Medicare Supplement

Medigap in Birmingham: which standardized plan letters you can still buy in Alabama

If you live in Birmingham and you are pairing Original Medicare with a Medicare Supplement policy — often called Medigap — the first thing to know is that the coverage itself is set by the federal government. Every Medigap policy is labeled with a letter, and the benefits inside each letter are the same from one insurer to the next. What changes is who sells it, how they price it, and which letters they choose to offer.

Birmingham is in Jefferson County, where the Medicare.gov Medigap policy search currently lists 22 insurers offering Plans A, B, C, D, F, F-HD, G, G-HD, K, L, M and N in the ZIP 35203 area. That gives shoppers plenty of choice, but it also means the decision can feel bigger than it needs to be. This guide walks through how the letters work, which ones a newly eligible Alabamian can actually buy, and how a Medigap policy fits alongside Part D drug coverage.

How the standardized letters work

Medigap is regulated by the Centers for Medicare & Medicaid Services (CMS), and the letters are the same in Alabama as in most of the country. (Massachusetts, Minnesota and Wisconsin use their own standardization systems.) Each letter describes a fixed benefit package — for example, whether it pays your Part A hospital coinsurance, your Part B coinsurance, skilled nursing coinsurance, or the Part A and Part B deductibles.

Because the benefits are locked in by letter, "Plan G" means the same coverage no matter whose name is on the envelope. What differs between companies is price, customer service, how they handle rate increases over time, and any household or wellness perks they add on. Medicare.gov's Medigap policy search is the clearest place to compare which insurers file which letters in your ZIP.

Which letters you can buy in Alabama today

If you became eligible for Medicare on or after January 1, 2020, you can shop from these letters: A, B, D, G, G-HD, K, L, M and N. Plans C and F are still legally sold, but only to people who were eligible for Medicare before that 2020 cutoff, because both plans pay the Part B deductible and federal law no longer allows new enrollees to buy first-dollar Part B coverage.

Plan G is the most comprehensive letter open to new enrollees. Plan N trades a slightly lower premium for small copays at the doctor and emergency room. Plans K and L cap your out-of-pocket costs but only pay a percentage of certain services. Plan G-HD (high-deductible) has a lower premium in exchange for a yearly deductible before benefits kick in. Plans B, D and M sit in between and are sold by fewer companies.

Who sells Medigap in the Birmingham area

The table below lists every insurer filed for Alabama and the letters each one offers. Familiar names on that list include AARP - UnitedHealthcare Insurance Company, AFLAC, Bankers Life, BlueCross BlueShield of Alabama, Humana (Emphesys Insurance Company), Mutual of Omaha (Omaha Insurance Company), State Farm Mutual Automobile Insurance Company and USAA Life Insurance Company, among others. Not every insurer files every letter — for example, BlueCross BlueShield of Alabama files Plan A, while United American Insurance Company files a longer list including A, B, C, D, F, F-HD, G, G-HD, K, L and N.

Since the benefits inside a letter are identical by law, comparing across companies mostly comes down to price and service history. Because we cannot quote premiums here, and rates change, use the Medicare.gov policy search or the Alabama Department of Insurance rate guide to see current figures before you enroll.

How Medigap pairs with Original Medicare and Part D

A Medigap policy only works with Original Medicare (Part A and Part B). It helps pay the out-of-pocket amounts Original Medicare leaves behind — deductibles, coinsurance and copays that vary by letter. It does not work with a Medicare Advantage plan, and it does not include prescription drug coverage.

For drugs, you add a stand-alone Part D plan. Two 2026 numbers are worth writing down: the Part D out-of-pocket cap is $2,100, and the maximum Part D deductible a plan can charge is $615. The old coverage gap (the "donut hole") was eliminated in 2025, so Part D now has three phases instead of four. If your drug costs bunch up early in the year, you can also opt into the new Medicare Prescription Payment Plan, which spreads what you owe across monthly installments.

One more figure to keep in mind: IRMAA — the income-related surcharge that can raise your Part B and Part D premiums — begins above $109,000 in income for a single filer in 2026. It is based on your tax return from two years earlier.

Timing and the Alabama rules that shape your choice

The single most important date for a Medigap shopper is the start of your Medigap Open Enrollment Period. It is a six-month window that begins the month you are 65 or older and enrolled in Part B. During that window, insurers must sell you any Medigap policy they offer at their best available rate for your age, regardless of your health.

After that window closes, Alabama follows federal guaranteed-issue rules, but does not add extra protections like the "birthday rule" that some states use. Outside a guaranteed-issue situation, insurers in Alabama can use medical underwriting — meaning they can ask health questions and decide whether to offer you a policy and at what price. For questions about your specific rights, the Alabama Department of Insurance and the Alabama State Health Insurance Assistance Program (SHIP), known locally as SHIP/SenioRx, offer free counseling.

Also keep the annual calendar in mind: the Medicare Annual Enrollment Period runs October 15 through December 7, and Medicare Advantage Open Enrollment runs January 1 through March 31. Those are the windows that matter if you are also considering — or switching away from — a Medicare Advantage plan.

How to decide, step by step

A useful order of operations:

1. Confirm you want to be on Original Medicare rather than Medicare Advantage. Medigap only pairs with Original Medicare. 2. Decide which letter matches how you want to handle costs — more predictable monthly premium (G, N) versus lower premium and more cost-sharing (K, L, G-HD). 3. Once you have a letter in mind, compare the insurers offering that letter in your ZIP on Medicare.gov. 4. Line up a stand-alone Part D plan separately, since Medigap does not include drugs. 5. If you are not in your six-month Open Enrollment window, ask about underwriting before you apply.