Dorothy Chen
Your kitchen table looks like a war zone. Stacks of mailers from insurance companies, each one swearing their Plan G is the gold standard, another insisting Plan N will save you a fortune, a third that doesn’t even bother explaining what the letters mean. You’re 64, retirement is three months away, and you have no idea what any of this means.
If that’s you right now, you’re in the right place. Let’s sort it out.
What Medicare Supplement Insurance Actually Is (And Why You Need It)
Original Medicare (Part A for hospital stuff, Part B for doctors and outpatient care) is solid insurance. But it was never built to cover everything. After Medicare pays its share, you’re stuck with coinsurance, copayments, and deductibles that pile up fast. A single hospital stay can trigger a Part A deductible of over $1,600 (2024 numbers). Stay longer than 60 days and you’re paying daily coinsurance on top of that.
Medicare Supplement insurance, also called Medigap, is where a private insurer steps in to cover some or all of those leftover costs. You pay a monthly premium. In return, they fill in the “gaps” Original Medicare leaves behind. That’s literally where the name comes from.
Here’s where people get confused: Medigap is not Medicare Advantage. Medicare Advantage replaces Original Medicare entirely with a private plan, usually an HMO or PPO with network restrictions. Medigap works alongside Original Medicare. You keep your Medicare card. You use it everywhere. Then your Medigap policy covers what’s left. Totally different things.
I’ve watched clients spend months comparing Advantage plans and Medigap plans at the same time, thinking they were the same product. Get that distinction clear first.
How Medigap Plans Are Standardized (This Is Actually Good News)
In most states, all Medigap plans with the same letter offer identical benefits, no matter who sells them. Plan G from Company A covers exactly what Plan G from Company B covers. The federal government standardizes them.
That changes everything about how you should shop. You’re not really comparing insurance companies on coverage when you’re looking at the same letter plan. You’re comparing price, financial stability, and how they treat you as a customer. Much simpler.
The standardized plans you’ll see most are A, B, D, G, K, L, M, and N. Plans C and F are gone for new enrollees (anyone turning 65 after January 1, 2020). Congress phased them out because they covered the Part B deductible (currently $240), and policymakers wanted to discourage first-dollar coverage.
Three states run their own systems instead: Massachusetts, Minnesota, and Wisconsin. If you’re in one of those, your state insurance department is your best resource.
The Plans Worth Comparing Most Closely: G, N, and K/L
Best Medicare Supplement Plans - What’s Changed for 2026 · Medicare Specialist - Abt Insurance Agency on YouTube
| Plan | Part A Deductible | Part B Coinsurance | Part B Excess Charges | ER Copayment | Monthly Premium |
|---|---|---|---|---|---|
| Plan G | Covered | Covered | Covered | Not applicable | Higher |
| Plan N | Not covered | Covered | Not covered | Up to $50 | Lower |
| Plan K | 50% of costs | 50% of costs | Not covered | Not applicable | Lowest |
| Plan L | 75% of costs | 75% of costs | Not covered | Not applicable | Low |
| High-Deductible Plan G | Covered (after ~$2,800 deductible) | Covered | Covered | Not applicable | Much lower |
Most people shopping for Medigap narrow it down to two or three plans quickly. Here’s what actually matters.
Plan G is the most comprehensive option available to new Medicare enrollees. It covers your Part A deductible, Part A coinsurance and hospital costs, Part B coinsurance or copayments, Part B excess charges (hang on, I’ll explain), skilled nursing facility coinsurance, and foreign travel emergency care (up to limits). The only thing it doesn’t cover is the Part B deductible, which you pay once yearly. After that, Plan G essentially picks up all your cost-sharing for the rest of the year. That predictability matters if you want a budget you can stick to or if you’re dealing with ongoing health issues.
Plan N covers almost everything Plan G does, with two catches. You’ll pay copayments up to $20 for some doctor visits and up to $50 for emergency room visits that don’t lead to admission. It also doesn’t cover Part B excess charges, which are the extra amounts doctors who don’t accept Medicare assignment can charge (up to 15% above the Medicare-approved amount). Live in New York, Ohio, Connecticut, or Massachusetts? This doesn’t matter. Excess charges are illegal there. Everywhere else, just make sure your doctors accept Medicare assignment. Most do. Problem solved.
The payoff: Plan N usually costs less per month than Plan G. Sometimes significantly less. Whether you actually save money depends on how often you visit doctors and whether excess charges are actually a realistic concern for you.
Plans K and L work differently. They cover a percentage of your gaps instead of all of them, and they have out-of-pocket maximums. Plan K covers 50% of most cost-sharing. Plan L covers 75%. These work well for relatively healthy people who want catastrophic protection without paying for comprehensive coverage. Once you hit the annual out-of-pocket limit, the plan covers 100% for the rest of the year. These limits change annually, so check Medicare.gov for current numbers before deciding.
High-Deductible Plan G deserves a mention if you’re budget-conscious. It’s exactly like Plan G except it doesn’t kick in until you’ve paid a high deductible out of pocket (about $2,800 in 2024). After that threshold, it covers everything standard Plan G does. Monthly premiums are much lower. For healthy people with savings, this can be genuinely appealing.
How to Compare Plans Side by Side: A Practical Process
Shopping Medigap doesn’t have to be a guessing game. Here’s what actually works.
Step 1: Decide which plan letter fits your life. Check the benefit summaries at Medicare.gov. Think about your health right now, how often you see doctors, whether you travel internationally, and how important monthly premium predictability is to you.
Step 2: Get quotes for that specific plan from multiple insurers. Because benefits are standardized, you’re comparing premiums for identical coverage. Direct from insurers, through a licensed broker, or through tools on sites like this one.
Step 3: Understand how each insurer prices premiums. This matters and people almost always miss it. There are three methods: community-rated (everyone pays the same regardless of age), issue-age-rated (your premium is based on your age when you buy), and attained-age-rated (your premium rises as you age). Attained-age plans often start cheap but can become the most expensive over time. That $85/month plan at 65 could be $250/month at 80.
Step 4: Check the insurer’s financial strength rating. Look at AM Best or Standard & Poor’s. You need a company that will still exist and be solvent for decades. Companies rated A or better.
Step 5: Confirm your doctors accept Medicare assignment. Call your primary care doctor and any specialists you see regularly. Ask whether they “accept Medicare assignment.” If they do, Part B excess charges don’t matter to your plan choice.
Step 6: Apply during your Open Enrollment Period. Your Medigap Open Enrollment Period is six months starting the month you turn 65 or older and enroll in Part B. During this window, insurers can’t deny you coverage or charge more based on pre-existing conditions. Miss it and you’ll likely face medical underwriting in most states.
Here’s a quick comparison:
| Feature | Plan G | Plan N | High-Deductible G | Plan K |
|---|---|---|---|---|
| Part A Deductible | Covered | Covered | Covered after deductible | 50% covered |
| Part B Deductible | Not covered | Not covered | Not covered | Not covered |
| Part B Coinsurance | Covered | Copays may apply | Covered after deductible | 50% covered |
| Part B Excess Charges | Covered | Not covered | Covered after deductible | Not covered |
| Foreign Travel Emergency | 80% (limits apply) | 80% (limits apply) | 80% (limits apply) | Not covered |
| Out-of-Pocket Maximum | None | None | High deductible amount | Annual limit applies |
| Typical Premium Level | Higher | Moderate | Lower | Lower |
What People Get Wrong When Comparing Plans
A few mistakes happen over and over.
Focusing only on the monthly premium. A lower premium looks great until you actually get sick and realize the plan has higher cost-sharing. Do the math on your own health situation, not some generic scenario someone else created.
Ignoring the pricing method. Attained-age pricing sneaks up on you. Ask directly how each insurer prices their premiums.
Thinking you can switch plans later without consequences. In most states, changing Medigap plans after Open Enrollment means medical underwriting. A diagnosis you got after 65 could make you uninsurable or triple your premium. Getting it right the first time actually matters.
Not checking state-specific rules. Some states have additional protections, including guaranteed issue rights beyond federal minimums. Your State Health Insurance Assistance Program (SHIP) offers free, unbiased counseling and knows your state inside and out. Find your local counselor at shiphelp.org. AARP’s Medicare resource center at aarp.org/health/medicare-insurance/ is solid for general education too.
Want more detail before talking to an agent? A good Medicare supplement insurance guide lays out every plan’s benefits clearly (note: this site may earn a commission on that purchase).
Sources & References
- Medicare.gov, What’s Medicare Supplement Insurance (Medigap)?, Explains Medigap basics, standardized plans, and how it differs from Medicare Advantage
- Medicare.gov, Medicare costs at a glance, Official 2024 Part A/B deductibles and coinsurance amounts
- CMS.gov, Choosing a Medigap Policy guide, Federal guide to comparing standardized Medigap plan letters
Photo: Mikhail Nilov 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.
