How Medigap works
Medigap policies are sold by private insurance companies and work alongside Original Medicare (Parts A and B). Medicare pays its share of the Medicare-approved amount for covered health care costs first, then your Medigap policy pays its share. You can see any doctor or hospital in the country that accepts Medicare — there are no networks with standard Medigap policies.
You can't use a Medigap policy to pay costs in a Medicare Advantage plan. And Medigap policies sold today don't include prescription drug coverage — most people pair Medigap with a stand-alone Part D plan.
What gaps are we talking about?
- Part A deductible: $1,736 per benefit period in 2026.
- Part A coinsurance for longer hospital and skilled nursing facility stays.
- Part B deductible: $283 in 2026.
- Part B coinsurance: generally 20% of the Medicare-approved amount, with no yearly cap under Original Medicare.
- Part B excess charges some providers may bill above the Medicare-approved amount.
- Foreign travel emergency care (some plans).
Standardized plans, lettered A to N
In most states Medigap plans are standardized and identified by letters. A Plan G from one company has the same basic benefits as a Plan G from another — what differs is the price, the company's customer service and how it raises premiums over time. (Massachusetts, Minnesota and Wisconsin standardize their plans differently.)
| Benefit | A | B | D | G | K | L | M | N |
|---|---|---|---|---|---|---|---|---|
| Part A coinsurance & hospital costs (365 extra days) | ✔ | ✔ | ✔ | ✔ | ✔ | ✔ | ✔ | ✔ |
| Part B coinsurance or copayment | ✔ | ✔ | ✔ | ✔ | 50% | 75% | ✔ | ✔* |
| Blood (first 3 pints) | ✔ | ✔ | ✔ | ✔ | 50% | 75% | ✔ | ✔ |
| Hospice care coinsurance | ✔ | ✔ | ✔ | ✔ | 50% | 75% | ✔ | ✔ |
| Skilled nursing facility coinsurance | — | — | ✔ | ✔ | 50% | 75% | ✔ | ✔ |
| Part A deductible | — | ✔ | ✔ | ✔ | 50% | 75% | 50% | ✔ |
| Part B deductible | — | — | — | — | — | — | — | — |
| Part B excess charges | — | — | — | ✔ | — | — | — | — |
| Foreign travel emergency (up to plan limits) | — | — | 80% | 80% | — | — | 80% | 80% |
*Plan N pays 100% of Part B coinsurance except for a copayment of up to $20 for some office visits and up to $50 for emergency room visits that don't result in an inpatient admission. Plans K and L have yearly out-of-pocket limits. Plans C and F (which cover the Part B deductible) aren't available to people who became eligible for Medicare on or after January 1, 2020. Source: Medicare.gov "Compare Medigap plan benefits."
Your best time to buy: the Medigap Open Enrollment Period
Your 6-month Medigap Open Enrollment Period starts the first month you're 65 or older and enrolled in Part B. During this window you can buy any Medigap policy sold in your state, generally regardless of your health — companies can't use medical underwriting to deny you or charge you more because of health problems. After it ends, you may not be able to buy the policy you want, or it may cost more, unless you qualify for a guaranteed-issue right.
If you're still working and covered by an employer plan, you may delay Part B — and your Medigap Open Enrollment Period won't begin until you enroll in Part B.
How Medigap premiums are priced
- Community-rated: everyone pays the same premium regardless of age.
- Issue-age-rated: based on your age when you buy; doesn't rise because you get older.
- Attained-age-rated: based on your current age, so premiums rise as you age.
Any type can also rise because of inflation and other factors. Your agent can show you how each company prices its plans in your ZIP code.
Frequently asked
Does Medigap cover prescriptions?
No. Medigap plans sold today don't include drug coverage. You can add a stand-alone Medicare Part D plan.
Does Medigap cover dental, vision or hearing?
Generally no. Medigap plans don't cover routine dental, vision, hearing aids, eyeglasses or long-term custodial care.
Does my spouse get coverage under my policy?
No. Medigap policies cover one person. Spouses must buy separate policies, though some companies offer household discounts.