Part A
Hospital insurance
The Payment Sequence
Medigap does not replace Medicare. It follows behind it.
Your doctors and hospitals bill Original Medicare first. The Medigap policy then applies the standardized benefits included in your plan letter.
Original Medicare reviews the claim.
Part A or Part B determines whether the service is covered and pays its share of the Medicare-approved amount.
Your Medigap policy applies its benefits.
The policy may pay selected coinsurance, copayments, deductibles, or other standardized benefits based on the plan letter you purchased.
You pay any remaining responsibility.
What remains depends on the plan letter, the service, the annual Part B deductible, and whether the care is covered by Medicare.
Medigap helps with selected out-of-pocket costs for services covered by Part A and Part B.
Medigap policies sold after 2005 do not include outpatient prescription drug coverage.
Medigap and Medicare Advantage are different coverage paths.
You cannot use a Medigap policy to pay Medicare Advantage deductibles, copayments, coinsurance, or premiums. A person generally chooses Original Medicare with optional Medigap, or Medicare Advantage, not both.
Standardized Benefits
Each plan letter fills a different combination of Medicare cost gaps.
Every standardized plan includes a defined set of benefits. Some benefits appear in every plan, while others are available only in certain letters.
Part A coinsurance
All standardized plans include hospital coinsurance and up to 365 additional hospital days after Medicare benefits are used.
Part B cost sharing
Plans cover all or a percentage of Part B coinsurance or copayments, depending on the letter.
First three pints of blood
Standardized plans include full or partial coverage for this Medicare cost gap.
Hospice cost sharing
Plans include full or partial coverage for Part A hospice coinsurance or copayments.
Skilled nursing coinsurance
Some plan letters help with skilled nursing facility coinsurance after Medicare requirements are met.
Part A deductible
Many plan letters cover all or part of the inpatient hospital deductible.
Part B excess charges
Plans F and G include this benefit when a provider is permitted to charge above the Medicare-approved amount.
Foreign travel emergency
Some plan letters cover 80% of qualifying emergency care outside the United States, subject to plan limits.
The letter defines the benefits.
A Plan G sold by one company has the same standardized medical benefits as Plan G sold by another company. The premium, customer service, discounts, and rate history may differ.
2026 Standardized Plans
Compare Medigap plans side by side.
Start with one plan, then add up to two more for a focused comparison. Or expand the chart to see all 10 standardized Medigap plan letters at once.
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Plan G vs. Plan N
Same letter = same standardized basic medical benefits. Premiums, discounts, underwriting, service, and availability can still differ by insurance company.
✓
100% covered
×
Not covered
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Percentage shown
Generally unavailable if you were new to Medicare on or after January 1, 2020. Certain people eligible for Medicare before that date may still be able to buy them.
Available in some states. In 2026, you pay Medicare-covered costs up to $2,950 before the high-deductible policy begins paying.
Their 2026 out-of-pocket limits are $8,000 and $4,000, respectively. The annual Part B deductible also applies.
Covers Part B coinsurance, except for copayments of up to $20 for some office visits and up to $50 for certain emergency room visits that do not result in an inpatient admission.
Standardized benefits and 2026 amounts shown here follow the official Medicare Medigap comparison chart. Massachusetts, Minnesota, and Wisconsin standardize Medigap differently.
Build the Full Monthly Picture
A Medigap premium is only one part of the coverage budget.
Compare the recurring premiums and the medical costs that may remain under the plan letter you are considering.
Medicare Part B premium
You continue paying the Part B premium while using Original Medicare with a Medigap policy.
Medigap monthly premium
Premiums can vary widely by insurance company, plan letter, location, discounts, and pricing approach.
Separate Part D costs
Prescription coverage generally requires a separate Part D plan with its own premium and cost sharing.
Costs the letter leaves to you
Examples can include the Part B deductible, Plan N copayments, high-deductible exposure, and noncovered care.
Compare equivalent benefits
Shop the same plan letter across multiple companies.
The standardized benefits are the same. Focus the carrier comparison on premium, discounts, rate history, financial stability, service, and household considerations.
Protect Your Enrollment Rights
Your strongest federal Medigap buying window is personal and one-time.
It begins the first month you are age 65 or older and enrolled in Medicare Part B, then continues for six months.
Month 1
Part B begins at age 65+
Federal Medigap Open Enrollment Period starts
1
2
3
4
5
6
End of month 6
Federal window ends
Later applications may involve underwriting unless another protection applies
During the six-month federal window
An insurance company cannot refuse to sell you a Medigap policy it offers or charge more because of pre-existing health problems.
After the federal window
Options may be limited, premiums may be higher, or medical underwriting may apply unless you have a guaranteed issue right or another state protection.
California Birthday Rule
Current Medigap policyholders generally receive a 60-day annual opportunity after their birthday.
During this period, a California policyholder may apply for another Medigap policy with equal or lesser benefits without a new medical screening or waiting period.
Review California Department of Insurance guidance ↗
Provider Access and Travel
Medigap follows Original Medicare’s provider structure.
In most cases, you can use any doctor or hospital in the United States that accepts Medicare. Original Medicare usually does not require referrals to specialists.
- Confirm that a provider accepts Medicare.
- Ask whether the provider accepts Medicare assignment.
- Review whether your plan letter covers Part B excess charges.
- Check foreign travel emergency benefits before leaving the country.
Medicare SELECT exception: Some Medigap policies use a provider network for full benefits and may have a lower premium.
U.S.
Any provider who accepts Medicare
Original Medicare rules apply
Travel
Some letters include emergency coverage abroad
Subject to plan limits and conditions
Know the Boundaries
Medigap is designed for Medicare cost gaps, not every health benefit.
A strong medical supplement can still require separate coverage or personal budgeting for services outside its purpose.
Outpatient prescriptions
New Medigap policies do not include Part D drug coverage.
Routine dental care
Dental cleanings, fillings, dentures, and similar routine services are generally separate.
Routine vision care
Routine eye exams and glasses are generally not Medigap benefits.
Hearing aids
Hearing aids and routine hearing benefits generally require another solution.
Long-term custodial care
Medigap does not function as long-term care insurance.
Private-duty nursing
This service is generally outside standardized Medigap coverage.
Shop the Policy, Not Just the Letter
Use the same checklist for every company you compare.
Standardized benefits simplify the medical comparison. The real carrier comparison happens in pricing, service, discounts, stability, and your ability to keep the policy affordable.
Compare apples to apples.
First choose the plan letter. Then compare that exact letter across the companies licensed to sell it in California.
Policy comparison checklist
Find Medigap policies on Medicare.gov ↗
Clearer Rules
Four assumptions that can create expensive surprises.
Open each statement to see the more accurate rule.
Assumption “Every Medigap company offers different Plan G medical benefits.” Click to reveal the clearer rule
Clearer rule
The medical benefits in a standardized Plan G are the same regardless of the company selling it. Premiums, discounts, service, and rate history may differ.
Assumption “Medigap includes prescription drug coverage.” Click to reveal the clearer rule
Clearer rule
Medigap policies sold after 2005 do not include outpatient prescription coverage. A separate Part D plan is usually considered with Original Medicare.
Assumption “I can buy or switch Medigap at any time without health questions.” Click to reveal the clearer rule
Clearer rule
Your six-month federal Medigap Open Enrollment Period is one-time. Outside protected periods, medical underwriting may apply. California provides additional rights, including its Birthday Rule for current policyholders.
Assumption “Medigap can pay the copayments from my Medicare Advantage plan.” Click to reveal the clearer rule
Clearer rule
Medigap supplements Original Medicare. It cannot be used to pay Medicare Advantage plan deductibles, copayments, coinsurance, or premiums.
Verify the Policy
Official Medicare Supplement resources
Medigap rights, premiums, plan availability, and underwriting can depend on exact dates, state law, company rules, and your prior coverage. Confirm details before replacing a policy.
This page provides general educational information about standardized Medicare Supplement Insurance. It does not quote premiums, determine eligibility, guarantee issue rights, or recommend a specific plan letter or insurance company. Benefits, availability, underwriting, rates, discounts, and state protections can vary. Review the policy outline and confirm all effective dates before enrolling, replacing, or canceling coverage.