Medigap and Medicare Supplement Are the Same Insurance
Medigap and Medicare Supplement are two names for the exact same type of insurance. There is no difference between them. Insurance companies, Medicare, and doctors all use both terms interchangeably, so you may see either one on paperwork, websites, or when talking to an agent.
Medigap exists because Original Medicare (Part A and Part B) does not cover everything. It leaves you responsible for deductibles, copayments, and coinsurance. A Medigap policy is private insurance you buy to cover those out-of-pocket costs. It works alongside Original Medicare, not instead of it.
If you have seen the terms used differently, it was likely a mistake or unclear wording. When shopping for this type of insurance, you can search for "Medigap" or "Medicare Supplement" and you will find the same plans and the same insurers.
Key Takeaways
- Medigap and Medicare Supplement are identical terms for the same private insurance product that covers gaps in Original Medicare.
- You must be enrolled in Medicare Part A and Part B before you can buy a Medigap policy.
- Medigap plans are standardized by the federal government, so Plan G from one insurer covers the same things as Plan G from another insurer.
- You pay a monthly premium to a private insurance company for Medigap, separate from your Medicare premium.
How Medigap Fills the Gaps in Original Medicare
Original Medicare pays its share of approved medical costs, but you still owe the rest. For example, Medicare Part B has a yearly deductible you must pay before it covers anything. After that, you typically pay 20 percent of the cost of doctor visits, lab work, and outpatient procedures. Hospital stays under Part A require you to pay a deductible and daily copayments after a certain number of days.
A Medigap policy covers some or all of these out-of-pocket amounts, depending on which plan you choose. Plan G, for instance, covers the Part B deductible, the Part A deductible, copayments for hospital stays, and coinsurance for doctor visits. Plan N covers most of the same things but leaves you responsible for small copayments at the doctor's office.
The federal government sets what each Medigap plan must cover. This means a Plan G sold by Aetna covers exactly the same benefits as a Plan G sold by United Healthcare. The only difference between insurers is the monthly premium you pay and the customer service they provide.
Medigap Is Different From Medicare Advantage
Medigap is often confused with Medicare Advantage (Part C), but they are completely different products. Medicare Advantage is an alternative to Original Medicare. You enroll in it instead of Part A and Part B, and it is run by a private insurance company under contract with Medicare.
Medigap, by contrast, works with Original Medicare. You keep your Part A and Part B coverage and add a Medigap policy on top. With Medigap, you can see any doctor or hospital that accepts Medicare. With Medicare Advantage, you usually must use doctors and hospitals in the plan's network, and you may need referrals.
If you have Medicare Advantage, you cannot buy Medigap at the same time. If you have Medigap, you do not need Medicare Advantage. The two are mutually exclusive.
When You Can Buy Medigap and What It Costs
You can buy a Medigap policy at any time after you enroll in Medicare Part A and Part B. However, the best time to buy is during your Medigap Open Enrollment Period, which lasts six months starting the first day of the month you turn 65 and are enrolled in Part B. During this window, insurers cannot deny you coverage or charge you more based on your health history.
If you buy Medigap outside this window, insurers may ask health questions and can charge higher premiums if you have pre-existing conditions. Some states have additional protections, but they vary. The cost of a Medigap policy depends on the plan you choose, the insurer, your age, your location, and whether you are a man or woman. Premiums typically range from under $100 per month for younger enrollees to $300 or more per month for people in their 80s, but these amounts vary widely by state and insurer.
The Ten Standardized Medigap Plans
Insurance companies can only sell ten different Medigap plans, labeled A through N (with G and F having different versions). Each plan covers a different combination of the gaps in Original Medicare. You choose which plan fits your needs and budget.
Plan A is the most basic and least expensive. It covers the Part A deductible, Part A copayments, and Part B coinsurance, but not the Part B deductible. Plan G is one of the most popular because it covers nearly everything except the Part B deductible. Plan N is less expensive than Plan G but requires you to pay small copayments at the doctor's office and for emergency room visits.
You can compare all ten plans side by side on Medicare.gov, which shows exactly what each one covers. Your doctor's office cannot tell you which plan to buy—that is your choice based on your budget and how much out-of-pocket cost you want to handle yourself.
How to Find and Compare Medigap Policies
Medicare.gov has a tool called the Medigap Plan Finder where you enter your state and birth date, and it shows you all the insurers selling Medigap in your area, the plans they offer, and their monthly premiums. This tool is free and does not require you to enter personal information like your Social Security number.
You can also contact insurers directly or work with an insurance agent who sells Medigap policies. Agents do not charge you a fee—they are paid by the insurance company—but make sure any agent you work with is licensed in your state. Some agents specialize in Medicare and can walk you through the differences between plans.
When comparing policies, look at the monthly premium, what the plan covers, and whether the insurer has good customer service ratings. You can read reviews on the National Association of Insurance Commissioners (NAIC) website or ask your State Health Insurance information Program (SHIP) for guidance. SHIP is a free counseling service in every state that helps seniors understand Medicare and Medigap options.
What to Ask Your Doctor and When to Seek Help
Before you buy a Medigap policy, ask your primary care doctor or their billing staff which plans are most common among their patients and whether they have seen problems with any particular insurer's claims processing. This is not medical information—it is practical information about how smoothly your care will be paid for.
If you are unsure whether Medigap is right for you or whether you should choose Medicare Advantage instead, contact your State Health Insurance information Program. They can review your situation for free and explain the trade-offs. You can find your state's SHIP by calling 1-800-MEDICARE or visiting Medicare.gov.
If you already have Medigap and your insurer denies a claim you believe should be covered, ask the insurer in writing why the claim was denied. If you disagree with their answer, you can file a complaint with your state's insurance commissioner's office.
Frequently Asked Questions
Can I switch from one Medigap plan to another?
Yes, you can switch to a different Medigap plan or a different insurer at any time. However, if you switch outside your Medigap Open Enrollment Period, the new insurer may ask health questions and charge you more based on your medical history. Some states allow you to switch without health questions under certain circumstances, so check with your state insurance commissioner's office.
Do I need Medigap if I have Medicare Advantage?
No. Medicare Advantage and Medigap serve different purposes. Medicare Advantage replaces Original Medicare, while Medigap supplements it. You cannot have both at the same time. If you have Medicare Advantage and want to switch to Original Medicare with Medigap, you can do so during the Annual Enrollment Period, which runs from October 15 to December 7 each year.
What happens to my Medigap if I move to a different state?
Your Medigap policy may not be available in your new state, or the premium may be different. Contact your insurer before you move to find out whether they operate in your new state. If they do not, you will need to buy a new Medigap policy from an insurer in that state. You may have limited protections against health-based denials or higher premiums depending on your state's rules.
Is Medigap the same as Medicaid?
No. Medigap is private insurance for people on Medicare. Medicaid is a separate government program for people with low income. Some people may have access to for both, but they are different programs with different rules. If you think you might may have access to for Medicaid, contact your state's Medicaid office or call 1-800-MEDICARE for a referral.