Similar to Medicare Advantage, Medicare Supplement Insurance helps to offset the costs of Original Medicare.**
How does Medigap help to cover costs? Let’s say you’re admitted as an inpatient to an acute care hospital. You have Original Medicare. Medicare will send you a bill for $1,736.00. This pays your hospitalization for a 60 day benefit period. While Part A is premium free for most people, this is your Part A deductible. For outpatient services (Part B), Medicare pays 80%. Your share is 20%. For physician visits, 20% is typically manageable. For emergency room visits, ambulance transport, radiological tests, and surgery at an outpatient hospital, 20% is expensive.
Medicare Supplement Insurance closes the ‘cost gap’ by paying your Part A deductible and many, if not all of the costs, associated with Part B. This is why Medicare Supplement Insurance is often called ‘Medigap.’ Depending on the plan, your out of pocket costs for medical services can be as low as zero.
Medigap plans are designated by letter (Plan N, Plan G, Plan K and so on). Medical benefits are the same from one state to another. What changes is your monthly premium. Medigap plans are the same across insurance companies. Plan N with ‘ABC Insurance’ is the same plan with ‘XYZ Insurance.’ Insurance companies compete for your business based on monthly premiums, customer service, and any value-added benefits they may offer. An example of a value added benefit is a vision discount plan.
Medicare Supplement Insurance is essentially a passport for routine, emergency and comprehensive care across the United States and its territories. You can see any doctor or go to any facility that accepts Medicare. No provider networks. No specialist referrals needed from a primary care doctor.
What are the tradeoffs? Monthly premiums can be expensive. You will need to enroll in a separate prescription plan. Medigap plans do not include the extra benefits (dental, vision, hearing) that are typically baked into Medicare Advantage plans. Eligibility for a Medicare Supplement plan typically requires medical underwriting.
Is it possible to purchase Medicare Supplement Insurance without medical underwriting? You have a six-month open enrollment period that begins the month you are 65 and/or enrolled in Medicare Part B. Insurance companies must sell you a policy at the best available rate regardless of your health status. You cannot be denied coverage. Other select situations may allow you to enroll in Medicare Supplement Insurance without medical underwriting.
Do I still have to pay my Part B premium? Yes.
Can I have a Medigap plan and Medicare Advantage plan at the same time? No. It is illegal to have both at the same time.
When should I consider purchasing a Medigap plan? If you anticipate needing routine care anywhere in the country. If you want to see any doctor, or go to any facility, that accepts Medicare. No provider networks. If access to medical care, no questions asked, is more important than the cost of the plan.
*This site is not affiliated with or endorsed by any government agency.
**Original Medicare is the public portion of the Medicare health system. It’s comprised of Parts A and B, found on your (red, white and blue) Medicare identification card. To find out what Parts A and B include, please read ‘Medicare’ under the Services tab, and my blog, ‘Medicare Costs for 2026.’
If you want to learn more about Medicare Supplement Insurance, including guaranteed issue rights, call 725-227-6795, email ken@deserthealthandlife.com, or fill out a contact form on this website.
