How Medigap works
- Only with Original Medicare. You generally need Part A and Part B. If you are leaving a Medicare Advantage Plan, you can apply before that coverage ends and ask for the policy to start when it does; the differences between the two routes are in Medicare Advantage vs Original Medicare.
- A separate premium. You pay the insurer a monthly premium on top of the Part B premium in Medicare costs 2026.
- One person per policy. Spouses each buy their own.
- Guaranteed renewable. A policy issued since 1992 cannot be cancelled because of health problems as long as you pay the premium.
- No drug coverage in plans sold after 2005; drugs come from a separate plan, covered in Medicare Part D explained.
- Not covered: long-term care such as non-skilled care in a nursing home, vision and dental care, hearing aids, glasses and private-duty nursing.
What each plan covers in 2026
All ten plans pay the Part A coinsurance and hospital costs for up to an additional 365 days after Medicare benefits are used. They also pay the Part B coinsurance, the first 3 pints of blood and Part A hospice coinsurance in full, except Plan K, which pays 50 percent of them, and Plan L, which pays 75 percent. Plan N pays the Part B coinsurance but leaves copayments of up to $20 for some office visits and up to $50 for emergency room visits that do not lead to an inpatient admission. The rest of the chart:
| Plan | Skilled nursing coinsurance | Part A deductible | Part B deductible | Part B excess charge | Foreign travel emergency |
|---|---|---|---|---|---|
| A | No | No | No | No | No |
| B | No | Yes | No | No | No |
| C* | Yes | Yes | Yes | No | 80% |
| D | Yes | Yes | No | No | 80% |
| F* | Yes | Yes | Yes | Yes | 80% |
| G | Yes | Yes | No | Yes | 80% |
| K | 50% | 50% | No | No | No |
| L | 75% | 75% | No | No | No |
| M | Yes | 50% | No | No | 80% |
| N | Yes | Yes | No | No | 80% |
* Plans C and F are not available to people new to Medicare on or after January 1, 2020, meaning people who turned 65 and got Part A on or after that date; they can buy Plans D and G instead. Plans K and L have a yearly out-of-pocket limit, $8,000 for K and $4,000 for L in 2026, after which they pay 100 percent of covered services for the rest of the year once the Part B deductible is also met. In some states Plans F and G also come as a high-deductible version, where you pay up to $2,950 in 2026 before the policy pays anything. Every insurer that sells Medigap must offer at least Plan A, and Plans E, H, I and J are no longer sold.
Massachusetts, Minnesota and Wisconsin standardize Medigap differently, and some states also sell Medicare SELECT policies, which may require network hospitals.
The 6-month Medigap Open Enrollment Period
Your Medigap Open Enrollment Period starts the first month you have Part B and are 65 or older, lasts 6 months and does not repeat. During it an insurer cannot refuse to sell you any policy it offers, cannot use medical underwriting and cannot charge you more because of health problems.
- Pre-existing conditions: an insurer may still wait up to 6 months before covering a condition treated or diagnosed in the 6 months before the policy starts. At least 6 months of continuous prior creditable coverage, with no break longer than 63 days, removes that wait.
- Employer coverage: if you or your spouse still work and have group coverage, you may decide to delay Part B. The open enrollment period then starts when you take Part B later.
- Under 65 on Medicare because of a disability or ESRD, you may not be able to buy the policy you want until you turn 65, though some states have extra enrollment periods.
Outside this window you may pay more, have fewer choices, or be turned down after medical underwriting, unless you have a guaranteed issue right.
Guaranteed issue rights
In these federal situations an insurer must sell you a policy and cover pre-existing conditions without a waiting period. States may add more.
| Situation | What you can buy | When to apply |
|---|---|---|
| Your Medicare Advantage Plan leaves Medicare, stops serving your area or changes its network significantly, or you move out of its area, and you switch to Original Medicare | Plan A, B, C*, D, F* or G | From 60 days before your plan coverage ends (or by the date in the termination notice) to 63 days after |
| Employer, retiree, COBRA or union coverage that pays after Medicare is ending | Plan A, B, C*, D, F* or G | No more than 63 days after the latest of: the coverage end date, the date on the notice, or the date on a claim denial |
| Trial right: you joined a Medicare Advantage Plan or PACE when first eligible at 65 and want to switch to Original Medicare within the first year | Any Medigap policy sold in your state | From 60 days before to 63 days after that coverage ends |
| Trial right: you dropped Medigap to join a Medicare Advantage Plan for the first time and have been in it less than a year | Your old policy if the same insurer still sells it, otherwise Plan A, B, C*, D, F* or G | From 60 days before to 63 days after that coverage ends |
| Your Medigap insurer goes bankrupt, or your policy ends through no fault of your own | Plan A, B, C*, D, F* or G | No more than 63 days after the policy ends |
The CMS guide lists one more case, moving out of a Medicare SELECT policy's service area, and notes that trial rights may last an extra 12 months in some circumstances; your State Insurance Department can confirm.
How insurers set the price
| Pricing method | How the premium is set |
|---|---|
| Community-rated (no-age-rated) | Generally the same for everyone regardless of age; it can rise with inflation and other factors, not because you get older |
| Issue-age-rated (entry-age-rated) | Based on your age when you buy; it does not rise because you get older |
| Attained-age-rated | Based on your current age, so it rises as you get older; often cheapest at first and can become the most expensive |
Because benefits are the same within a letter, compare the same plan across insurers and ask which pricing method each uses. If you switch policies, you get a 30-day free look period on the new one and pay both premiums for the month you have both. The budget planner and retirement savings calculator show how a premium fits into retirement spending.
Frequently asked questions
What is the difference between Medigap and Medicare Advantage?
Medigap is extra insurance that helps pay the coinsurance, copayments and deductibles of Original Medicare. Medicare Advantage is a different way of getting Medicare from a private plan. You can generally only buy Medigap if you have Original Medicare, Part A and Part B, per the CMS guide.
When is the best time to buy a Medigap policy?
During your 6-month Medigap Open Enrollment Period, which starts the first month you have Part B and are 65 or older. It happens once and does not repeat. In it, an insurer cannot refuse to sell you any Medigap policy it offers or charge you more because of health problems.
Can I still buy Medigap Plan F?
Only if you were eligible for Medicare before January 1, 2020. Plans C and F cannot be sold to people new to Medicare on or after that date, meaning people who turned 65 and got Part A on or after January 1, 2020. They can buy Plans D and G instead, which give the same benefits without the Part B deductible.
Does Medigap cover prescription drugs?
Medigap plans sold after 2005 do not include drug coverage, according to the CMS guide. With Original Medicare, drug coverage comes from a separate Medicare drug plan (Part D).
Is Plan G from one company the same as Plan G from another?
Yes. Plans with the same letter offer the same basic benefits whatever the insurer, and price is the only difference, per the CMS guide. Massachusetts, Minnesota and Wisconsin standardize their policies in a different way.
Sources
- Centers for Medicare & Medicaid Services: Choosing a Medigap Policy, product no. 02110, March 2026 (how Medigap works, the 2026 plan chart, Plans C and F after January 1, 2020, what Medigap does not cover, the Medigap Open Enrollment Period, pre-existing condition waiting periods and creditable coverage, the three pricing methods, guaranteed issue rights and trial rights, the 30-day free look period)
- Medicare.gov: Compare Medigap plan benefits (out-of-pocket limits of $8,000 for Plan K and $4,000 for Plan L in 2026, the $2,950 high-deductible amount for Plans F and G in 2026, the Plan N copayments)
General information based on the sources above, not medical advice.