Medigap is a supplemental insurance policy sold by private companies to help fill “gaps” in the Original Medicare coverage.

Medigap policies sold after January 1, 2006 aren't allowed to include prescription drug coverage.¹

Medigap plans (Plans C and F) sold to Medicare beneficiaries enrolled on or after January 1, 2020 will no longer cover the Part B deductible and are no longer available to people new to Medicare. If a beneficiary were eligible for Medicare before January 1, 2020, but not yet enrolled, they may be eligible for a Medigap plan that covers the Part B deductible. Any beneficiary who already had Plan C or F before January 1, 2020, can keep the coverage.¹

Original Medicare does not cover all the health care costs for a beneficiary, a Medigap policy can help pay for costs, like: copayments, coinsurance, or deductibles.

In order to attain a Medigap policy a beneficiary must have Medicare Part A and Part B. A Medigap policy is different from a Medicare Advantage Plan, which is original Medicare benefits administered through a private insurer. Unless a beneficiary plans to return from a Medicare Advantage plan to original Medicare it is illegal for them to have a Medigap policy. Medicare enrollees can purchase a Medigap policy from any insurance company that's licensed in their state to sell them. A beneficiary will pay Medigap premiums in addition to those required by their Medicare plan.¹

Medigap is supplemental insurance, therefore Medicare pays its share of the covered health care costs, then the Medigap policy pays its share. Medigap policies don't cover: long-term care, vision, dental, hearing aids, eyeglasses, or private-duty nursing.² Health insurance companies use three pricing methods for Medigap plans:

• Community-rated: Premiums are not rated based on age, gender, health status, or claims history in a specific area.

• Issue-age-rated: Premiums based on the age at which you purchased the policy.

• Attained-age-rated: Premiums increase with age.²

While Medigap provides a financial cushion for Medicare beneficiaries and for services covered under Parts A and B, Medigap premiums can be costly and can rise with age.³ 

In 2018, over one-fifth of the 54.5 million medicare beneficiaries, elected Medigap supplemental insurance.³ 

Estimated average monthly premiums for Medigap policies range from $150 to around $200.²

Some Medigap policies also cover medical care if a beneficiary travels outside the U.S.¹

1. What's Medicare Supplement Insurance (Medigap)?. Medicare.gov. https://www.medicare.gov/supplements-other-insurance/whats-medicare-supplement-insurance-medigap. 

2. Cost of Supplemental Health Insurance for Seniors. HealthMarkets. https://www.healthmarkets.com/resources/medicare/cost-of-supplemental-health-insurance-for-seniors/. Published 2021.

3. Koma W, Cubanski J, Neuman T. A Snapshot Of Sources Of Coverage Among Medicare Beneficiaries In 2018. Kaiser Family Foundation; 2021. https://www.kff.org/medicare/issue-brief/a-snapshot-of-sources-of-coverage-among-medicare-beneficiaries-in-2018/.