Medicare Supplement plans help cover out-of-pocket costs left by Original Medicare (Parts A and B), such as deductibles and coinsurance. These private insurance plans work alongside Original Medicare, requiring enrollment in both Parts A and B. Importantly, Medigap plans do not cover prescription drugs, so a standalone Medicare Part D Prescription Drug Plan (PDP) is recommended to address this gap. Below, we group plans into Budget, Shared Cost, and Comprehensive Coverage categories based on cost-sharing, outlining their differences and ideal users.
Medigap Plan Groups
Budget Coverage Plans
These plans offer basic coverage with lower premiums but higher out-of-pocket costs.
- Plans: A, B, K
- Cost-Sharing:
- All cover 100% of Part A coinsurance and hospital costs (up to 365 extra days).
- Plan A covers Part B coinsurance fully but not the Part B deductible ($240 in 2025) or excess charges.
- Plan B adds coverage for the Part A deductible ($1,632 in 2025).
- Plan K covers 50% of Part B coinsurance, certain hospital costs, and blood transfusions, with a $7,220 out-of-pocket limit in 2025, after which it pays 100%.
Ideal For: Healthy individuals on a tight budget who rarely need medical services beyond routine care and prefer lower monthly premiums.
Shared Cost Plans
These balance moderate premiums with some cost-sharing through copays or partial coverage.
Plans: L, M
- Cost-Sharing:
- Both cover 100% of Part A coinsurance, hospital costs, hospice, and skilled nursing coinsurance.
- Plan L covers 75% of Part B coinsurance with a $3,610 out-of-pocket limit in 2025.
- Plan M covers 50% of the Part A deductible and 100% of Part B coinsurance (after the deductible) but excludes excess charges.
Ideal For: Active seniors with regular doctor visits who want affordable premiums but can handle small copays or partial deductibles.
Comprehensive Coverage Plans
These offer extensive coverage with higher premiums but minimal out-of-pocket costs.
- Plans: C, D, F, G, N (Note: Plans C and F are unavailable to new enrollees post-January 1, 2020).
- Cost-Sharing:
- All cover 100% of Part A and B coinsurance, hospital costs, hospice, and skilled nursing.
- Plan C and F cover both Part A and B deductibles,excess charges and also includes foreign travel emergencies ($50,000 lifetime).
- Plan G covers everything except the Part B deductible, including excess charges and travel emergencies.
- Plan D mirrors G but excludes excess charges.
- Plan N covers Part B coinsurance with $20 doctor visit/$50 ER copays, excluding the Part B deductible and excess charges.
Ideal For: Those with chronic conditions, frequent medical needs, or who travel and want predictability. Plan G is ideal for new enrollees; Plan N suits those okay with copays for lower premiums.
Premiums vary by insurer, location, and age, ranging from $50–$150/month for Budget plans to $150–$300+ for Comprehensive ones.
Summary: Benefits of a Qualified Broker
Choosing the right Medigap plan is easier with a qualified licensed broker. They offer:
- Price Comparison: Shop multiple insurers to find the best rates for your plan.
- Carrier Comparison: Assess insurers for reliability and service quality.
- Needs Assessment: Tailor recommendations to your health, budget, and lifestyle.
Brokers provide free guidance, helping you enroll during your Medigap Open Enrollment Period to avoid medical underwriting. Contact a licensed broker to simplify your Medicare planning.