Medicare Supplement Plans: Your Medigap Guide for 2025

But it doesn’t cover everything. Not by a long shot. And it is not designed to stand on its own. There are significant gaps in Medicare coverage. Even with Medicare, seniors are still potentially exposed to the risk of thousands of dollars in out-of-pocket health care costs.

A recent study from Fidelity Investments found that the average retired couple age 65 may need approximately $315,000 saved (after tax) to cover health care expenses in retirement.

And that’s where Medicare supplement insurance, or “Medigap” comes in: Medigap insurance exists to help Medicare beneficiaries fill in the “gaps” in Medicare coverage: In exchange for a small, affordable, and predictable monthly premium, Medigap plans shield members from large and unexpected or unpredictable out-of-pocket costs for Medicare-approved services.

Medicare Basics

To understand how Medigap works, you should understand the basic parts and structure of Medicare, including what each part covers – and what it doesn’t. 

Original Medicare (Parts A and B)

The term “Original Medicare” refers to the two main “parts” of Medicare that came into being with the passage of Title XVIII of the Social Security Act of 1965. Seniors are normally automatically enrolled in Medicare Part A and B when they first become eligible at age 65. 

Medicare Part B is Medical Services insurance. This optional plan covers physicians’ charges, lab fees, blood, and durable medical equipment like oxygen machines, electric wheelchairs. Some people put off enrolling in Part B because they still receive benefits from a health plan at work.

If you fail to enroll in Part B during your Medicare Initial Enrollment Period (normally a 7-month period surrounding the month in which you turn age 65), and you did not maintain credible coverage in the interim, you may have to pay a lifetime penalty of 10% of the normal Part B premium. 

Newer Medicare Programs

Medicare Part D covers prescription drug charges for Medicare beneficiaries, subject to certain deductibles, coinsurance, and co–pays. These plans are optional. You will not be automatically enrolled in Medicare Part D. You must opt in.

These are the basic segments of Medicare.

Each of them serves an important purpose. But Original Medicare, especially, still leaves seniors exposed to significant expenses in the form of deductibles, co-insurance, co-pays, and limitations on covered hospital stays.

Medicare Part A. As of 2023, Medicare Part A kicks in only after you have covered the $1,600 deductible ($1,556 for 2022). 

In addition, even with Medicare Part A, you will be responsible for paying co-pays for hospital stays as follows (as of 2025).

It’s easy to see how fast your out-of-pocket costs can add up if you have one or two significant hospitalizations or more, or long stays in covered nursing facilities.

And those costs are just the beginning.

Medicare Part B only covers 80% of costs. You are responsible for covering the remaining 20%. With high-cost durable medical equipment and physicians’ fees for expensive or repeated procedures, you may face thousands in additional out-of-pocket costs – unless you take action by covering them under a Medicare supplement plan or Medicare Advantage plan.

There is also a Medicare Part B deductible of $226 as of 2023.

Medicare supplement insurance is an affordable, realistic, and flexible way for seniors to plug those gaps in coverage, smooth out their Medicare spending, and blunt the financial effects of significant and costly medical events, such as hospitalizations and chronic disease treatment.

TIP: The best time, by far, to buy a Medigap policy is during your initial Medigap Enrollment Period, beginning the first day of the month in which you are both age 65 or older and enrolled in Medicare Part B.

See the “When To Buy Medigap” section below.

Compare Medicare Supplement Plans and the Carriers We Offer

Medigap is the secondary insurer, with Medicare as the primary. If you have a Medigap policy, Medicare will pay its share of the Medicare‐approved amounts under Original Medicare (Parts A and B) for covered health care costs.

Medicare doesn’t pay any of the costs of buying a Medigap policy. You are responsible for purchasing and paying for Medigap premiums out of your own pocket.

Medicare SELECT: A Lower-Cost Alternative

In some states, you may be able to buy a special type of Medigap policy called Medicare SELECT. Medicare SELECT plans are hybrids: They may require you to see certain providers for non-emergency care, but also may cost less per month than other Medigap plans.

If you’re on a budget, and you’re not worried about not being able to choose your own doctor, then electing a Medicare SELECT Medigap plan or a zero-premium Medicare Advantage plan may be good options for you, depending on what’s available in your area. 

Standard Medicare Supplement Plans

You can view all the standard Medigap plans as adopted in 47 states plus the District of Columbia here.

Medicare SELECT: A Lower-Cost Alternative

In some states, you may be able to buy a special type of Medigap policy called Medicare SELECT. Medicare SELECT plans are hybrids: They may require you to see certain providers for non-emergency care, but also may cost less per month than other Medigap plans.

If you’re on a budget, and you’re not worried about not being able to choose your own doctor, then electing a Medicare SELECT Medigap plan or a zero-premium Medicare Advantage plan may be good options for you, depending on what’s available in your area. 

Standard Medicare Supplement Plans

You can view all the standard Medigap plans as adopted in 47 states plus the District of Columbia here.

Can I Buy Medigap Plan F, Plan C, Plan E, Plan H, Plan I or Plan J?

Plans E, H, I, and J are no longer sold, but current Medicare beneficiaries who are already enrolled in one of those plans are usually grandfathered in.

Plan F and Plan C are also closed to new Medicare beneficiaries. But you can still buy them if you were eligible for Medicaid on or before January 1st, 2020.

These plans were hugely popular because they essentially covered all out-of-pocket expenses associated with Medicare. However, Congress eventually decided that they were too good a deal, and that people needed to participate in the cost in some way. So they closed those plans for people who were not already Medicare eligible.

If you aren’t eligible for Plan F or Plan C, the next most comprehensive plans are Plans G and N. Medicare Supplement Plan G covers all out-of-pocket costs for Medicare services under Part A and B, except for the Part B deductible of $226, as of 2023. Medicare Supplement Plan N covers everything except the Part B deductible and any physicians’ “excess charges” over and above the Medicare-approved rates, if your state allows excess charges.

Plan N also requires a copayment of up to $20 for some office visits, and up to a $50 copayment for emergency room visits that don’t result in a hospital admission.

If your state does not allow excess charges, then Plan N may be a slightly better deal than Plan G. But if you’re a frequent customer at your local Emergency Department, your co-pays might offset any premium savings from using Plan N rather than Plan G.

Give us a call and we’ll help you assess which of these plans might be the best one for your particular circumstances. 

They have to sell them at the best rate. As long as you buy during your initial enrollment period, the Medigap insurance company cannot charge you any more than they charge another person your age and sex and location with no medical issues.  They can charge more for smokers, however.

If you’re overweight, have diabetes, heart disease, or a history of any kind of medical condition, you should definitely keep an eye on your initial enrollment period.

You can put off your initial enrollment period by delaying enrollment in Part B. This is common for people who still get medical insurance from an employer. But once your initial enrollment period ends and you haven’t already enrolled in Medigap, you will have to go through medical underwriting in the future.

That means that insurance companies can charge a higher premium due to your medical history, or even turn you down outright.

Some companies have stricter underwriting standards than others. Other companies are more willing to enroll people with diabetes, high blood pressure, or other conditions. But premiums for these plans are normally higher.

By buying a Medigap plan during your initial enrollment period, while you are still in good health, and before any new medical conditions can onset, you preserve your choices and you get access to the best risk pools.

Putting off the decision means paying higher Medigap premiums in the future, for life, loss of access to the more selective (and therefore lower-cost) Medigap carriers, and potentially being turned down outright for Medigap insurance. 

Can I Switch Medicare Supplement Plans?

Sometimes people want to switch from one Medicare supplement plan to a different one.

There are several good reasons you might want to do this:

• You need new benefits you didn’t need before, such as foreign travel benefits, and you want to switch to a plan that has them. 
• You’re overpaying for benefits you no longer need. 
• You aren’t happy with your insurance company’s customer service, communication, or claims payments. 
• You find the same plan available for a lower premium. 

In most states, you only have a right to switch from one Medigap policy to another if:

A. you’re within your six-month Medigap Open Enrollment Period, or;

B. you’re eligible for guaranteed issue rights because of specific circumstances. 

Outside of these circumstances, you don’t have an automatic right to be accepted by another Medigap plan provider. To switch outside of these circumstances, you must pass medical underwriting. That means you could be “rated up” (required to pay a higher premium due to your medical history) or turned down altogether.

Medigap plans aren’t subject to the same Affordable Care ACT rules that otherwise force insurance companies to accept applicants with pre-existing medical conditions. Medigap plans only have to take you during your initial enrollment period, or under specific life conditions (such as your existing plan being terminated).  

Some states have less stringent rules on switching between Medigap plans than others. 

Go here to read more about Medicare supplement plan open enrollment periods. 

If you’re in good health, you may well pass medical underwriting, and be able to find another Medigap provider who will accept you. Your premium may go up, however, due to you being older than you were when you first enrolled in Medigap.

Before switching, be sure to compare all aspects of both Medigap plans, including not only current premiums, but the outlook for future premium increases, before switching. For example, some Medigap plans will guarantee level premiums for life  to customers who sign on during the open enrollment period.

Switching to a plan that has attained age pricing, and out of a plan with a guaranteed level premium lock-in may save money in the short run. In the long run, you may be exposed to significant premium increases in future years, as you get older.

Also, be aware that there are some benefits available in Medigap plans that were purchased prior to 2010 that aren’t available today. 

During the annual election period, you may make any of these changes to your Medicare coverage: 

Note that “enroll in a Medigap plan” is conspicuously absent from these choices. You can apply to a Medigap plan, but you are generally not entitled to a guaranteed enrollment privilege, except in very specific circumstances.

Where To Go From Here: