Medicare Supplement

What Is Medicare Supplement (Medigap)?

Medicare Supplement plans—also known as Medigap, are offered by private insurance companies to help cover the out-of-pocket costs not paid by Original Medicare, such as deductibles, copayments, and coinsurance.

As of 2021, nearly 41% of individuals enrolled in Original Medicare, approximately 12.5 million people, enhanced their coverage with a Medigap plan, according to the Kaiser Family Foundation.

There are 10 standardized Medigap plans available, labeled A through N, each offering different levels of coverage. While these plans help reduce your share of costs for Medicare-approved services, they do not include prescription drug coverage. For that, you’ll need to enroll in a separate Medicare Part D plan.

Understanding Medigap Enrollment Timelines

If You’re Turning 65:

Your six-month Medigap Open Enrollment Period is a critical window. It begins the first day of the month you turn 65 and are enrolled in Medicare Part B. For example, if your 65th birthday is in July and you enroll in Part B the same month, your Medigap enrollment period runs from July through December.

During this time, you’re guaranteed the right to purchase any Medigap plan available in your state—without medical underwriting. This means insurers cannot deny you coverage, delay your benefits, or charge more due to preexisting conditions. Enrolling during this window ensures the widest range of plan options at the best possible rates.

If You’re 65 or Older and Applying After the Enrollment Period:

If you miss your initial six-month window, insurance companies are not required to sell you a Medigap policy. They may:

Request your medical history
Delay or deny coverage
Charge higher premiums based on health status

Because of this, applying early is always in your best interest.

If You’re Under 65:

Federal law doesn’t require insurers to offer Medigap plans to individuals under 65. However, some states do require it, often for individuals with disabilities. Availability and eligibility requirements vary by state, so it’s important to speak with a licensed agent to understand your options.

Why Choose a Medicare Supplement (Medigap) Plan?

A Medicare Supplement plan helps make your healthcare expenses more predictable, offering peace of mind and easier budgeting. Rather than facing uncertain out-of-pocket costs each time you visit the doctor or hospital, Medigap provides consistent cost-sharing, so you know what to expect.

One of the biggest advantages? Freedom to choose any doctor or hospital nationwide that accepts Medicare, no referrals or networks required. Whether you're seeing a local specialist or traveling across the country to a facility like the Mayo Clinic, you have the flexibility to access care when and where you need it.

However, many people underestimate the long-term value of Medigap coverage when they first enroll in Medicare. Often in good health, they may opt for a lower-cost Medicare Advantage plan without considering how their needs may change if they develop serious health conditions later. And switching from Medicare Advantage to Medigap can be complicated.

For example, if you try Medicare Advantage for the first time and decide it's not a good fit, federal law gives you a one-time, 12-month trial right to return to Original Medicare and purchase a Medigap plan—without underwriting. After that, switching requires either a qualifying Special Enrollment Period or applying during Open Enrollment, with no guarantee you’ll be approved for Medigap.

If you're thinking about leaving your Medicare Advantage plan and enrolling in a Medigap plan, it’s wise to speak with your State Health Insurance Assistance Program (SHIP) or consult with one of Halcyon’s licensed Medicare advisors to understand your options.

Ultimately, your decision may come down to budget. While Medigap plans typically have higher monthly premiums than Medicare Advantage plans, they offer fewer surprises and more flexibility when it comes to accessing care.

What About Dental, Vision, and Hearing?

A recent analysis by The Commonwealth Fund revealed that only about 7% of Medicare Supplement (Medigap) plans offer additional benefits like vision, dental, and hearing services—care that’s not typically covered by Original Medicare.

Most people aren’t aware that some Medigap plans include benefits similar to those found in Medicare Advantage. These plans remain limited in number but represent an important opportunity for individuals seeking more comprehensive coverage.

At the federal level, there’s ongoing debate about how to structure and expand access to these services. For example, the American Dental Association is advocating for the creation of a separate program to deliver full dental benefits for low-income older adults, rather than folding those services into Medicare Part B as proposed in previous legislation.

“We need full oral health coverage in Medicare, as well as vision and hearing,” says Amber Christ, Directing Attorney at Justice in Aging. “Today, nearly 32 million Medicare enrollees, about half, have no dental coverage at all. That includes many older adults and people with disabilities.”

At Halcyon Insurance Agency, we understand that coverage gaps in dental, vision, and hearing can lead to larger health and financial issues over time. We can help you compare your Medigap options and explore additional stand-alone plans to meet your full range of healthcare needs.

How Much Do Medicare Supplement Plans Cost?

Monthly premiums for Medicare Supplement (Medigap) plans typically range between $150 and $200, though costs can vary based on your state, insurance provider, and the specific plan you choose.

Just like with Medicare Advantage, it pays to compare. According to a price analysis by eHealth, Inc., 65-year-olds can save an average of $840 per year with Plan G or $648 per year with Plan N simply by enrolling in the lowest-cost option available in their area.