Medicare 2026

Medicare SELECT Explained: The Medigap Policy That Uses a Hospital Network

Medicare SELECT is a type of Medigap policy sold in some states. It works like any other standardized Medigap plan, with one important twist: you generally need to use hospitals — and in some cases doctors — inside the policy's network to get the full Medigap benefit. In exchange for agreeing to that network, SELECT policies generally cost less than other Medigap policies with the same letter.

If that trade-off sounds familiar, it's because many people face a similar choice between Original Medicare paired with Medigap (broad provider access, higher premiums) and Medicare Advantage (often lower premiums, provider networks and plan rules). Medicare SELECT sits inside the Medigap world but borrows the network idea. Whether it fits your situation depends on where you live, where you'd want to be treated, and how much flexibility you want.

How Medicare SELECT works

With a regular Medigap policy, you can see any provider in the country that accepts Medicare, and your Medigap plan pays its share of the coinsurance, copays or deductibles the plan is designed to cover.

A Medicare SELECT policy covers the same standardized benefits for its plan letter, but it builds in a network. If you use a network hospital — and, where the policy requires it, a network doctor — for non-emergency care, the policy pays its full share as expected. If you go outside that network for non-emergency services, you may have to pay some or all of the costs the Medigap policy would normally pick up.

One important thing stays the same either way: Medicare itself still pays its share of covered services no matter which Medicare-participating hospital or doctor you choose. The network rules only affect what the SELECT policy pays on top of Medicare.

Emergencies and urgent out-of-network care

Federal law protects you when something unexpected happens. A Medicare SELECT policy must pay full benefits for out-of-network care that is medically necessary and immediately required because of an unforeseen illness, injury or condition, when it isn't reasonable to get the care through the network. So if you're traveling, or an emergency happens far from a network hospital, the SELECT policy is required to step in.

What the insurer must tell you up front

When you enroll in a Medicare SELECT policy, the insurer is required to walk you through several things in writing:

• How the policy pays — and doesn't pay — when you use providers outside the network.
• How the policy handles out-of-area and emergency care.
• The availability of a standard (non-SELECT) Medigap policy, including its premium.

You'll be asked to acknowledge that you received this explanation. Read it carefully; it's the clearest side-by-side comparison you'll see of the trade-off you're accepting in return for a lower premium.

Changing your mind: the 12-month right

If you buy a Medicare SELECT policy and later decide the network isn't a fit, you have the right to switch to a standard Medigap policy within 12 months. That's a meaningful safety net and worth knowing before you sign up.

There's also a specific protection if you dropped a prior Medigap policy to try SELECT for the first time and have had the SELECT policy less than a year: you can "buy back" your former Medigap policy if the same insurer still sells it. If that isn't possible, you have the right to buy Medigap Plan A, B, C, D, F or G from an insurance company in your state. Plans C and F are only available to people who were eligible for Medicare before January 1, 2020; people who became eligible for Medicare on or after that date have the right to buy Plan D or G instead.

If you move out of the service area

Because SELECT policies rely on a local hospital network, moving out of the service area triggers special rights. You have two options:

• Buy a standardized Medigap policy from your current insurer with the same or fewer benefits. If you've had the SELECT policy more than six months, no medical questions are allowed.
• Use a guaranteed-issue right to buy Medigap Plan A, B, C, D, F or G sold in your state or the state you're moving to. (Again, Plans C and F are only available to people eligible for Medicare before January 1, 2020; others have the right to buy Plan D or G.)

Timing matters. You can apply as early as 60 days before your SELECT policy ends and no later than 63 days after it ends. Mark those dates on your calendar as soon as a move is on the horizon.

Is a SELECT policy right for you?

There's no universal answer. A SELECT policy can be attractive if the network hospitals are ones you'd choose anyway and the lower premium matters in your budget. On the other hand, a standard Medigap policy keeps your choices wide open nationwide. Some people also compare these options against Medicare Advantage, which bundles hospital, medical and usually drug coverage with its own network rules and out-of-pocket maximum. Each path has trade-offs, and the right fit depends on your health, your travel patterns, your providers and your finances.

A few program notes for 2027

Separate from Medigap, if you also have Part D drug coverage, the Part D out-of-pocket cap is $2,400 in 2027 (it is $2,100 in 2026). The most any Part D plan may charge as a deductible in 2027 is $700. The Part D base beneficiary premium — a national figure used to calculate the late-enrollment penalty — is $41.33 in 2027; actual plan premiums are set plan by plan. The Medicare Annual Enrollment Period runs October 15 – December 7, 2026, with choices taking effect January 1, 2027. Social Security announced a 3.6 percent cost-of-living adjustment for benefits payable beginning January 2027.

The 2027 Part B standard premium and deductible, and the 2027 IRMAA income brackets, have not yet been announced; CMS typically releases those figures in the fall.

If you have Medicaid or qualify for Extra Help with drug costs, you have a monthly Special Enrollment Period to move to Original Medicare with a stand-alone Part D plan, or to switch stand-alone Part D plans. Full-benefit dual-eligible individuals can also join an integrated Dual Eligible Special Needs Plan (D-SNP) in any month.

Where to learn more

For plan availability, enrollment rules and updated figures as they're published, visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048. Medicare SELECT availability and network details vary by insurer and state, so confirm the specifics before you enroll.