If you've recently turned 65 or are approaching Medicare eligibility, you've probably realized that Original Medicare doesn't cover everything. In fact, Medicare Part A and Part B together can leave you responsible for significant out-of-pocket costs — including a Part A hospital deductible of $1,632 per benefit period in 2024 and Part B coinsurance of 20% of most outpatient costs with no annual cap. That's where Medicare Supplement plans, also called Medigap, come in. These private insurance policies are designed to fill those coverage gaps, but with so many options available, choosing the right one can feel overwhelming. Let's break it down so you can make a confident, money-smart decision.
Medicare Supplement plans are standardized by the federal government, meaning a Plan G from one insurance company offers the exact same benefits as a Plan G from another company. The difference between carriers is price and customer service — not coverage. The most popular plans right now are Plan G and Plan N, though Plan F is also still common for those who were eligible for Medicare before January 1, 2020.
Plan G is currently the most comprehensive option available to new Medicare enrollees. It covers nearly everything Original Medicare doesn't, including the Part A deductible, skilled nursing facility coinsurance, and foreign travel emergencies. The only thing it doesn't cover is the Part B deductible, which is $240 in 2024 — a relatively small price to pay for nearly complete coverage.
Plan N is a solid middle-ground option that tends to have lower monthly premiums than Plan G. The trade-off is that you'll pay up to $20 copays for office visits and up to $50 for emergency room visits (waived if you're admitted). If you're generally healthy and don't visit the doctor frequently, Plan N can save you a meaningful amount each year.
Plan F, while the most comprehensive historically, is no longer available to those who became Medicare-eligible after January 1, 2020. If you're already enrolled in Plan F, you can keep it — and it may still be worth holding onto depending on your health needs.
Here's the thing most people miss: because the benefits are identical across carriers for the same plan letter, you should be shopping almost entirely on price and company reputation. Premiums for the same plan can vary by hundreds of dollars per year depending on where you live and which company you choose.
Here are some concrete steps to help you compare costs smartly:
One of the most important and underappreciated facts about Medigap is that your Open Enrollment Period is the best — and sometimes only — time to get guaranteed coverage. This six-month window begins the month you turn 65 and are enrolled in Medicare Part B. During this period, insurance companies cannot deny you coverage or charge you higher premiums due to pre-existing conditions.
Miss this window, and you may face medical underwriting, meaning the insurer can review your health history, charge you more, or even refuse to cover you altogether. There are some exceptions — called guaranteed issue rights — that apply in specific situations, but they're limited.
Tip: If you're still working at 65 and covered by an employer plan, talk to a Medicare specialist before assuming you should delay enrollment. The rules are nuanced, and making the wrong move could cost you significant money and coverage gaps down the road.
Even after you've chosen a plan, there are ways to keep your costs in check over time:
Choosing the right Medicare Supplement plan doesn't have to be a stressful guessing game. With a little research, smart timing, and the right professional guidance, you can lock in comprehensive coverage that protects both your health and your wallet for years to come. Take it one step at a time, ask plenty of questions, and remember — the best plan is the one that fits your specific needs and budget, not the one with the fanciest brochure.