Frank Thompson
You just turned 65, enrolled in Original Medicare, and your first Explanation of Benefits shows a 20% coinsurance charge plus a $1,676 hospital deductible for 2025. One serious illness or two surgeries in a year and you’re looking at thousands in out-of-pocket costs. That gap is exactly why Medigap exists. Pick the right plan in 2026 and you could save thousands, or sleep better at night knowing you’re covered.
What Medigap Actually Is (and What It Isn’t)
Medigap, also called Medicare Supplement Insurance, is private insurance that fills the holes in Original Medicare. It doesn’t replace Medicare. It works alongside it. When Medicare pays its portion, your Medigap policy covers some or all of what’s left, depending on which plan you chose.
There are 10 standardized Medigap plans, labeled A through N (C and F aren’t available to anyone who became Medicare-eligible after January 1, 2020). Because the federal government standardizes these plans, a Plan G from Blue Cross covers the exact same benefits as a Plan G from Aetna or Cigna. The only real difference is the premium and customer service quality.
What Medigap does NOT cover: prescription drugs (that’s Part D), dental, vision, hearing, or long-term care. I’ve talked with seniors who thought their Medigap card would cover everything, and the confusion around dental alone causes genuine frustration. Know the boundaries before you commit.
The Top Medigap Plans for 2026 and Who They’re Best For
| Medigap Plan | Hospital Deductible | Part B Coinsurance | Office Visit Copay | ER Copay | Part B Excess Charges | Monthly Premium (Relative) |
|---|---|---|---|---|---|---|
| Plan G | Covered | Covered | None | None | Covered | Higher |
| Plan N | Covered | Covered | Up to $20 | Up to $50 | Not covered | Lower |
| High-Deductible Plan G | Covered (after ~$2,870 deductible) | Covered | None | None | Covered | Lowest |
| Plan K | 50% covered | 50% covered | Not specified | Not specified | Not covered | Low |
| Plan L | 75% covered | 75% covered | Not specified | Not specified | Not covered | Low-Medium |
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Not every plan fits every person.
Plan G: The Gold Standard for New Enrollees
If you’re becoming Medicare-eligible in 2020 or later, Plan G is the most comprehensive option. It covers your Part A hospital deductible, Part A coinsurance and hospital costs for up to 365 days after Medicare benefits end, Part B coinsurance or copayments, the first three pints of blood, Part A hospice care coinsurance, skilled nursing facility coinsurance, and 80% of foreign travel emergency costs (up to limits).
The only thing Plan G doesn’t cover is the Part B deductible, which is $257 in 2025. You pay that yourself at the start of each year, then you’re covered for Medicare-approved services. If you see specialists regularly or expect surgery, that tradeoff almost always makes sense.
Plan N: A Smart Choice for the Relatively Healthy
Plan N covers what Plan G does except it adds copayments of up to $20 for office visits and up to $50 for emergency room visits that don’t result in admission. It also won’t cover Part B excess charges (the amount some doctors bill above Medicare’s approved rate).
The benefit is a noticeably lower monthly premium. In my experience, Plan N works well for people who are generally healthy, don’t see doctors constantly, and can handle small copays. If you live in Massachusetts, New York, or another state that restricts or bans excess charges, the gap between G and N shrinks, and N becomes even more attractive.
High-Deductible Plan G: For Budget-Conscious Seniors
This is Plan G’s lower-premium cousin. You get the same coverage, but you pay a deductible (around $2,870 in 2025, adjusted annually) before the plan kicks in. After you hit that deductible, coverage works like standard Plan G.
This works for people who are healthy, have some savings for an unexpected medical bill, and want to keep monthly premiums down. Think of it as a high-deductible health plan for your retirement.
Plan K and Plan L: Partial Coverage at Lower Premiums
Plans K and L cover a percentage of benefits rather than 100%. Plan K covers 50% of most cost-sharing; Plan L covers 75%. Both have out-of-pocket maximums, which matters. They’re less popular but can work for people on tight budgets who still want catastrophic protection.
How Premiums Are Calculated (This Part Really Matters)
Two people with identical Plan G policies can pay completely different premiums, and it comes down to how the insurance company prices things. Three rating methods matter here.
Community-rated: Everyone in your geographic area pays the same premium regardless of age. It can still increase over time, just not because you’re aging.
Issue-age-rated: Your premium is based on your age when you buy the policy. It won’t climb as you age, though inflation can push it up.
Attained-age-rated: Your premium reflects your current age, so it rises as you get older. This offers the lowest premiums at 65 but the highest by your 80s.
This is one of the most important decisions most people never think to ask about. I’ve seen clients pick an attained-age plan because it seemed cheap at 65, then struggle with premiums a decade later. Ask every insurer directly: “How do you rate your premiums?”
When and How to Enroll (Timing Is Everything)
Your Medigap Open Enrollment Period starts the first month you’re both 65 or older AND enrolled in Medicare Part B. It lasts exactly six months. During this window, insurers can’t deny you coverage or charge you more because of pre-existing conditions. This is the most protected moment to buy a Medigap policy.
Miss this window and most insurers will use medical underwriting, which means they can turn you down or charge higher premiums based on your health history. Some exceptions exist, called Guaranteed Issue rights, that protect you in specific situations like losing employer coverage.
Here’s a practical checklist:
- Confirm your Part B start date. Your six-month window begins that month. Write it down.
- Decide on a plan type. Use the comparison above and your health situation to narrow it to one or two plans.
- Compare premiums from multiple insurers. The standardized benefits are identical, so you’re shopping price and reputation. Medicare.gov has a comparison tool.
- Ask about the rating method. Community-rated, issue-age, or attained-age?
- Check the insurer’s financial stability rating. Look for an A.M. Best rating of A or better.
- Apply before your window closes. Don’t wait until month five.
For free, unbiased one-on-one help, contact your State Health Insurance Assistance Program (SHIP) at shiphelp.org. SHIP counselors are trained volunteers with no financial stake in your choice. They’re genuinely invaluable.
Common Mistakes That Cost Seniors Real Money
Skipping Medigap and relying on Medicare Advantage instead. Medicare Advantage (Part C) is a completely different product, it replaces Original Medicare rather than supplementing it. Some people do well with Advantage plans. But if you want the freedom to see any Medicare-accepting doctor anywhere in the country, Medigap with Original Medicare gives you that. Advantage plans come with networks and prior authorization requirements that Medigap doesn’t.
Waiting too long to enroll. I’ve talked with people who decided to “wait and see how healthy they stay,” then developed diabetes or heart disease before buying. In most states, they then faced medical underwriting, higher premiums, or denial.
Choosing a plan based only on lowest monthly premium. A Plan N with copays might cost less per month, but if you see multiple specialists yearly, Plan G could save you money overall. Run the numbers based on your actual usage.
Not shopping for lower premiums after the first few years. If you’re still healthy, some states let you switch Medigap plans and take advantage of lower premiums. Review your premium every two to three years.
AARP’s Medicare resource center at aarp.org/health/medicare-insurance has updated guides that break down these tradeoffs clearly. Worth bookmarking alongside this.
Medigap Plan Comparison Table: 2026 Quick Reference
| Plan | Part A Deductible | Part B Coinsurance | Part B Deductible | SNF Coinsurance | Foreign Travel (80%) | Excess Charges | Best For |
|---|---|---|---|---|---|---|---|
| Plan G | Yes | Yes | No | Yes | Yes | Yes | Most new enrollees wanting full coverage |
| Plan N | Yes | Yes (with copays) | No | Yes | Yes | No | Healthy seniors wanting lower premiums |
| HD Plan G | Yes (after deductible) | Yes (after deductible) | No | Yes | Yes | Yes | Budget-conscious, healthy seniors |
| Plan K | 50% | 50% | No | 50% | No | No | Very tight budget, some protection needed |
| Plan A | No | Yes | No | No | No | No | Minimal coverage, lowest premium |
Note: Plan F and Plan C cover the Part B deductible but are only available to those eligible for Medicare before January 1, 2020.
The right Medigap plan depends on your health, budget, doctor relationships, and how much financial uncertainty you can tolerate. After two decades of helping seniors with these decisions, I can tell you this: taking time to understand your options before your enrollment window opens is one of the most valuable things you can do for your financial and physical wellbeing. A little homework now saves a lot of stress later.
Sources & References
- Medicare.gov, What’s Medicare Supplement Insurance (Medigap)?, Official overview of Medigap plans, standardization, and coverage
- Medicare.gov, Medicare costs at a glance, Confirms Part A deductibles and coinsurance amounts
- CMS.gov, Choosing a Medigap Policy guide, Official CMS guide detailing all 10 standardized plan letters
Photo: RDNE Stock project via Pexels
This article is for informational purposes only. Medicare rules change annually. Always verify current plan details at Medicare.gov or by calling 1-800-MEDICARE (1-800-633-4227). This site does not sell insurance or recommend specific plans.
Recommended Resources
Disclosure: As an Amazon Associate, we earn a small commission from qualifying purchases at no extra cost to you. We only recommend products that genuinely support the topics covered in this article.
- Medicare For Dummies (~$22), The definitive consumer guide to Medicare, enrollment windows, Part A/B/C/D, and supplement plans.
- Get What’s Yours for Medicare (~$17), Maximize your Medicare benefits and minimize out-of-pocket costs. Covers Part D drug coverage gaps and Medigap in depth.
- Get What’s Yours for Medicare (Original) (~$15), The original bestselling guide to navigating Medicare and Social Security timing, over 100,000 copies sold.
