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How Medigap Works

Medigap can be purchased from private insurance companies in each state. There are 11 different standard Medigap plans that can be sold in most states. The 11 standard plans are labeled A-D, F, high-deductible F, G and K-N. Each of these plans covers different services. Starting 2020, Plan C and Plan F (including high deductible F) are no longer being sold to new Medicare beneficiaries including those who turn 65 or become eligible due to disability or diagnosis (ESRD, ALS) on or after January 1, 2020.

Massachusetts, Minnesota and Wisconsin all have their own standardized plans that can be purchased.

A graph that compares coverage of benefits compared across 10 different Medigap plans.

What doctors can be seen with Medigap?

With Medigap, any doctor can be seen whether they accept Medicare assignments or not.

  • If the doctor “accepts assignment,” meaning they agree to be paid the Medicare-approved amount for a service, Medigap insurance companies usually pay doctors directly.

  • If the doctor does not accept Medicare assignments, send claims to the insurance company and costs must be paid out-of-pocket.

Medigap plans generally do not pay for care received outside of the United States, except for medically necessary emergency care that occurs during the first 60 days of a trip.

Medigap Rights

Do you have a specific scenario and want to know your rights when buying a Medigap policy? Learn about your rights.

People who purchase a Medigap policy have certain rights which include:

  • Free look periods

  • Pre-existing condition wait periods

  • Guaranteed issue rights

  • Renewals

These rights offer protection from being denied coverage. They also protect from having to keep a plan that is not a good fit. If consideration are being made about purchasing a Medigap plan, or already owned, keep these tips in mind.


Related Content

Changing Medigap Plan After Purchase
By law, when a Medigap policy has been purchased, there is a 30-day “free look” or trial period. The plan can be canceled, and money refunded if unsatisfied.
What is Medigap?
Medigap is supplemental insurance that can be used along with Medicare Parts A & B. Medicare covers many healthcare costs, but it does not pay for everything.
Changing Medicare Part D Plans
Most people are allowed to switch Part D plans once a year, during the Annual Election/Open Enrollment Period (October 15 – December 7).

Age Well Planner is an educational website created by nonprofit the National Council on Aging (NCOA). We provide information, resources, and referrals on topics such as: Benefits, Income, and Medicare.

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