Picking the right Medigap plan is one of the most important decisions you’ll make about your healthcare coverage. Original Medicare leaves gaps in coverage that can cost you thousands of dollars each year.
We at Dave Silver Insurance help people navigate these choices every day. This guide walks you through the 10 standardized plans, shows you how to match coverage to your needs, and explains the enrollment deadlines that matter.
What Medigap Covers and How It Works
The Basics of Medigap Coverage
Medigap is straightforward insurance designed to fill the gaps Original Medicare leaves behind. Medicare Part A covers hospital stays, but you pay a $1,676 deductible in 2026 before coverage kicks in. Medicare Part B covers doctor visits and outpatient care, but carries a $283 deductible and requires you to pay 20% coinsurance on most services. Medigap steps in to cover these out-of-pocket costs that Medicare doesn’t pay. About 40% of Original Medicare enrollees have chosen Medigap according to Kaiser Family Foundation data, which tells you this is the most common way people supplement their coverage. The average monthly Medigap premium was $217 in 2023, and you’ll pay this in addition to your Part B premium of $202.90 monthly. Foreign travel emergency care is another benefit Medigap provides, covering 80% of costs up to plan limits when you’re outside the United States.
Original Medicare Plus Medigap Versus Medicare Advantage
This distinction matters because you cannot have both. Medicare Advantage, also called Part C, is a complete alternative to Original Medicare offered by private insurers. These plans often include dental, vision, and prescription drug coverage that Original Medicare doesn’t provide, but they typically require you to use doctors and hospitals within their network. If you enroll in Medicare Advantage, you cannot purchase a Medigap policy.
Medigap only works with Original Medicare, giving you the freedom to see any doctor or hospital that accepts Medicare. Plan G is the most popular Medigap option, held by about 39% of all Medigap policyholders, because it covers virtually all gaps in Original Medicare except the Part B deductible. Your choice between Original Medicare with Medigap versus Medicare Advantage depends on whether you value network flexibility and predictable costs or prefer integrated benefits and lower premiums.
The 10 Standardized Plans Explained
The 10 Medigap plans are labeled A through N, with each letter offering the same core benefits regardless of which insurance company sells it. Plan F and Plan C are no longer available to people who turned 65 after January 1, 2020, though some older beneficiaries can still purchase them. Plans K and L set annual out-of-pocket limits at $8,000 and $4,000 respectively in 2026, meaning your costs stop there. Plan N requires you to pay small copays for some doctor visits and emergency room visits, but provides comprehensive coverage otherwise. High-deductible Plan G requires you to pay $2,950 in covered costs before Medigap pays anything, which appeals to healthy people who want lower monthly premiums.
Shopping for the Best Price
Premiums for the same plan letter vary dramatically by insurer, sometimes ranging from $124 to $419 monthly for a 65-year-old man in Richmond, Virginia, according to Medicare Plan Finder data. This price variation means shopping around is not optional if you want to control costs. Three pricing structures affect how your premium changes over time: community-rated plans charge the same price regardless of age, issue-age plans are based on your age when you buy, and attained-age plans increase as you get older. Your age, location, tobacco use, and the specific plan you select all influence what you’ll pay each month. Understanding these pricing models helps you predict whether your premium will stay stable or climb significantly over the next decade.
Which Medigap Plan Matches Your Health Situation
Assess Your Health Needs First
Your health status today and your expected medical needs over the next five years should drive your Medigap choice more than anything else. Someone managing multiple chronic conditions needs different coverage than a generally healthy person. Start by listing your current conditions, medications, and how often you see specialists.
People with diabetes, heart disease, or arthritis visit doctors monthly or more frequently, making comprehensive plans like G or N worth the higher premium because they cover costs that would normally be your responsibility, such as copayments for doctor’s office visits. If you’ve had recent hospitalizations or surgeries, Plan G’s near-complete coverage justifies its cost since you’ll hit the deductible quickly anyway.
Account for Prescription Drug Coverage Separately
If you take prescription medications regularly, you’ll need Original Medicare with Part D drug coverage regardless of which Medigap plan you select, since Medigap doesn’t cover prescriptions. The key is matching your actual healthcare usage to a plan that won’t leave you exposed to unexpected bills.
Use the Medicare Plan Finder to Compare Local Prices
The Medicare Plan Finder tool lets you enter your ZIP code, age, tobacco use, and sex to see exact premiums for each plan in your area. A 65-year-old nonsmoker in Richmond, Virginia faced monthly costs ranging from $124 to $419 for the same plan depending on the insurer, according to 2024 data, which shows how critical shopping around becomes.
Choose Based on Your Budget and Lifestyle
Your lifestyle and financial situation determine whether you can afford gaps in coverage or need predictability. If you travel internationally more than two weeks annually, foreign travel emergency coverage matters, and Plans C through G provide 80% coverage up to limits when you’re outside the United States.
Attained-age-rated plans start cheap but climb steeply each birthday, while issue-age plans stay flat after your initial purchase, so project your costs across a decade before choosing. If your budget is tight, high-deductible Plan G at around $30 monthly makes sense only if you can afford the $2,950 deductible without hardship. Plans K and L cap your annual out-of-pocket costs at $8,000 and $4,000 respectively in 2026, providing a safety net if unexpected health events occur.
Move Forward With Enrollment Timing
Once you’ve matched a plan to your health needs and budget, enrollment timing becomes your next critical decision-and missing key deadlines can cost you thousands in higher premiums or coverage gaps.
Timing Your Enrollment and Locking in Your Rate
The Six-Month Window That Changes Everything
The 6 month “Medigap Open Enrollment” period after you first enroll in Medicare Part B is the only time insurers must sell you any Medigap plan without medical underwriting or health-based premium increases. This Open Enrollment Period represents your golden ticket to guaranteed coverage regardless of pre-existing conditions. If you enrolled in Part B at 65, your six-month clock started then, not when you turned 65. Miss this window and you enter a completely different landscape where insurers can deny you coverage entirely or charge substantially higher premiums based on your health history.
Many people waste this protection by assuming they can shop for Medigap anytime, then face rejections or astronomical rates when they finally apply. The financial penalty for waiting is severe: postponing your application even a few months after your Open Enrollment ends could mean paying substantially higher premiums than you would have during the guaranteed period, or facing outright rejection if you developed a new condition.
How Your Pricing Structure Affects Long-Term Costs
Your actual monthly premium depends on four concrete factors that vary widely across insurers and locations. Age matters, but how it matters depends on your plan’s pricing structure. Community-rated plans charge everyone the same regardless of age, issue-age plans lock in your rate based on your current age and rarely increase, while attained-age plans climb every birthday and can double or triple over two decades.
Location drives massive differences-a 65-year-old in one state might pay $140 monthly for Plan G while someone the same age in another state pays $380 for identical coverage. Tobacco use and sex also factor into premiums in most states, with smokers paying substantially more. The plan letter itself is the biggest cost driver: Plan N might cost $150 monthly while Plan G costs $300 for the same person in the same ZIP code.
Getting Your Exact Premium and Available Discounts
Don’t rely on online estimates alone; contact the specific insurers offering your preferred plan in your area and ask them to confirm your exact premium, your pricing structure, and whether discounts apply. Some insurers offer 5 to 15 percent discounts for automatic payments or bundling with a spouse’s policy-savings that can total hundreds annually.
The Medicare Plan Finder tool shows you price ranges by ZIP code and age, providing a realistic baseline before calling insurers directly to verify their current rates and available discounts.
Final Thoughts
Picking the right Medigap plan requires you to match coverage to your actual health needs, calculate what you’ll pay monthly and over time, and act before your Open Enrollment window closes. Plan G works for 39% of Medigap holders because it covers nearly everything except the Part B deductible, but someone with minimal doctor visits might save thousands annually on a high-deductible Plan G instead. Your location, age, tobacco use, and pricing structure determine whether your premium stays stable or climbs steeply over the next decade-a 65-year-old in Richmond, Virginia could pay anywhere from $124 to $419 monthly for the same plan depending on the insurer.
The six-month Open Enrollment Period after you enroll in Part B represents your only guaranteed window to buy any plan without medical underwriting or health-based premiums. Miss this deadline and insurers can deny you coverage or charge substantially more based on your health history. Attained-age pricing looks cheap initially but can double by age 75, while issue-age plans lock in your rate and rarely increase, so these differences compound to tens of thousands of dollars over your retirement.
We at Dave Silver Insurance help people navigate how to pick Medigap plans that fit their specific situation, identify the lowest premiums in your area, and enroll before deadlines pass. Contact us today to get personalized recommendations based on your health and financial needs. We’re available seven days a week to answer your questions and help you move forward with confidence.
Disclaimer: The information provided in this blog is for general informational purposes only and does not constitute legal, financial, or insurance advice. Coverage options, terms, and availability may vary. Please consult with a licensed professional for advice specific to your situation