Medicare Part D

Medigap in Joliet: what Medicare Supplement really covers

JOLIET, Ill. — If you're new to Medicare, or helping a parent sort through the mail piling up on the kitchen table, one term keeps coming up: Medicare Supplement insurance, better known as Medigap. It's one of the most misunderstood pieces of the Medicare puzzle — and getting it wrong can lock you into more out-of-pocket costs than you expected.

Medigap, explained without the sales pitch

Here's a plain-language guide to what Medigap does, what it doesn't, and how to avoid a few common mistakes right here in Joliet.

What Medigap actually is

Medigap is private insurance you can buy to help pay some of the costs Original Medicare (Part A and Part B) leaves behind — things like coinsurance, copayments, and deductibles. It works with Original Medicare, not instead of it.

A few important ground rules from Medicare.gov:

• You must already be enrolled in Part A and Part B to buy a Medigap policy.
• Medigap only works with Original Medicare. It does not work with Medicare Advantage.
• Each Medigap policy covers one person. Spouses need their own policies.
• Medigap does not include prescription drug coverage. For drugs, you'd add a separate Part D plan.

Medigap also doesn't cover long-term care, most dental, vision, hearing aids, or private-duty nursing.

The standardized letters — A, B, D, G, K, L, M, N

This is where people get lost. Medigap plans are standardized by the federal government and labeled with letters. In most states, including Illinois, you'll see plans A, B, D, G, K, L, M, and N.

Here's the key point: a Plan G from one company covers the exact same core benefits as a Plan G from any other company. The letters tell you what is covered. The company you buy from determines the price and customer service — not the benefit design.

A few notes worth knowing:

• Plan F (and high-deductible Plan F) is only available if you became eligible for Medicare before January 1, 2020. If you turned 65 after that date, Plan F isn't an option for you.
• Plans K and L have out-of-pocket limits but cover a smaller share of certain costs.
• Plan N has some cost-sharing (like small copays for office visits and ER trips that don't result in admission).

You can see the full standardized benefit chart on Medicare.gov's Medigap pages.

Why timing matters more than almost anything

The single most important thing to understand about Medigap is the Medigap Open Enrollment Period. It's a one-time, six-month window that starts the month you're 65 and enrolled in Part B.

During that window:

• Insurance companies must sell you any Medigap policy they offer.
• They can't charge you more or deny you because of health conditions.

Miss that window, and in most cases insurers in Illinois can use medical underwriting — reviewing your health history — to decide whether to sell you a policy and at what price. That's the mistake that catches the most people off guard: assuming they can switch Medigap plans years later just as easily. Often, they can't.

Medigap vs. Medicare Advantage — a choice, not a combo

You cannot have both a Medigap policy and a Medicare Advantage plan at the same time. They are two different paths:

• Original Medicare + Medigap + a Part D drug plan — you stay in the federal program and add supplemental coverage.
• Medicare Advantage (Part C) — a private plan that replaces how you receive your Part A and Part B benefits, often with drug coverage bundled in.

Joliet is in Will County, where multiple Medicare Advantage plans and standalone Part D drug plans are offered each year. Availability and the specific carriers change annually, so plan counts are set at the county level — not by city or ZIP alone. The 2027 lineup is detailed in each plan's Annual Notice of Change and on the Plan Finder at Medicare.gov.

2026 and 2027 numbers worth writing down

Even if you go the Medigap route, some Medicare figures apply across the board. For 2026:

• Part D out-of-pocket cap: $2,100 in 2026 and $2,400 in 2027. Once your drug spending hits that, you pay nothing for covered drugs the rest of the year.
• Part D maximum deductible: $615 in 2026 and $700 in 2027 (plans can set a lower one).
• The "donut hole" is gone. As of 2025, Part D moved to three phases — deductible, initial coverage, and catastrophic.
• Medicare Prescription Payment Plan: an optional program that lets you spread your drug costs across the calendar year in monthly installments instead of paying at the pharmacy counter.
• IRMAA surcharges (higher Part B and Part D premiums for higher incomes) begin above $109,000 for a single filer in 2026.
• Annual Enrollment Period: October 15 – December 7 (for Part D and Medicare Advantage changes).
• Medicare Advantage Open Enrollment: January 1 – March 31.

Note: Medigap has its own enrollment rules and is not tied to the fall Annual Enrollment Period.

Common mistakes to avoid

• Assuming Medigap covers drugs. It doesn't. You need a separate Part D plan.
• Waiting past your six-month Medigap Open Enrollment window and expecting the same guaranteed rights later.
• Comparing Medigap plans by letter alone without comparing prices between companies — same benefits, different premiums.
• Trying to keep Medigap while switching to Medicare Advantage. You can't hold both.
• Forgetting the Part B requirement. You must be enrolled in Part B to have Medigap.