What is a Medigap Policy?
Navigating the world of Medicare can feel like deciphering a complex puzzle. While Original Medicare (Parts A and B) provides a solid foundation for healthcare coverage, it rarely pays for everything. Most beneficiaries are still left with out-of-pocket costs, such as deductibles, copayments, and coinsurance.
This is where Medigap, also known as Medicare Supplement Insurance, comes into play. As of 2026, these policies remain a vital tool for millions of Americans looking to stabilize their healthcare spending and gain peace of mind.
The Basics: Bridging the “Gaps”
A Medigap policy is extra insurance you buy from a private company to help pay your share of costs in Original Medicare. It is specifically designed to fill the “gaps” in coverage.
Key Characteristics:
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Standardization: In most states, Medigap plans are standardized and named by letters (Plan A through Plan N). This means Plan G from Company X must offer the exact same basic benefits as Plan G from Company Y.
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Monthly Premiums: You pay a monthly premium to the private insurance company in addition to the monthly Part B premium you pay to Medicare.
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Individual Coverage: A Medigap policy only covers one person. Spouses must buy separate policies.
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Eligibility: You must have both Medicare Part A and Part B to buy a Medigap policy.
What Does Medigap Cover?
While coverage varies by the lettered plan you choose, most Medigap policies help pay for:
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Part A Coinsurance: Costs for hospital stays up to an additional 365 days after Medicare benefits are exhausted.
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Part B Coinsurance or Copayment: Usually 20% of the Medicare-approved amount for doctor services.
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Blood: The first three pints of blood each year.
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Hospice Care: Part A coinsurance or copayments.
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Skilled Nursing Facility (SNF) Care: Coinsurance for facility stays.
What is NOT Covered?
It is equally important to know what Medigap does not cover. Typically, these policies do not include:
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Long-term care (like non-medical custodial care in a nursing home).
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Vision or dental care.
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Hearing aids.
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Private-duty nursing.
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Prescription drugs: You must join a separate Medicare Prescription Drug Plan (Part D) for medication coverage.
Popular Plans in 2026
While there are 10 standardized plans, a few stand out as the most common choices for new enrollees:
| Plan | Best For | 2026 Context |
| Plan G | High Coverage | The most comprehensive plan for new enrollees. It covers everything except the $283 Part B deductible. |
| Plan N | Lower Premiums | Offers lower premiums but requires small copays for some office and emergency room visits. |
| Plan F | Zero Out-of-Pocket | Only available if you were eligible for Medicare before January 1, 2020. |
Medigap vs. Medicare Advantage
One of the most common points of confusion is the difference between Medigap and Medicare Advantage (Part C).
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Medigap works with Original Medicare. You can see any doctor or hospital in the U.S. that accepts Medicare. There are no networks and no referrals required.
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Medicare Advantage is an alternative to Original Medicare. These are “all-in-one” plans that usually have restricted networks (HMOs or PPOs) and often include drug, dental, and vision coverage.
Note: You cannot have both a Medigap policy and a Medicare Advantage plan at the same time.
When to Buy: The “Open Enrollment” Window
The best time to buy a Medigap policy is during your Medigap Open Enrollment Period. This is a one-time, six-month window that starts the month you turn 65 and are enrolled in Part B.
During this period, insurance companies must sell you any policy they offer at the best available rate, regardless of your health history. If you wait until this window closes, insurers can use “medical underwriting” to deny you coverage or charge you significantly more based on pre-existing conditions.