosing healthcare providers

Some Medigap plans also include limited emergency medical coverage while traveling outside the United States.

Pennsylvania Residents Have an Advantage

If you live in Pennsylvania, there’s an important benefit many people don’t realize.

Pennsylvania law prohibits Medicare providers from billing Part B excess charges.

That means Pennsylvania Medicare beneficiaries don’t have to worry about one of the differences between Plan G and Plan N that exists in many other states.

This is one reason why Plan N has become especially popular among many Pennsylvania residents looking to lower their monthly premiums while maintaining excellent coverage.

Is Medigap Right for You?

Medigap may be a good fit if you:

Want predictable healthcare costs
Travel throughout the United States
Prefer seeing any Medicare provider without worrying about networks
Want fewer surprise medical bills
Value flexibility when choosing doctors and hospitals

On the other hand, if your priorities are keeping monthly premiums as low as possible and you’re comfortable using provider networks, a Medicare Advantage plan may be worth considering.

The best choice depends on your individual needs, healthcare usage, and budget—not just the monthly premium.

Frequently Asked Questions

What is Medigap insurance?

Medigap is another name for Medicare Supplement insurance. It helps pay many of the out-of-pocket costs left after Original Medicare pays its share of approved medical expenses.

Is Medigap the same as Medicare Supplement insurance?

Yes. The terms “Medigap” and “Medicare Supplement insurance” mean the same thing.

Do I need Medicare Part D if I have Medigap?

Yes, if you want prescription drug coverage. Medigap plans sold today do not include prescription drug benefits, so you’ll generally need to enroll in a separate Medicare Part D plan.

Can I have both Medigap and Medicare Advantage?

No. You cannot use a Medigap plan and a Medicare Advantage plan at the same time.

Can insurance companies charge different prices for the same Medigap plan?

Yes. While the medical benefits of standardized plans are identical, insurance companies can charge different premiums and offer different household discounts or value-added programs.

Can I be denied a Medigap plan?

If you’re applying during your Medigap Open Enrollment Period or have a guaranteed issue right, you generally cannot be denied coverage because of your health.

Outside those situations, many insurance companies require medical underwriting, and your application may be approved or declined based on your health history.

Does Medigap cover dental and vision care?

No. Medigap plans generally do not cover routine dental care, vision exams, hearing aids, or long-term custodial care.

Can I use my Medigap plan in another state?

Yes. One of the biggest advantages of Medigap is that it generally works anywhere in the United States where the provider accepts Medicare.

Schedule Your Medicare Consultation Today

Medicare can be confusing, but getting answers shouldn’t be.

Whether you’re enrolling for the first time, reviewing your current coverage, considering a plan change, or simply looking for a second opinion, I’m happy to help you understand your options and answer your questions.

I’ve been helping Medicare beneficiaries since 1985, and I’ve built my practice on straightforward advice, long-term relationships, and treating people the way I’d want my own family treated.

If you’d like to discuss your Medicare options, call or text The DeAngelis Agency at 215-967-8828.

Click here to ask a question.

There’s no pressure and no obligation—just honest guidance to help you make a confident decision.

What Is Medigap? A Complete Guide to Medicare Supplement Insurance