Medicare Supplement

Medigap in 2026: What Medicare Supplement Actually Covers

TUSCALOOSA, Ala. — With Medicare's Annual Enrollment Period running Oct. 15 through Dec. 7, a lot of people across West Alabama are trying to sort out one of the most confusing parts of the program: Medicare Supplement insurance, better known as Medigap.

Medigap isn't Medicare Advantage. It isn't a drug plan. It's a separate kind of coverage that works alongside Original Medicare to help pay some of the costs Medicare leaves behind. Here's a plain-English look at how it works in 2026.

What Medigap actually does

Original Medicare (Part A and Part B) pays a big share of your hospital and doctor bills, but not all of it. You're still on the hook for things like the Part A hospital deductible, the Part B 20% coinsurance, and other out-of-pocket costs.

A Medigap policy is sold by private insurance companies and helps fill in those gaps. Depending on which policy you choose, it can help pay deductibles, coinsurance, and copayments tied to Original Medicare.

Medigap does not cover:

• Prescription drugs (you'd need a separate Part D plan)
• Long-term care
• Vision, dental, or hearing
• Private-duty nursing

How the standardized letters work

Here's the part that trips people up. Medigap plans are standardized by the federal government and labeled with letters — Plan A, B, C, D, F, G, K, L, M, and N. (Plans C and F are generally only available to people who became eligible for Medicare before Jan. 1, 2020.)

The letter tells you what the plan covers. That means a Plan G sold by one company covers the same core benefits as a Plan G sold by another company. What can differ is the price and the customer service.

Massachusetts, Minnesota, and Wisconsin standardize their Medigap plans differently, but Alabama follows the standard federal lettering.

Availability in and around Tuscaloosa

Tuscaloosa is in Tuscaloosa County, where Medigap policies are regulated at the state level through the Alabama Department of Insurance. Unlike Medicare Advantage, Medigap plans are not tied to a county service area in the same way — insurers file their plans with the state, and you generally can apply as long as the carrier sells that lettered plan in Alabama.

For a full list of carriers licensed to sell Medigap in Alabama, Medicare's plan finder at Medicare.gov lets you search by ZIP code to see who offers which lettered plans in the Tuscaloosa area.

The enrollment window that matters most

The single most important date for Medigap isn't in the fall — it's your Medigap Open Enrollment Period. This is a one-time, six-month window that starts the month you're 65 and enrolled in Part B.

During that window:

• Insurers can't turn you down for health reasons.
• They can't charge you more because of a pre-existing condition.
• You have "guaranteed issue" rights.

Miss it, and outside of a few special situations, insurers in Alabama can use medical underwriting — meaning they can review your health history and either charge more or decline to cover you.

How Medigap fits with 2026 Medicare changes

Medigap doesn't cover prescriptions, but 2026 brings some important drug-cost changes worth knowing if you also have Part D:

• The Part D out-of-pocket cap is $2,100 in 2026.
• The Part D maximum deductible is $615.
• The old "donut hole" coverage gap was eliminated in 2025; Part D now has three phases.
• The Medicare Prescription Payment Plan lets you spread your drug costs across the year in monthly installments if you choose.
• IRMAA income-related surcharges start above $109,000 for single filers in 2026.

If you have a Medigap policy, none of this changes your supplement coverage — but it may affect the drug plan you pair with it.

Medigap vs. Medicare Advantage: pick one lane

You cannot use a Medigap policy with a Medicare Advantage plan. Medigap only works with Original Medicare. If you switch to Medicare Advantage, your supplement won't pay anything toward your Advantage plan's costs.

That's why the choice between Original Medicare + Medigap + Part D, versus Medicare Advantage, is really a fork in the road. The Medicare Advantage Open Enrollment Period (Jan. 1 – March 31) lets people already in an Advantage plan switch or return to Original Medicare, but going back to Medigap later may involve underwriting.