Original Medicare (Parts A and B) is a little like ordering a burger that comes with the bun and patty… and then discovering
the “optional” toppings include hospital coinsurance, deductibles, and copays that can add up fast. A Medicare Supplement
Insurance policybetter known as Medigapis the side dish that helps cover many of those out-of-pocket “gaps.”
This guide breaks down how Medigap plans work, what the plan letters actually mean, how companies differ (even when the plan
letter is the same), and a practical way to shop without getting lost in alphabet soup.
Medigap in plain English
Medigap is extra insurance sold by private companies that helps pay certain costs that Original Medicare doesn’t fully
coverthings like deductibles, coinsurance, and copayments. You generally must have Medicare Part A and Part B to buy a
Medigap policy, and Medigap works only with Original Medicare (not Medicare Advantage).
Two quick reality checks:
- Medigap isn’t prescription drug coverage. For most people, drug coverage comes from a separate Part D plan.
- Medigap doesn’t add “extra benefits” like dental, vision, or long-term care. It’s mainly about stabilizing your medical cost-sharing under Original Medicare.
The good news: in most states, Medigap plans are standardized. That means a Plan G from Company A must cover the same
medical benefits as a Plan G from Company B. (More on why prices still varybecause yes, of course they do.)
Medigap plan letters: what they actually mean
In most of the U.S., Medigap plans are labeled A through N (not every letter is used today, and not every plan is sold everywhere).
The letter tells you the benefit package. The company you choose determines the price, underwriting rules (when allowed),
customer service, and how premiums may change over time.
Standardization (the part that saves your sanity)
Standardization means if two policies have the same letter, they cover the same basic benefitsno matter the company selling them.
So if someone says, “My Plan G is better because it’s from a famous brand,” what they usually mean is:
“I like their price, billing, and customer service.” The medical benefits are the same.
Important exception: Massachusetts, Minnesota, and Wisconsin standardize Medigap differently. If you live in one of those states,
you’ll want to look at your state’s specific plan structure before comparing apples to apples.
Plan F isn’t “gone,” but it is “closed” for many new enrollees
If you became newly eligible for Medicare on or after January 1, 2020, you generally can’t buy Medigap plans that pay the Part B deductible,
which includes Plan C and Plan F (and, where offered, high-deductible Plan F). If you were eligible before that date, you may still be able
to buy them (availability depends on your state and insurers).
The “most-talked-about” Medigap plans (and why)
There isn’t a single “best” Medigap plan for everyone. But there are a few repeat stars because they balance coverage and premiums well.
Here’s how people typically think about them.
Plan G: the “set-it-and-forget-it” favorite
Plan G is popular because it’s comprehensive and predictable. In general terms, once you handle your Medicare Part B deductible,
Plan G can make the rest of your Medicare-covered costs feel much less surprising. It also covers Part B excess charges (where applicable),
which matters if you see providers who don’t always accept Medicare assignment.
Plan N: the “lower premium, I can handle a few copays” option
Plan N usually comes with a lower premium than Plan G, but you may pay some copays for certain office visits or ER visits.
It’s often appealing for people who are generally healthy, want protection from big costs, and don’t mind small cost-sharing.
Plans K and L: “budget-friendly with a built-in ceiling”
Plans K and L typically cover a smaller percentage of many costs than Plan G, but they include an annual out-of-pocket limit.
Once you hit that limit (plus your Part B deductible), the plan pays 100% of covered services for the rest of the year. This structure can
feel reassuring if you like the idea of a maximum “worst-case” number.
High-deductible Plan G: “catastrophe coverage, but you carry the early costs”
In some areas, you may see a high-deductible version of Plan G. Premiums are typically lower, but you pay for covered costs up to a deductible
amount before the plan starts paying. It can work well for people who want protection from very large expenses and are comfortable self-funding
routine care.
Medigap vs. Medicare Advantage (quick clarity, big impact)
This confusion causes a lot of “Wait… what?” moments. Here’s the simplest way to separate them:
- Medigap works with Original Medicare and helps pay some of Original Medicare’s out-of-pocket costs.
- Medicare Advantage (Part C) is an alternative way to get your Part A and Part B coverage, usually with networks, plan rules, and different cost structures.
You generally can’t use Medigap to pay costs under a Medicare Advantage plan. If you’re switching between Advantage and Original Medicare,
timing matters (we’ll cover that soon).
How Medigap companies differ (even when the plan letter is identical)
Since benefits are standardized, shopping for a Medigap company is less about “Who has the best Plan G?” and more about:
“Who sells Plan G at a competitive price, with a pricing structure I understand, and a track record I can live with?”
1) Premium price (today) and premium increases (tomorrow)
Two companies can sell the same Plan G with dramatically different premiums. And premiums can change annually.
It’s smart to ask about historical rate increases in your statenot because history guarantees the future, but because patterns matter.
2) Pricing method: community-rated vs. issue-age vs. attained-age
Medigap premiums are commonly priced in one of three ways:
- Community-rated: everyone in the area pays the same premium, regardless of age (though premiums can still rise due to inflation and other factors).
- Issue-age-rated: your price is based on your age when you buy the policy; it doesn’t increase just because you get older (but can rise for other reasons).
- Attained-age-rated: premiums are based on your current age, so they tend to rise as you age (in addition to other increases).
Your state may limit which pricing methods companies can use, and different insurers may use different methods even in the same state.
This is one of the biggest “quiet drivers” of long-term affordability.
3) Underwriting rules (when allowed) and how strict they are
During certain protected enrollment windows, insurers can’t use medical underwriting. Outside those windows, in many states, they can.
Some companies are more flexible than others, so if you’re applying outside open enrollment, the company choice can matter a lot.
4) Service details that affect real life
- Household discounts (if two people have policies with the same company)
- Autopay discounts
- Easy-to-read billing and smooth claims coordination (yes, boringuntil it isn’t)
- Complaint history and responsiveness
5) Financial strength
Medigap is a long-term purchase for many people. Looking at an insurer’s financial strength ratings can be one way to gauge stability.
(Ratings aren’t a guarantee, but they’re a useful signallike checking the weather before a road trip.)
A practical way to choose a Medigap plan letter
Use this simple framework: Premium vs. predictability.
Step 1: Decide how much surprise you can tolerate
- If you want very few medical bill surprises, you’ll usually lean toward Plan G (or, if eligible, Plan F).
- If you want a lower premium and can handle some copays, Plan N is often the first stop.
- If you want a lower premium and a defined annual ceiling, look at Plan K or L.
- If you want the lowest premium and you’re comfortable paying more upfront in a bad year, consider high-deductible Plan G (where available).
Step 2: Think about “excess charges” if you travel or see certain providers
Some providers may charge more than the Medicare-approved amount (these are called Part B excess charges). Not all Medigap plans cover them.
If you live in or travel to areas where this comes up, that may push you toward plans that include that protection.
Step 3: Remember what Medigap doesn’t cover
Even the most comprehensive Medigap plan doesn’t replace a Part D drug plan, and it won’t cover routine dental/vision/hearing or long-term care.
Plan your coverage as a “stack”: Original Medicare + Medigap + Part D (and any other coverage you choose).
When to buy: the 6-month Medigap Open Enrollment Period
Timing is the difference between “Pick any plan you like” and “Please answer 37 health questions while we dramatically zoom in on your medical history.”
Your best window (for most people)
Under federal rules, you get a one-time, 6-month Medigap Open Enrollment Period that starts when you’re 65 or older and enrolled in Medicare Part B.
During this period, you can generally buy any Medigap policy sold in your state without medical underwriting.
Guaranteed issue rights: a safety net in specific situations
Outside open enrollment, you may still have “guaranteed issue” rights in certain situations (for example, if you lose certain kinds of coverage, or in some
transitions involving Medicare Advantage). These rights are specific, time-limited, and paperwork-sensitive. If you think you qualify, act quickly and keep copies
of everything.
Trial rights and Medicare SELECT “change your mind” rules
There are a couple of situations where Medicare gives you a “try it and switch back” option. For example, if you drop a Medigap policy to join a Medicare Advantage plan
for the first time, you may have a limited trial period to return to Medigap. Also, in some states, Medicare SELECT (a network-based type of Medigap policy)
gives you the right to switch to a standard Medigap policy within a certain timeframe after enrolling.
Translation: don’t assume you can switch Medigap plans whenever you want. In many cases, you can’tat least not without underwritingunless you’re in a protected situation.
How to compare Medigap companies (without losing a weekend)
Since the plan letter controls the benefits, shopping is mostly a structured comparison exercise. Here’s a checklist that keeps you focused.
Medigap shopping checklist
- Start with the plan letter (G vs N vs K/L vs high-deductible G), based on your budget and risk tolerance.
- Confirm availability in your ZIP code and compare premiums for the same plan letter.
- Ask how the policy is priced (community/issue-age/attained-age), and whether your state restricts rating methods.
- Ask about discounts (household, autopay, non-tobacco, etc.).
- Ask about rate increase history in your state for that plan letter.
- Check complaint information through your state insurance department or national resources that compile complaint data.
- Look at financial strength ratings from independent rating organizations.
- Never cancel your current policy until your new coverage is approved (if underwriting applies, this is non-negotiable).
What “best Medigap company” really means
You’ll see plenty of lists naming big insurersUnitedHealthcare (often branded with AARP for some members), Mutual of Omaha, Blue Cross Blue Shield affiliates,
Cigna, Humana, Aetna, and others. These names can be useful starting points, but the best company for you is the one that:
- Sells the plan letter you want in your area
- Offers a competitive premium for your age, tobacco status, and household situation
- Uses a pricing method you’re comfortable with long-term
- Has a complaint/service track record you trust
- Has solid financial strength indicators
In other words: the “best” company is local and personal. The plan letter is standardized; your premium and experience are not.
Three examples that make plan choice feel less abstract
Example 1: “I want predictable costs more than the lowest premium.”
Pat sees multiple specialists and expects regular labs and follow-ups. Pat dislikes surprise bills more than Pat dislikes paying a higher premium.
A plan like Plan G often fits this style because it reduces many cost-sharing surprises after the Part B deductible.
Example 2: “I’m healthy, I want value, and I don’t mind a few copays.”
Sam mostly does annual visits and occasional urgent care. Sam wants strong protection from expensive events but prefers a lower premium.
Plan N is commonly attractive here: lower premium in exchange for some predictable copays when care is used.
Example 3: “I’m budget-conscious, but I want a clear worst-case cap.”
Jordan wants the comfort of an annual maximum out-of-pocket amount and is okay paying a share of costs along the way.
Plan K or L can be worth a look because they combine lower premiums with an annual out-of-pocket limit.
Free, unbiased help: use SHIP before you sign anything
If you want help comparing options without a sales pitch, the State Health Insurance Assistance Program (SHIP) offers free, local, one-on-one Medicare counseling.
SHIP counselors can help you understand enrollment windows, compare Medigap and Part D options, and spot marketing that sounds too good to be true.
Conclusion: the smartest Medigap strategy is boringand that’s a compliment
A strong Medigap decision usually looks like this:
- Pick a plan letter that matches your budget and “surprise tolerance.”
- Shop multiple companies selling that same letter plan in your ZIP code.
- Compare pricing method, discounts, complaint history, and financial strengthnot just today’s premium.
- Time your purchase around your Medigap Open Enrollment Period if you can.
- Ask for help from SHIP if you’re unsure or switching coverage types.
Medigap is one of those purchases where the goal isn’t excitementit’s sleep. The best outcome is the quiet confidence that
a surprise hospital stay won’t become a surprise financial crisis. Boring? Absolutely. Beautiful? Also yes.
Experiences: what shopping for Medigap often feels like (500-word reality check)
If you’ve ever tried to buy a mattress online, you already understand the emotional arc of shopping for Medigap:
confident at 9:00 a.m., suspicious by lunch, and deeply committed to the idea that someone invented jargon just to watch you squint.
The good news is that most people’s “Medigap journey” follows a few predictable beatsand knowing them can keep you calm.
First comes the alphabet anxiety. People often start by assuming the plan letter is a brandlike Plan G is a “premium” plan
and Plan N is the “budget” plan everywhere. Then they discover the truth: the letter is a standardized benefit package, and the company name
is mostly about price, pricing method, and service. That realization is oddly freeing. It turns the process from “Which company has the best plan?”
into “Which company sells the plan I want on terms I can live with?” Suddenly, the shopping list becomes shorterand your blood pressure follows.
Then comes sticker shock… followed by perspective. It’s common to see a premium and think, “Wait, that’s every month?”
But many shoppers quickly reframe it: the premium is the price you pay to reduce the risk of large, unpredictable bills. People who’ve been hit
by an unexpected outpatient procedure or frequent specialist visits often say the predictability is the real product they’re buying.
On the flip side, healthier shoppers often enjoy the feeling of “I’m protected, but I’m not overpaying,” which is why Plan N and high-deductible
options stay popular conversation starters.
The third experience is timing pressure. Many people only learn about the 6-month Medigap Open Enrollment Period after they’ve already
enrolled in Part B, and that can create a frantic “Did I miss my window?” moment. When someone buys during open enrollment, the process often feels
surprisingly smooth: fewer medical questions, fewer obstacles, more choice. When someone applies later, underwriting can make it feel like the insurance
company is reading their medical chart with a magnifying glass and a detective’s hat. Either way, the takeaway people share is consistent:
timing is not a minor detailit’s a major feature.
Another common moment is the “Plan G vs. Plan N” debate with a real-life twist. Shoppers will run numbers, compare premiums,
and then realize the choice isn’t purely math. It’s personality. Some people hate copays the way others hate small talk. They’ll happily pay a higher premium
to avoid point-of-service costs. Others don’t mind a small copay because it makes the premium feel “earned” and keeps monthly costs down. When people choose
a plan that matches their personality, they tend to be happier with it long-termeven if they could have saved a few dollars with a different letter.
Finally, many shoppers describe the relief of getting an outside set of eyes. A quick conversation with a SHIP counselor, a careful read of
the official plan comparison chart, or a simple checklist can turn confusion into clarity. The experience people seem to like best is the one where they
stop chasing the mythical “perfect” plan and instead choose a plan letter and company they understand. In Medigap shopping, understanding is underrated
and it’s the closest thing you’ll get to a superpower.