Medicare Supplement (Medigap)
A private policy that pairs with Original Medicare and pays the costs Medicare leaves to the patient. "Gap" is literal. Medigap fills the financial gaps in Medicare.
What Medigap is and what it covers
Medigap doesn't replace Medicare, and it isn't an alternative to Medicare Advantage. It's a separate decision your parent makes on top of Original Medicare (Parts A and B).
When using Original-Medicare-covered care, your parent normally pays some of the cost themselves:
- Deductible on a hospital stay.
- 20% of approved costs for doctor visits, after the annual Part B deductible.
- Coinsurance on longer hospital or rehab stays.
Medigap covers some or all of those costs. The exact scope depends on the lettered plan chosen. Some policies also cover emergency care abroad, relevant for parents traveling to Poland.
What Medigap doesn't cover
Just as important as what's covered:
- Prescription drugs. A separate Part D plan is needed. More on the Part D page.
- Long-term care. Like permanent nursing-home residency unrelated to rehab.
- Routine dental, vision, hearing aids. Beyond what Medicare itself covers, which is very limited.
- Private at-home nursing beyond what Medicare covers.
How "lettered plans" work
Medigap policies are federally standardized by CMS. A plan with the same letter offers exactly the same benefits, no matter which insurance company sells it.
Plans are labeled by letter: Plan F, Plan G, Plan N, Plan K, Plan L, and others. Plan G from Carrier A covers exactly the same things as Plan G from Carrier B. The only difference is price.
So the decision becomes two steps:
- First, pick the letter. That sets the benefits.
- Then, pick the carrier. Compare prices for that same letter across insurers.
Our role: help you understand what each letter covers, then find a carrier with a fair price and a stable rate history. Prices shift yearly. The cheapest company one year isn't necessarily cheapest the next.
Note for parents in Massachusetts, Minnesota, or Wisconsin. Those states have their own Medigap systems that differ from the federal standardization.
- IEP · Initial Enrollment Period
7 months: the 3 months before the month you turn 65, that month, and the 3 months after.
- Medigap · Medicare Supplement Insurance open enrollment (private policy)
6 months from the first day of the month you are 65 or older and have Part B.
- AEP · Annual Election Period
October 15 – December 7, every year. Changes take effect January 1.
- MA-OEP · Medicare Advantage Open Enrollment
January 1 – March 31, only for people already in a Medicare Advantage plan.
- SEP · Special Election Periods
After certain events, such as a move or losing coverage from work. Each has its own conditions.
* In this drawing Part B starts in the birthday month. If it starts later, the Medigap window moves with it.
Source: Medicare.gov, checked October 15, 2026.
The critical, one-time six-month window
One of the most common sources of regret in Medicare. Read this carefully.
Your parent has a one-time, six-month window called the Medigap Open Enrollment Period. It starts the month they turn 65, as long as Part B is active. During this window, three guarantees apply:
- Guaranteed issue. An insurance company cannot refuse a Medigap policy.
- No medical underwriting. The carrier cannot ask health questions.
- No health-based pricing. The insurance company can't charge more because of past or present health problems.
This window opens only once in a lifetime. After it closes, most states allow carriers to require medical underwriting, refuse a policy, or charge higher rates based on health.
In the states where we serve clients (Illinois, Florida, Colorado, Arizona), post-65 guaranteed-issue rights are limited. So if your parent is considering Medigap, we recommend talking to an agent at the start of the six-month window, not at the end.
Exceptions exist. Guaranteed issue applies in certain situations: losing employer group coverage, moving outside an Advantage plan's service area during a "trial right" period, and others. Even after the standard window closes, it's worth a conversation. Sometimes there's a path.
Medigap under 65 and pairing with Part D
If your parent qualified for Medicare due to disability before 65, Medigap access is limited. Some states guarantee it for under-65 beneficiaries; others don't. Illinois, Florida, Colorado, and Arizona each have their own rules. Call us. We'll walk you through what's available in your situation.
Once your parent turns 65, the standard six-month window opens, regardless of whether they had Medicare via disability earlier.
Medigap doesn't cover drugs, so the "Original Medicare + Medigap" path almost always also includes a standalone Part D plan. Otherwise there's a lifetime penalty risk and no drug coverage at all.
The combination Original Medicare + Medigap + Part D is the classic setup for people who value:
- Freedom to see any doctor across the U.S., no network restrictions.
- Predictable, low out-of-pocket costs at visits.
- Independence from yearly network changes.
Medicare Advantage: a private company’s plan approved by Medicare. Medigap: a private policy.
| Comparison | Medicare Advantagea private company’s plan approved by Medicare | Original Medicare + Medigap + Part DMedigap is a private policy |
|---|---|---|
| Choice of doctors | The plan’s network; some plans also cover out-of-network doctors | Doctors anywhere in the U.S. who accept Medicare |
| Travel in the U.S. | Usually suits people who rarely leave their state; emergencies are covered anywhere in the U.S. | Usually suits people who travel often |
| How many plans | One plan; most plans also include Part D | Original Medicare, Medigap and a separate Part D plan |
| Monthly rate | Often lower | Usually higher |
| Costs when you get care | Depend on the plan; every plan has a yearly limit on what you pay for covered Medicare services | Usually more predictable with Medigap; Original Medicare alone has no yearly limit |
| Prior authorizations | Most plans require them for some services | Usually far fewer |
Neither option is better for everyone: it depends on your doctors, prescriptions, travel and budget. A general comparison with no company or plan names.
Changing plans, and the Medigap vs. Advantage decision
A Medigap plan can be changed at any time, but without an open enrollment window, the insurer can require medical underwriting and refuse coverage or charge more. So it's worth reviewing the policy regularly: not just price, but the carrier's rate stability. In some cases (e.g., when the current carrier hikes rates), it's possible to switch and keep a good rate. We work through those individually.
Choosing Medicare Advantage at 65 and then trying to switch back to Original + Medigap two years later can be hard, no guaranteed issue, underwriting required. This is not a one-year decision.
That's why it's worth talking through with an agent who'll explain the long-term implications, not just the next year's premium.
How we help
We're a licensed, independent agency serving Polish-speaking families across 18 states. We explain in Polish to your parent what each lettered plan covers, compare carrier prices, and help with enrollment, ideally before the six-month window closes.
Working with our agency costs your family nothing. Agents are paid directly by the insurance carriers.
Wszystko jak należy. Dziękuję Let's talk through Medigap.
The six-month window is shorter than it sounds, and options narrow after it closes. Schedule a no-obligation Polish/English consultation. We'll walk through what's available calmly.
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