My mother turned 65 during what I can only describe as the most confusing three months of her life. Not because of anything dramatic, but because of Medicare.
She had been healthy her whole life, rarely needed doctors, and assumed Medicare would simply cover what she needed the way her employer plan had for decades. What she discovered instead was a system of Parts, Supplements, Advantages, and Gaps that nobody had ever explained to her in plain language. She called me weekly with questions. I spent hours researching. By the end of it, I had a working knowledge of Medicare Supplement insurance that I genuinely wish I had from the start.
This guide is what I wish had existed during those three months. It covers the top Medicare Supplement plans available in 2026, how each one works, what they actually cost, and how to choose the right one for your specific situation without overpaying for coverage you do not need or underpaying for coverage that leaves you exposed.
Why Original Medicare Alone Is Not Enough for Most People
Before getting into supplement plans, it is worth understanding the coverage gap that makes them necessary in the first place.
Original Medicare consists of two parts. Part A covers hospital care, skilled nursing facility stays, hospice, and some home health services. Part B covers doctor visits, outpatient care, preventive services, and medical equipment. Together they cover a significant range of healthcare services.
What they do not cover is everything else. And the costs that fall outside coverage can be substantial:
Part A costs:
- Hospital deductible of $1,632 per benefit period in 2024 (adjusted annually)
- Daily coinsurance for extended hospital stays ($408 per day for days 61 to 90)
- Lifetime reserve day coinsurance ($816 per day)
- Skilled nursing facility coinsurance ($204 per day for days 21 to 100)
Part B costs:
- Annual deductible of $240 in 2024
- 20% coinsurance on all covered Part B services with no out-of-pocket maximum
That last point is the one that surprises most people. Medicare Part B has no cap on your out-of-pocket spending. If you have a serious illness that requires $200,000 in outpatient treatment and medical equipment, you owe 20% of that, which is $40,000, with no ceiling. For someone on a fixed retirement income, that exposure is catastrophic.
Medicare Supplement insurance, also called Medigap, exists specifically to fill these gaps. Medigap plans are sold by private insurance companies and are standardized by the federal government, meaning every Plan G from any insurer offers exactly the same benefits. The only difference between companies is the premium they charge and the quality of their service.
How Medicare Supplement Insurance Works
When you have both Original Medicare and a Medigap policy, claims work in a coordinated way.
Medicare pays its share of approved costs first. Your Medigap plan then pays its share of the remaining costs according to your specific plan’s benefits. In many cases, this coordination eliminates your out-of-pocket cost entirely for covered services.
You can use any doctor or hospital in the United States that accepts Medicare. There are no networks, no referrals required, and no prior authorization hoops for most services. This nationwide any-provider access is one of the most significant advantages of the Medigap system compared to Medicare Advantage plans, which typically use restricted networks.
Key eligibility rules:
- You must be enrolled in Medicare Part A and Part B to purchase a Medigap plan
- You pay a separate monthly premium to your Medigap insurer in addition to your Part B premium
- Medigap plans do not cover prescription drugs. For drug coverage, you need a separate Medicare Part D plan
- Medigap plans do not cover dental, vision, or hearing
- Each Medigap plan covers one person. Spouses must purchase separate policies
Open Enrollment Period: The six-month window beginning the month you are both 65 and enrolled in Part B is your Medigap Open Enrollment Period. During this window, insurers cannot deny you coverage or charge you more based on pre-existing health conditions regardless of your medical history. This is the most important window in the entire Medicare Supplement process, and purchasing during this period guarantees access to the best available pricing.
After Open Enrollment ends, insurers in most states can use medical underwriting, meaning they can charge you more, exclude pre-existing conditions, or deny you coverage based on your health history. This makes the Open Enrollment timing critically important.
The Standardized Medigap Plans: What Is Available in 2026
Medicare Supplement plans are labeled with letters: A, B, C, D, F, G, K, L, M, and N. Plans C and F are not available to people who became eligible for Medicare after January 1, 2020, due to changes in federal law. For most people turning 65 today, the relevant plans are A, B, D, G, K, L, M, and N.
Each lettered plan offers a specific set of benefits that is identical across all insurers offering that plan type. Here is what the core coverage components look like:
| Benefit | Plan A | Plan B | Plan D | Plan G | Plan K | Plan L | Plan M | Plan N |
|---|---|---|---|---|---|---|---|---|
| Part A coinsurance and hospital costs | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes |
| Part B coinsurance or copayment | Yes | Yes | Yes | Yes | 50% | 75% | Yes | Yes (with copays) |
| Blood (first 3 pints) | Yes | Yes | Yes | Yes | 50% | 75% | Yes | Yes |
| Part A hospice coinsurance | Yes | Yes | Yes | Yes | 50% | 75% | Yes | Yes |
| Skilled nursing facility coinsurance | No | No | Yes | Yes | 50% | 75% | Yes | Yes |
| Part A deductible | No | Yes | Yes | Yes | 50% | 75% | 50% | Yes |
| Part B deductible | No | No | No | No | No | No | No | No |
| Part B excess charges | No | No | No | Yes | No | No | No | No |
| Foreign travel emergency | No | No | 80% | 80% | No | No | 80% | 80% |
The three plans that matter most for the majority of new Medicare enrollees are Plan G, Plan N, and Plan A. Understanding the differences between these three covers the decision most people actually face.
Plan G: The Most Comprehensive Option for New Enrollees
Since Plan F was closed to new enrollees in 2020, Plan G has become the most comprehensive Medicare Supplement plan available to people turning 65 today. It covers virtually everything Original Medicare does not cover, with a single exception: the Part B annual deductible, which is $240 in 2024.
What Plan G covers:
- Part A hospital coinsurance and costs up to 365 additional days after Medicare benefits end
- Part A deductible ($1,632 per benefit period)
- Part A hospice care coinsurance or copayment
- Skilled nursing facility care coinsurance
- Part B coinsurance or copayment (the 20% you would otherwise owe on all outpatient services)
- Part B excess charges (what doctors who don’t accept Medicare assignment can charge above Medicare rates)
- Foreign travel emergency care (80% up to plan limits after a deductible)
- First three pints of blood
After paying the $240 Part B deductible at the start of each year, you essentially have no further out-of-pocket costs for Medicare-covered services for the rest of the year. Doctor visits, specialist appointments, outpatient procedures, and hospital stays are covered in full.
Who Plan G is right for: Plan G is the right choice if you want maximum predictability and protection against large unexpected medical costs. It is particularly valuable for people with chronic conditions, those who anticipate frequent medical care, or anyone who prioritizes financial certainty in retirement over premium optimization.
Typical monthly premium range: $120 to $280 depending on age, gender, location, and insurer. Premiums vary significantly between companies offering identical benefits.
Pros:
- Most comprehensive coverage available to new enrollees
- Predictable costs with essentially no surprise bills for covered services
- Works with any doctor or hospital that accepts Medicare nationwide
- Covers foreign travel emergencies, valuable for people who travel internationally
- Part B excess charge coverage protects against non-participating providers
Cons:
- Highest premium of the commonly chosen plans
- The $240 Part B deductible is the only gap, making the premium cost hard to justify versus Plan N for healthy individuals who rarely use healthcare
Plan N: The Best Value for Healthy Enrollees
Plan N offers strong coverage at a meaningfully lower premium than Plan G, making it the best value option for people who are generally healthy and do not frequently use outpatient medical services.
Plan N covers everything Plan G covers with two differences:
- You pay a copayment of up to $20 for office visits and up to $50 for emergency room visits that do not result in an inpatient admission
- Plan N does not cover Part B excess charges. If you see a doctor who does not accept Medicare assignment, you may owe the difference between their charge and the Medicare-approved amount, up to 15% above Medicare rates
Who Plan N is right for: Plan N makes financial sense if you are in good health, do not have chronic conditions requiring frequent doctor visits, and primarily see doctors who accept Medicare assignment (the majority of US doctors do). The premium savings relative to Plan G are typically $30 to $80 per month, which is $360 to $960 per year. If you have fewer than a dozen doctor visits per year, the copay costs are likely less than the premium savings.
Typical monthly premium range: $90 to $200 depending on age, gender, location, and insurer.
Pros:
- Significantly lower premium than Plan G
- Strong coverage for hospital stays and major medical events
- No annual out-of-pocket maximum for covered services (copays aside)
- Works with any Medicare-accepting provider nationwide
Cons:
- Copays add up if you have frequent office visits or emergency room trips
- No Part B excess charge coverage creates exposure with non-participating doctors
- Requires more active cost management than Plan G
Plan A: The Bare Bones Option
Plan A is the minimum standardized Medigap plan and covers only the most basic benefits: Part A hospital coinsurance and extended hospital costs, Part B coinsurance, the first three pints of blood, and Part A hospice coinsurance.
It does not cover the Part A deductible, skilled nursing facility coinsurance, the Part B deductible, or foreign travel emergencies.
Plan A’s premium is lower than G or N, but the coverage gaps it leaves are significant enough that most insurance advisors do not recommend it as a primary Medigap option. The Part A hospital deductible alone, at $1,632 per benefit period, can exceed the premium savings in a single hospitalization.
Who Plan A might be appropriate for: Individuals who want the basic guarantee that Medicare’s coinsurance is covered but have assets sufficient to absorb the deductibles and other gaps without financial hardship. For most people, Plan G or Plan N offers materially better protection at a premium difference that is easy to justify.
Plan K and Plan L: The Cost-Sharing Options
Plans K and L are structured differently from the other Medigap plans. Rather than covering most costs in full, they share costs with you at 50% (Plan K) or 75% (Plan L).
Both plans have annual out-of-pocket limits, which are $7,060 for Plan K and $3,530 for Plan L in 2024. Once you reach the annual limit, the plan covers 100% of covered costs for the rest of the year.
These plans carry lower premiums than G or N but create uncertainty about annual costs that many people find uncomfortable. They are most appropriate for individuals who are in excellent health and want to minimize premiums while having a defined worst-case annual cost ceiling.
High-Deductible Plan G: An Underrated Option
High-Deductible Plan G is a variant of standard Plan G that carries a deductible of $2,800 in 2024. After you pay $2,800 in covered costs out of pocket in a calendar year, the plan functions identically to standard Plan G, covering everything in full.
The premium for High-Deductible Plan G is significantly lower than standard Plan G, typically $30 to $70 per month compared to $120 to $280 for standard Plan G.
The math makes this plan attractive for healthy individuals who rarely incur significant medical costs. If you go most years with minimal healthcare usage, the premium savings over standard Plan G exceed the deductible in four to six years. When a significant medical event does occur, your maximum exposure is capped at $2,800 for the year.
Who High-Deductible Plan G is right for: Individuals in good health who want catastrophic protection with the lowest possible ongoing premium. It is not the right choice for people with chronic conditions or those who anticipate regular significant healthcare use.
Top Insurance Companies Offering Medigap Plans in 2026
Remember: the benefits of any lettered plan are identical regardless of which insurer sells it. Every Plan G covers the same things. What differs between companies is the premium they charge, their financial stability, and the quality of their customer service and claims processing.
AARP/UnitedHealthcare
AARP endorses UnitedHealthcare’s Medigap products and together they represent the largest Medicare Supplement market share in the country. The AARP branding provides significant consumer recognition and trust, and UnitedHealthcare’s financial strength rating is A from AM Best.
Their pricing is not always the lowest, but their stability, claims processing reputation, and broad availability across states make them a top consideration for most enrollees.
Pros:
- Widest availability across all 50 states
- Strong financial stability
- Household discounts when two people in the same household purchase coverage
- Stable rate history in most markets
Cons:
- Premiums often higher than some competitors
- AARP membership required (modest annual fee)
Mutual of Omaha
Mutual of Omaha has been a Medicare Supplement specialist for decades and consistently earns strong marks for customer service and claims handling. Their premiums are competitive in most markets, and their Plan G and Plan N products are among the most purchased in the country.
Pros:
- Strong customer satisfaction ratings
- Competitive pricing in most states
- High financial strength rating (A+ from AM Best)
- Efficient claims processing
Cons:
- Not available in all states
- Rate increases in some markets have been above average in recent years
Cigna
Cigna offers competitive Medigap pricing in many markets and has a strong reputation for straightforward claims processing. Their Plan G and Plan N products are worth including in any quote comparison.
Pros:
- Competitive pricing in many markets
- Strong customer service ratings
- Good financial stability
Cons:
- Market availability varies by state
- Fewer plan type options than some larger carriers
Humana
Humana is one of the largest Medicare insurers in the country and offers Medigap products alongside their Medicare Advantage business. Their pricing is competitive and they have strong market presence in most states.
Pros:
- Broad market availability
- Competitive pricing in many markets
- Strong Medicare expertise
Cons:
- Some rate increase history that varies significantly by market
- Customer service ratings vary by region
Anthem Blue Cross Blue Shield
Anthem’s Blue Cross Blue Shield affiliates offer Medigap plans in many states with the regional brand recognition that comes from decades of health insurance presence. Pricing and availability vary by state affiliate.
Pros:
- Strong regional brand recognition
- Broad provider relationships
- Competitive pricing in many markets
Cons:
- Quality and pricing vary significantly between state affiliates
- Not a single national experience
How Medigap Premiums Are Calculated: Three Pricing Methods
Not all Medigap plans are priced the same way. Understanding the three rating methods helps you evaluate long-term cost, not just today’s premium.
Community-rated (also called no-age-rated) Everyone in the same area pays the same premium regardless of age. Premiums may increase over time due to inflation and healthcare cost trends, but not because you are getting older. This method typically results in higher initial premiums for younger enrollees and lower long-term cost increases.
Issue-age-rated Your premium is based on your age when you first purchase the policy and does not increase as you age. Premiums can still increase due to inflation and trend factors, but your age is locked in at enrollment. Younger enrollees benefit from lower base rates.
Attained-age-rated Your premium increases each year as you age, in addition to any inflation-based increases. This method typically produces the lowest initial premium but the highest long-term cost. Premiums can become significantly more expensive in your 70s and 80s under this method.
When comparing quotes between companies, ask specifically which rating method each company uses. A community-rated plan with a slightly higher initial premium may cost significantly less over a ten-year period than an attained-age-rated plan that starts lower but increases rapidly.
How to Choose the Right Medigap Plan for Your Situation
There is no universally correct answer. The right plan depends on your health status, your financial situation, your risk tolerance, and how you use healthcare.
If you have chronic conditions or expect frequent medical care: Plan G provides the most comprehensive protection. The predictable annual cost, after the $240 Part B deductible, is worth the higher premium for people who regularly use healthcare services. Knowing you will not receive a surprise bill regardless of how much care you need is genuinely valuable.
If you are generally healthy and want to optimize cost: Plan N offers the best combination of meaningful coverage and lower premium. The copays are manageable if your healthcare usage is low, and the premium savings are real. High-Deductible Plan G is worth considering if you want even lower premiums and can absorb the $2,800 annual deductible in a high-use year.
If you travel internationally: Plans G and N both include foreign travel emergency coverage at 80% up to plan limits after a $250 deductible, up to a lifetime maximum of $50,000. If you spend significant time abroad, this coverage matters and is one reason Plan G or N is preferable to Plan A or B for international travelers.
Work with an independent Medicare insurance agent: An independent agent who represents multiple carriers can provide side-by-side quotes for identical plans from different companies and help you understand the rating method each company uses. Since Medigap agent commissions are regulated and cannot exceed certain limits, their compensation does not vary dramatically between companies, reducing the conflict of interest that exists in some insurance sales contexts.
Medigap vs Medicare Advantage: A Critical Distinction
Medicare Advantage (Part C) is an entirely separate alternative to the Medigap system. Understanding the difference is critical to making the right enrollment decision.
| Feature | Medigap with Original Medicare | Medicare Advantage |
|---|---|---|
| Provider access | Any Medicare-accepting provider nationwide | Usually restricted to plan network |
| Referrals required | No | Often yes, for HMO plans |
| Out-of-pocket maximum | Effectively zero with Plan G (after Part B deductible) | Varies, up to $8,850 per year in many plans |
| Premium | Monthly Medigap premium plus Part B premium | Often low or $0, but cost-sharing applies |
| Drug coverage | Requires separate Part D plan | Often included |
| Extra benefits | Rarely | Often includes dental, vision, hearing |
| Predictability | Very high | Lower, depends on utilization and plan |
Medicare Advantage plans often advertise $0 premiums and extra benefits that appeal to budget-conscious enrollees. But the network restrictions, referral requirements, and potential for high out-of-pocket costs in a serious illness year make them a meaningfully different product from Original Medicare with a Medigap supplement.
For people who want maximum freedom of provider choice and maximum predictability of costs, the Medigap path is generally the stronger option. For people who are healthy, budget-constrained, and comfortable with network-based care, Medicare Advantage deserves consideration.
The key is understanding the tradeoffs clearly before making a decision you may not be able to easily reverse without medical underwriting.
Frequently Asked Questions
Q1: Can I switch Medigap plans after my Open Enrollment Period ends?
Yes, but with significant limitations. Outside of your initial Open Enrollment Period, most states allow insurers to use medical underwriting when you apply to switch or purchase a new Medigap plan. This means they can charge you more, exclude coverage for pre-existing conditions, or deny you coverage based on your health history. A small number of states, including Connecticut, Maine, Massachusetts, New York, and a few others, have more consumer-friendly guaranteed issue rules that extend beyond Open Enrollment. If you are in one of these states, your options are broader. In all other states, the importance of choosing the right plan during your initial Open Enrollment window cannot be overstated.
Q2: Does Medigap cover prescription drugs?
No. Medigap plans do not include prescription drug coverage. For drug coverage, you need to enroll in a separate Medicare Part D prescription drug plan. If you have a Medigap policy and want drug coverage, you purchase a stand-alone Part D plan in addition to your Medigap policy. The annual Part D enrollment period runs from October 15 to December 7 each year. Failing to enroll in Part D when first eligible can result in a late enrollment penalty that increases your Part D premium permanently.
Q3: If I am still working at 65 and have employer health insurance, should I still buy Medigap?
Not necessarily, and the answer depends on your specific employer coverage. If you work for an employer with 20 or more employees, your employer plan is primary and Medicare is secondary. In this case, you may not need Medigap immediately, and delaying Medicare Part B enrollment is often advisable to avoid paying the Part B premium unnecessarily. When you eventually retire and lose employer coverage, you will have a Special Enrollment Period to sign up for Part B and begin your Medigap Open Enrollment period. Plan this transition carefully, ideally with guidance from a Medicare specialist, to avoid gaps in coverage and premium penalties.
Q4: What is the difference between Medigap and Medicare Supplement insurance?
Nothing. They are the same thing. Medigap is the informal common name for Medicare Supplement insurance, the standardized private insurance plans that fill the coverage gaps in Original Medicare. Both terms refer to identical products. You may see either term used in government publications, insurance company materials, and consumer guides. The formal name in federal regulations is Medicare Supplement insurance, but Medigap is equally recognized and commonly used.
Q5: How much can Medigap premiums increase over time, and can the insurer cancel my policy?
Medigap premiums can and do increase over time due to healthcare cost trends, claims experience in your market, and, for attained-age-rated plans, your increasing age. Premium increases require state insurance department approval in most states and must be applied uniformly to all policyholders of the same plan in the same market. Insurers cannot single out individual policyholders for rate increases based on their health claims. Importantly, as long as you pay your premium on time, your Medigap insurer cannot cancel your policy or refuse to renew it regardless of how much healthcare you use or how your health changes. This guaranteed renewability is one of the most important protections in the Medigap system.
Conclusion
Medicare Supplement insurance is one of the most consequential financial decisions most Americans make at 65, and it is also one of the least well-understood. The combination of standardized plan letters, private insurer variation in pricing, complex premium rating methods, and limited windows of guaranteed access creates a system that is genuinely difficult to navigate without a clear guide.
What the research consistently shows, and what my own experience helping my mother through this process confirmed, is that the initial Open Enrollment window matters more than any other single factor. Getting into the right plan at the right price during that six-month window, when medical underwriting cannot be used against you, sets the foundation for your healthcare cost structure for years.
For most people turning 65 today, Plan G and Plan N are the plans worth comparing most seriously. Plan G offers the most comprehensive coverage with the highest predictability. Plan N offers meaningful coverage at a lower premium for healthier individuals who want to optimize cost. High-Deductible Plan G is the right conversation for people in excellent health who want a catastrophic protection floor at minimal ongoing cost.
Get quotes from at least three to four carriers, understand the rating method each uses, and work with an independent agent who can help you compare options across insurers rather than pushing a single company’s product.
The goal is not the cheapest plan. The goal is the right plan for your health situation, your financial situation, and your peace of mind in retirement. Those three things together, not the monthly premium alone, are what should drive the decision.