Original Medicare (Parts A and B) is a strong foundation — but it was never designed to cover everything. The gaps it leaves can expose you to thousands of dollars in out-of-pocket costs each year. A Medicare Supplement plan, also called Medigap, fills those gaps and gives you predictable, controlled healthcare costs for the rest of your life.
What Original Medicare Doesn’t Cover
Most people are surprised by how much Original Medicare leaves unpaid. Here are the most significant gaps:
- Part A deductible: $1,632 per benefit period in 2024 — and you can be charged multiple times per year if you’re hospitalized more than once
- Part A coinsurance: $408/day for hospital stays of 61–90 days, and $816/day for lifetime reserve days
- Part B deductible: $240 per year, paid before Medicare begins covering outpatient services
- Part B coinsurance: You pay 20% of all Medicare-approved outpatient costs with no annual cap — a $100,000 cancer treatment could leave you with a $20,000 bill
- No out-of-pocket maximum: Unlike private insurance, Original Medicare has no annual limit on your total expenses
- Skilled nursing facility coinsurance: $204/day for days 21–100 of skilled nursing care
- Foreign travel emergencies: Medicare provides virtually no coverage outside the United States
How Medigap Fills the Gaps
A Medigap plan works alongside Original Medicare to pay costs that Medicare doesn’t cover. Depending on the plan you choose, Medigap can cover your Part A and Part B deductibles, the 20% coinsurance that Medicare leaves unpaid, skilled nursing facility costs, and emergency care abroad. The most popular plans — Plan G and Plan N — cover nearly everything after Medicare pays its share, leaving you with minimal or zero exposure at the point of care.
Key Benefits of Owning a Medigap Plan
Predictable, Controlled Healthcare Costs
With Medigap, you know exactly what your healthcare will cost each month — your premium — and your out-of-pocket exposure is dramatically reduced. No surprise bills, no large deductibles hitting unexpectedly, no 20% coinsurance on a major procedure. For people on fixed retirement incomes, this financial predictability is one of the most valuable features any insurance product can offer.
No Networks — See Any Doctor Who Accepts Medicare
Medigap plans have no provider networks. If a doctor, hospital, or specialist accepts Medicare — anywhere in the United States — your Medigap plan covers you there. You never need a referral, never need to check if a provider is “in-network,” and never face out-of-network penalties. This is a significant advantage over Medicare Advantage plans, which typically restrict you to a local network and require referrals to see specialists.
Your Coverage Travels With You Across the Country
Because Medigap works with Medicare and has no networks, your coverage travels wherever you go in the U.S. Snowbirds, frequent travelers, and retirees with family in multiple states particularly value this benefit. Whether you’re receiving care at the Mayo Clinic in Minnesota, visiting family in Florida, or spending the winter in Arizona, your plan covers you exactly the same way.
Guaranteed Renewable — Cannot Be Cancelled
As long as you pay your premium, your Medigap plan cannot be cancelled — regardless of your health status, your age, or how many claims you make. This is a federal guarantee. Unlike employer health coverage or marketplace plans, your Medigap insurer cannot drop you or charge you more based on your personal health history.
Coverage Moves With You If You Relocate
If you move to a new state or zip code, your Medigap coverage continues seamlessly — your premium simply adjusts to the rates for your new area. In most states you don’t need to re-apply or re-qualify medically. Your plan moves with you without interruption.
Doctor-Driven Care — No Prior Authorization Required
With Medigap, it is Medicare — not an insurance company — that determines what care is covered. If Medicare approves a treatment, test, or procedure, your Medigap plan must cover its share of the cost. There are no pre-certification requirements, no utilization reviews, and no insurance company second-guessing your doctor’s recommendations. You get the care your doctor orders.
No Copayments at the Point of Service
With most Medigap plans — particularly Plan G — there are no copayments due when you receive care. After Medicare processes the claim and pays its portion, your Medigap plan covers the remainder. You walk out of the doctor’s office or hospital without writing a check.
Access to the Nation’s Best Medical Centers
Medigap covers care at any facility that accepts Medicare — including elite institutions such as the Mayo Clinic, MD Anderson Cancer Center, Cleveland Clinic, and Johns Hopkins. If you ever face a serious diagnosis, you can seek the best specialist or treatment center in the country without worrying about network restrictions or out-of-network costs.
Medigap vs. Medicare Advantage: A Key Distinction
Medicare Advantage (Part C) is the other main alternative to Original Medicare. It often carries low or $0 monthly premiums and can bundle in dental, vision, and drug coverage — which makes it appear attractive on the surface. But it comes with real tradeoffs: local provider networks, referral requirements, prior authorization for many procedures, and out-of-pocket maximums that can reach $8,000 or more in a given year.
Medigap typically costs more in monthly premiums, but provides significantly more freedom, predictability, and financial protection — especially for people who use healthcare regularly, have complex medical needs, travel frequently, or simply want the peace of mind of knowing their costs are controlled. When people calculate their actual total out-of-pocket exposure under each option, Medigap is often the better financial value.
When to Enroll in Medigap
The best time to enroll in a Medigap plan is during your Medigap Open Enrollment Period — the six-month window that begins the month you turn 65 and are enrolled in Medicare Part B. During this window, insurance companies are legally required to sell you any Medigap plan they offer at standard rates, regardless of your health history. Outside of this window, insurers can medically underwrite and may charge higher premiums or decline coverage in most states. Enrolling at the right time protects both your access and your rate.
Call us at 1-888-972-0024 for a free comparison of Medigap plans and rates from all major carriers in your area. As independent brokers, we represent every major insurer offering Medigap plans and will help you find the best coverage at the lowest available rate — at no cost to you.