Choosing a Medigap Policy: What You Need to Know First
If you’re approaching 65 or are already enrolled in Medicare, you’ve likely encountered the term Medigap. Medigap, also known as Medicare Supplement Insurance, helps cover out-of-pocket costs not paid by Original Medicare, such as deductibles, copayments, and coinsurance. In 2025, navigating the world of Medigap has become more streamlined but also slightly more complex due to plan changes, insurer options, and state-specific rules. Choosing a Medigap policy is now more critical than ever due to evolving healthcare costs and changing Medicare coverage rules.
Why Choosing a Medigap Policy Matters
Medicare alone doesn’t cover everything. With high deductibles and 20% coinsurance for many services, a sudden illness or chronic condition could lead to significant out-of-pocket costs. That’s where Medigap policies come into play.
Choosing a Medigap policy isn’t just about plugging coverage gaps. It’s about gaining peace of mind, predictable healthcare expenses, and flexible provider options without the need for referrals.
Who Is Eligible for a Medigap Plan?
To purchase a Medigap policy, you must:
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Be enrolled in Medicare Part A and Part B
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Be 65 or older (in most states)
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Not enrolled in a Medicare Advantage Plan (you can’t have both)
Some states offer Medigap to individuals under 65 with disabilities, but options and availability can vary. The best time to enroll is during your Medigap Open Enrollment Period—a one-time six-month window that begins when you turn 65 and are enrolled in Medicare Part B.
How Medigap Complements Original Medicare
Original Medicare covers roughly 80% of approved medical costs. The remaining 20% can stack up fast, especially for hospital stays or frequent doctor visits. Medigap helps fill these gaps, offering coverage for:
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Part A coinsurance and hospital costs
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Part B coinsurance and copayments
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Blood (first 3 pints)
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Skilled nursing facility coinsurance
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Foreign travel emergency (depending on the plan)
Types of Medigap Policies Available in 2025
In 2025, there are 10 standardized Medigap plans in most states, labeled A through N. Each plan offers a different level of coverage, and the benefits of each specific letter plan are the same across all insurance companies.
Plan A
Plan A offers the most basic coverage and is the only plan all Medigap insurers must offer. It includes:
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Part A coinsurance and hospital costs
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Part B coinsurance or copayment
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Blood (first 3 pints)
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Part A hospice care coinsurance
Plan B
Plan B includes everything in Plan A plus:
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Medicare Part A deductible
Plan G
Plan G is the most comprehensive Medigap plan available to new enrollees in 2025. It covers everything except the Medicare Part B deductible.
Plan K
Plan K covers a percentage (usually 50%) of most benefits but features a lower premium. It also includes an out-of-pocket maximum, which can be a safety net for those who want to limit expenses.
Plan N
Plan N is a popular, cost-effective choice that covers most services but requires copayments for doctor and ER visits.
Call the official Medicare helpline at 1-800-MEDICARE (1-800-633-4227) to ask your questions or get more information.
What Has Changed in Medigap Plans for 2025?
Since 2020, Plans C and F are no longer available to new Medicare enrollees. This remains true in 2025. However, beneficiaries who enrolled in Medicare before 2020 can keep or switch to those plans.
Other changes in 2025 include:
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Adjusted premium pricing due to inflation and claims data
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Enhanced digital tools from insurers for comparing plans
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More state-specific variations and rules
Step-by-Step Guide to Choosing the Right Medigap Policy
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Understand Your Coverage Needs: Consider your health, medications, frequency of care, and travel habits.
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Compare Plan Types: Use the Medigap comparison chart provided by Medicare.gov.
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Check Prices: Premiums can vary significantly between insurance companies for the same plan.
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Research Companies: Look at financial stability and customer service ratings.
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Enroll During the Open Enrollment Period: Avoid underwriting and denial of coverage.
Comparing Medigap vs. Medicare Advantage
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Provider Flexibility:
Medigap allows you to see any provider who accepts Medicare, while Medicare Advantage typically uses a network of doctors and may limit your choices (HMO/PPO). -
Referrals Needed:
Medigap does not require referrals to see specialists. With Medicare Advantage, referrals are sometimes required, depending on the plan. -
Prescription Drugs:
Medigap plans do not include prescription drug coverage—you’ll need a separate Part D plan. Medicare Advantage plans often include drug coverage. -
Coverage Abroad:
Some Medigap plans offer coverage when traveling outside the U.S. Medicare Advantage plans rarely include international coverage. -
Premiums:
Medigap plans usually have higher monthly premiums, while Medicare Advantage plans often have lower premiums, sometimes even $0.
Factors to Consider Before Choosing a Medigap Plan
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Budget: Monthly premiums vary based on plan, age, and insurer.
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Health Status: Chronic conditions may require more comprehensive coverage.
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Location: Medigap rules and availability differ by state.
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Travel Habits: Frequent travelers may prefer plans with foreign travel emergency coverage.
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Future Needs: Choose a plan that suits long-term healthcare usage.
How to Enroll in a Medigap Policy
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Enroll in Medicare Part A and B
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Research Available Medigap Plans in Your Area
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Request Quotes from Multiple Insurers
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Submit Application During Open Enrollment
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Confirm Your Coverage Start Date
Visit Medicare.gov to compare available Medigap policies and request official plan booklets.
Costs Associated with Medigap Plans in 2025
While Medigap plans are standardized, premiums vary. In 2025, average monthly costs range from $90 to $300+, depending on:
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Plan type (e.g., Plan G vs. Plan N)
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Age (attained-age vs. community-rated policies)
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Gender
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Location
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Tobacco use
Be aware of potential rate increases as you age.
Understanding Guaranteed Issue Rights
Guaranteed Issue Rights (or “Medigap protections”) allow you to buy a policy without medical underwriting under specific circumstances, such as:
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Losing Medicare Advantage coverage
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Moving out of a plan’s service area
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Your current Medigap insurer going out of business
These rights ensure you’re not denied coverage or charged more due to health conditions.
Medigap Coverage for Travel and Foreign Emergency Care
Only Plans C, D, F, G, M, and N offer foreign travel emergency coverage:
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Covers 80% of emergency medical care abroad
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Lifetime limit of $50,000
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Typically requires a $250 deductible
This feature is essential for retirees who travel outside the U.S.
Tips for Saving Money on Medigap Insurance
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Compare at least 3 insurers
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Choose the right plan for your needs—don’t overpay
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Consider high-deductible versions of Plan G
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Check eligibility for household discounts
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Avoid late enrollment penalties
Reliable Sources for Researching Medigap Plans
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Medicare.gov
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State Health Insurance Assistance Programs (SHIP)
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National Association of Insurance Commissioners (NAIC)
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Local insurance brokers with Medigap expertise
Frequently Asked Questions (FAQs)
What Medigap plan do most people choose?
As of 2025, Plan G is the most popular Medigap plan for new enrollees. It offers comprehensive coverage with fewer out-of-pocket costs compared to other plans. For those eligible before 2020, Plan F remains widely chosen.
What is the downside to Medigap plans?
Downsides include:
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Higher monthly premiums
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No coverage for prescription drugs (must get Part D separately)
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Limited to Original Medicare’s structure (no dental, vision, or hearing unless added separately)
Do I really need a Medigap policy?
If you’re enrolled in Original Medicare and want to avoid unexpected out-of-pocket costs, a Medigap policy is often a smart investment, especially if you have frequent medical visits or travel extensively.
Are Medigap policies being phased out?
Only Plans C and F are being phased out for new Medicare enrollees after 2020. All other Medigap plans remain available and stable in 2025. Individuals eligible before 2020 may still purchase Plans C and F.
Can I change my Medigap policy later?
Yes, but you may be subject to medical underwriting unless you qualify for a special enrollment period with guaranteed issue rights.
What’s the best time to buy a Medigap policy?
The best time is during your six-month Medigap Open Enrollment Period, which begins the first month you’re 65 and enrolled in Medicare Part B.
Final Thoughts
Choosing a Medigap policy in 2025 is a crucial step toward securing your healthcare future. With rising medical costs and gaps in Original Medicare coverage, the right Medigap plan offers peace of mind, flexibility, and protection against unforeseen expenses.
By understanding your needs, comparing available options, and acting during your optimal enrollment window, you’ll ensure you get the best value and most appropriate coverage. Whether you travel frequently, manage chronic conditions, or simply want predictable costs, there’s a Medigap plan designed to support your lifestyle.
Say goodbye to confusing Medicare options. Visit NewMedicare.com or call 📞 (833) 203-6742 for expert help.
