What is Medigap

What is Medigap – Overview

Those who sign up for Medicare must surely have heard about Medigap. You must be wondering what Medigap is.

These are special insurance policies aimed at covering some out-of-pocket costs relating to your Medicare insurance plan.

You can choose from a variety of Medigap policies, so it is essential to conduct thorough research. Find the plan that best suits you in terms of medical coverage and financial expenses.

In this article, we’ve explained Medigap, Medigap coverage, the cost of Medigap, and Medigap insurance plan prices.

What is Medigap Health Insurance

Medigap is a supplemental insurance plan to Medicare, sold by private insurance carriers, to help cover original Medicare costs such as copayments, deductibles, and coinsurance.

Sometimes, Medigap also covers emergency medical charges if you need emergency medical care when traveling outside the United States.

Medigap insurance pays out only after Medicare and you have paid your share of expenses for the medical services.

As of 2025, there are still 8 Medigap plans available for new enrollees – Plans A, B, D, G, K, L, M, and N (with a high-deductible Plan G option now offered). Plans C and F remain unavailable to Medicare enrollees who became eligible on or after January 1, 2020. (source)

What is Covered Under Medigap Insurance Plans

Most Medigap plans differ only in terms of coinsurance, copayments and miscellaneous medical fees that they cover.

However, the common benefits covered by Medigap insurance plans include:

Medicare Part A (hospital fees and coinsurance)

Medicare Part A (copayment costs and hospice coinsurance)

Medicare Part B (copayment and coinsurance costs)

Blood transfusion costs (for the first 3 pints)

Medicare Part A deductible

Medicare Part B deductible (covered only by Medigap Plans C and F, which are not available to new beneficiaries) (source)

Medicare Part B excess charges

Skilled nursing facility costs

Emergency medical costs (during foreign travel)

Remember, Medigap and Medicare Advantage are two different insurance plans. Medicare Advantage is an alternative to Original Medicare, providing coverage through private insurance companies and includes all Part A and B benefits.

In contrast, Medigap plans are meant to pay the charges for coverage you qualify for.

Medigap insurance is supplemental insurance for those with Original Medicare, designed to fill gaps in Original Medicare coverage.

Though Medigap plans will cover some of the Medicare costs, the plan will not cover the cost of:

• Hearing, dental or vision care
• Health perks (transportation services, fitness memberships, etc.)
• Prescription drugs

How much do Medigap insurance plans cost

The specific costs associated with original Medicare and Medigap vary from plan to plan. Let’s check out the tentative cost of Medigap insurance cover:

Monthly Premium

Medigap policyholders still have to pay the original Medicare premiums, which include:

• Most people do not pay a monthly premium for Medicare Part A if they have worked and paid Medicare taxes for a certain amount of time.
• The standard monthly premium for Medicare Part B is $185.00 in 2025 (this amount changes annually). (source)

Apart from these, you may also have to pay an additional premium for Medigap coverage.

Deductibles

It is important to meet your deductible amounts before seeking the benefits of Medicare Part A or Medigap insurance plans.

• Plan C and Plan F cover both Part A and Part B deductibles. However, as of January 1, 2020, Plans C and F are unavailable to new Medicare enrollees who became eligible for Medicare on or after this date.
• Plan D and Plan G cover Part A but not the Part B deductible.
• Plans K, L, and M offer partial coverage for the Part A deductible and do not cover the Part B deductible; Plan N covers the Part A deductible in full but, like the others, does not cover the Part B deductible.

Several Medigap insurance plans may also pay for some (or all) of these deductible amounts.

Copayments and Coinsurance

Once you meet your deductibles, Medicare will pay its portion of the cost. Still, you may end up owing some coinsurance and copay fees, including:

Up to $838 coinsurance per day (for Medicare Part A coverage, as of 2025) (source)

Around 20% of the Medicare-approved amount (for items covered under Medicare Part B)

According to the specific Medigap policy, your Medigap insurance plan bears the copayment and coinsurance amounts.

Out-of-Pocket costs

Medigap Plans K and L have annual out-of-pocket limits (capped at $7,220 for Plan K and $3,610 for Plan L in 2025). Medicare Part A and Part B do not have an out-of-pocket limit, so many choose Medigap for additional coverage.

If you buy Medigap that doesn’t cover Medicare fees you will still need to pay the out-of-pocket costs.

When to enroll in Medigap

There are several enrollment periods for Medicare plans, but you can join Medigap only at certain times. These are the Medigap enrollment periods:

Initial enrollment period – You can apply for Medicare (including a Medigap policy) during the 3 months before the month you turn 65, the month of your 65th birthday, and the 3 months after. (source)

Open enrollment period – In case you miss the initial enrollment period, you can still apply for a policy during the Medigap open enrollment period. If you are already 65, you can start by enrolling in Medicare Part B.

As of 2025, many states require insurance companies to offer at least one Medigap policy to Medicare beneficiaries under 65 who qualify due to disability or specific conditions (notably, new laws in states like Nebraska and Indiana have expanded access for under-65 enrollees). (source) Make sure to apply for Medigap insurance during the initial and open enrollment period.

You may find it extremely difficult to find another way. Once you enroll in Medicare Part B, you can also apply for Medigap benefits.

Conclusion

Medigap insurance plans are supplemental insurance options for individuals enrolled in Original Medicare who seek additional coverage.

Once you enroll in a Medigap plan, it will provide coverage for certain costs, such as deductibles, coinsurance and copayments.

Still, you should be prepared to pay some out-of-pocket costs, even with Medigap insurance plans.

See Also

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Federal Home Care and Family Support

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Does Medicare Cover Long Term Care

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