Medigap is extra health insurance that helps cover the gaps in Medicare, like deductibles, copays, and coinsurance, so your medical bills are more predictable.
Understanding Medigap in Plain English
Medigap, also called Medicare Supplement Insurance, is a type of private health insurance designed to work alongside Original Medicare (Part A and Part B). Medicare covers a lot of healthcare costs, but it doesn’t pay for everything. That’s where Medigap comes in.
Think of Medicare as the main foundation of your health coverage. Medigap is the extra layer that helps fill in the cracks—those out-of-pocket costs that can add up quickly when you visit the doctor, stay in the hospital, or need frequent care.
Medigap is sold by private insurance companies, but it’s regulated by the government. That means the benefits are standardized and clearly defined, making it easier to compare plans.
Why Medigap Exists
Even with Medicare, you’re often responsible for things like:
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Deductibles
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Copayments
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Coinsurance
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Certain hospital costs after a long stay
For example, Medicare Part B usually covers 80% of approved medical services. That remaining 20%? You’re responsible for it—and there’s no yearly out-of-pocket cap. If you have ongoing medical needs, those costs can become stressful.
Medigap helps by paying some or all of those leftover expenses, depending on the plan you choose.
How Medigap Works With Medicare
Medigap only works with Original Medicare (Part A and Part B). When you receive medical care:
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Medicare pays its share first.
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Your Medigap policy then pays its portion.
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You’re left with little to nothing out of pocket for covered services.
It’s important to know that Medigap does not replace Medicare. It simply supplements it.
Also, Medigap plans generally let you see any doctor or hospital that accepts Medicare, without needing referrals. That flexibility is one of the biggest reasons people choose Medigap.
What Medigap Does Not Cover
While Medigap is helpful, it doesn’t cover everything. Most Medigap plans do not include:
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Prescription drugs
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Dental care
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Vision care
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Hearing aids
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Long-term care
Prescription drug coverage is handled separately through Medicare Part D. If drugs are important to you, you’ll usually need a standalone Part D plan along with Medigap.
Standardized Medigap Plans
Medigap plans are labeled with letters, such as Plan A, Plan G, or Plan N. Each plan letter offers a specific set of benefits. For example, a Plan G from one insurance company must offer the same coverage as Plan G from another company—the only difference is the price and customer service.
This standardization makes shopping easier because you’re comparing costs, not confusing benefit details.
Who Might Consider Medigap?
Medigap can be a good fit for people who:
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Want predictable healthcare costs
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Visit doctors often or have chronic conditions
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Travel within the U.S. and want broad provider access
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Prefer fewer surprise medical bills
For instance, if you’re retired and living on a fixed income, Medigap can help you budget more confidently by reducing unexpected expenses.
Medigap vs. Medicare Advantage
Many people confuse Medigap with Medicare Advantage, but they’re very different. Medicare Advantage replaces Original Medicare and usually has networks and copays. Medigap keeps Original Medicare and simply helps pay what Medicare doesn’t.
If you value flexibility and simplicity, Medigap often feels more straightforward.
The Bottom Line
Medigap is supplementary private health insurance that helps cover the costs Medicare leaves behind. It doesn’t replace Medicare—it strengthens it. For many people, Medigap offers peace of mind, predictable expenses, and the freedom to choose doctors without worrying about large medical bills.
If understanding healthcare coverage feels overwhelming, Medigap is one option designed to make Medicare easier to live with, not harder.
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