Navigating Medicare can be overwhelming, especially when it comes to understanding what’s covered—and more importantly, what isn’t. That’s where Medigap comes in. Also known as Medicare Supplement Insurance, Medigap is designed to fill the “gaps” in Original Medicare. But how do these plans work, and why might they be essential for seniors?
This guide breaks it all down.
Medigap plans are private insurance policies that help pay for healthcare costs not covered by Original Medicare (Parts A and B). These costs may include copayments, coinsurance, and deductibles. Medigap policies are standardized and labeled by letters (Plan A, B, C, D, F, G, K, L, M, and N), each offering a different level of coverage.
Medigap is not a standalone policy. Instead, it works alongside your Original Medicare. After Medicare pays its share of the approved healthcare costs, your Medigap policy kicks in to cover the remaining eligible expenses. This means fewer out-of-pocket surprises and greater financial predictability for your healthcare needs.
To be eligible for a Medigap plan, you must be enrolled in Medicare Part A and Part B. The best time to sign up is during your Medigap Open Enrollment Period, which starts the first month you’re 65 or older and enrolled in Part B. During this six-month window, you can purchase any Medigap policy without being denied or charged more for preexisting conditions.
The most popular Medigap plans among seniors are:
When comparing plans, think about:
Medigap helps pay for hospital coinsurance and costs under Medicare Part A, including extended hospital stays beyond the 60-day mark and up to 365 additional days after Medicare benefits are used up.
Some Medigap plans (like G and N) cover coinsurance for skilled nursing facility care, which can become essential after a hospital stay.
Many Medigap plans include emergency coverage abroad, reimbursing 80% of costs (up to plan limits) after you pay a deductible. Original Medicare does not provide this, making Medigap a must for international travelers.
Medigap does not cover routine dental, vision, hearing aids, or prescription drugs. These are considered outside the scope of “medically necessary” services under Original Medicare.
To fill this gap, many seniors purchase separate dental and vision insurance or opt for Medicare Advantage plans that include these benefits. Alternatively, you can find affordable standalone policies or discount plans tailored to your needs.
Here are six major areas not covered by Medicare:
Medicare doesn’t cover custodial care in nursing homes or assisted living, which can cost thousands monthly.
Routine dental cleanings, exams, fillings, and dentures are not included.
Eye exams, glasses, and contacts for routine vision needs are excluded.
Medicare does not pay for hearing aids or the exams to fit them.
Services like callus removal or nail trimming (unless medically necessary) are not covered.
With few exceptions, Medicare doesn’t cover healthcare received outside the U.S.
Original Medicare Part A covers hospitalization, but not fully. You’re responsible for a deductible (over $1,600 in 2025) and daily coinsurance after 60 days of hospitalization.
Plans like Medigap G and F cover these deductibles and coinsurance costs, making hospitalization more financially manageable.
One of the biggest gaps is long-term care, such as extended stays in nursing homes or help with daily activities like bathing or dressing. Medicare only covers short-term rehabilitative stays, not ongoing custodial care.
To prepare, consider long-term care insurance or hybrid life insurance policies with long-term care benefits. Medigap will not cover these services, so financial planning is key.
The best time to buy a Medigap plan is during your open enrollment period, when insurers can’t deny you for preexisting conditions or charge higher premiums. After this window, you may face underwriting.
A licensed agent can help you compare plans, premiums, and benefits side-by-side. They’re knowledgeable about state-specific options and can explain which plans best match your budget and healthcare needs.
Medigap offers peace of mind by covering the expenses that Original Medicare leaves behind. While not all-encompassing, it’s a solid foundation for protecting your health and your finances.
There’s no one-size-fits-all. Take time to compare options, or better yet, consult a licensed Medicare insurance expert who can help you make a confident, informed decision.
If you’re nearing retirement or already enrolled in Medicare, don’t leave your health—or wallet—unprotected. Medigap plans are key to bridging the coverage gaps in Medicare, giving you better control over your healthcare spending and peace of mind for the future.
Ready to compare Medigap plans and find the one that’s right for you? Contact us!
I do not offer every plan available in your area. Currently I represent 9 organizations which offer many products in your area.
Please contact Medicare.gov or 1–800–MEDICARE, or your local State Health Insurance Program to get information on all your options.
