For Consumers

What is a Medigap plan and why should I buy it?

A Medigap plan (also called a Medicare Supplement), sold by private companies, can help pay some of the health care costs Original Medicare doesn't cover, like copayments, coinsurance and deductibles.

Some Medigap plans also offer coverage for services that Original Medicare doesn't cover, like medical care when you travel outside the U.S. If you have Original Medicare and you buy a Medigap plan, Medicare will pay its share of the Medicare-approved amount for covered health care costs. Then your Medigap plan pays its share.

What are the differences between Medigap and Medicare Advantage plans?

A Medigap plan is different from a Medicare Advantage (MA) plan (PDF, 107KB). MA plans are a way to get Medicare benefits, while a Medigap only supplements your Original Medicare benefits.

A comparison of Medigap and Medicare Advantage plans

 

Medigap plans

Medicare Advantage plans

Premium costs

Higher premiums
$44 - 392 per month
(estimated)

Lower premiums
$0 - 295 per month
(estimated)

Out-of-pocket costs

Fewer out-of-pocket costs

More out-of-pocket costs

Where you can get care

Works in any state

Works only in your state, by region

Provider network

Don't need a provider network (unless you buy a Medigap Select plan)

Must use a provider network

Prescription drugs (Part D)

Medicare Part D not included

Medicare Part D usually included

Things to consider before you buy a plan

  • You must have Medicare Part A and Part B.
  • If you have a Medicare Advantage (MA) plan, you can apply for a Medigap policy, but make sure you leave the MA plan before your Medigap plan starts.
  • You pay the private insurance company a monthly premium for your Medigap plan in addition to the monthly Part B premium you pay to Medicare.
  • A Medigap plan only covers one person. If you and your spouse both want Medigap coverage, you'll each have to buy separate policies.
  • You can buy a Medigap plan from any insurance company that's licensed in your state to sell one.
  • Any standardized Medigap plan is guaranteed renewable even if you have health problems. This means the insurance company can't cancel your Medigap plan as long as you pay the premium.