Medicare Supplement

Same Medigap Letter, Same Rules: What G, N, K, L Actually Pay

# Same Medigap Letter, Same Rules: What G, N, K, L Actually Pay

LANCASTER, Calif. — If you've started shopping for a Medicare Supplement policy, you've probably noticed the same letters showing up across every brochure: Plan G, Plan N, Plan K, Plan L, and a "high-deductible" version of Plan G. That's not marketing. Those letters are set by federal law, which means Plan G from one company covers the same gaps as Plan G from any other company. The price and the customer service can vary. The benefits inside the letter cannot.

Lancaster is in Los Angeles County, where Original Medicare beneficiaries have the option to pair their coverage with a standardized Medigap policy instead of enrolling in a Medicare Advantage plan. Here's what each letter actually does — and does not — cover, based on the federal rules published at Medicare.gov.

Why the letters exist in the first place

Before standardization, Medigap policies were a confusing patchwork. Congress fixed that by requiring insurers to sell coverage inside a set of lettered boxes. Every company that sells Plan G has to include the same list of benefits in that plan. The same is true for Plan N, Plan K, Plan L, and every other lettered plan.

What changes from company to company is the monthly premium, how they handle rate increases over time, and extras like a gym benefit or 24-hour nurse line. The core medical coverage does not.

What Plan G covers

Plan G is one of the most comprehensive Medigap options available to people new to Medicare. It pays the Part A hospital coinsurance and gives you an extra 365 days of hospital coverage after Medicare benefits are used up. It covers the Part B coinsurance or copayment, the first three pints of blood each year, hospice coinsurance, skilled nursing facility coinsurance, and the Part A deductible.

The one thing Plan G does not cover is the annual Part B deductible. You pay that yourself before the plan starts filling in the gaps.

What high-deductible Plan G changes

High-deductible Plan G includes the same benefit list as regular Plan G. The difference is that you have to meet a separate plan deductible — set each year by the federal government — before the coverage kicks in. Premiums tend to be lower to reflect that trade-off, but you're taking on more upfront risk.

What Plan N covers

Plan N covers most of the same items as Plan G, with two wrinkles. You may owe a copay of up to $20 for some office visits and up to $50 for an emergency room visit that does not lead to a hospital admission. Plan N also does not cover Part B "excess charges" — the amount some providers can bill above the Medicare-approved rate. Plan G does cover those excess charges.

What Plans K and L do differently

Plans K and L work more like traditional cost-sharing coverage. Instead of paying most gaps in full, they pay a percentage:

• Plan K pays 50% of many covered costs, including the Part A deductible, Part B coinsurance, and skilled nursing facility coinsurance. You pay the other 50% until you hit an annual out-of-pocket limit set by Medicare, after which the plan pays 100% of Medicare-covered services for the rest of the year.
• Plan L works the same way but pays 75% instead of 50%, with its own annual out-of-pocket limit.

These two plans typically carry lower premiums than Plan G, in exchange for more cost-sharing along the way.

Plans C and F: why you may not see them offered

If you became eligible for Medicare on or after January 1, 2020, you cannot buy Plan C or Plan F as a new enrollee. Federal law closed those plans to newly eligible beneficiaries because they covered the Part B deductible, which Congress wanted to phase out of Medigap for new enrollees. People who were already eligible before that date can generally still buy or keep them.

What Medigap never covers

No matter which letter you pick, standard Medigap policies do not include prescription drug coverage. For prescriptions, you would need a separate Part D plan. Medigap also does not cover routine dental, vision, hearing aids, long-term custodial care, or private-duty nursing.

For 2026, Part D has an out-of-pocket cap of $2,100 and a maximum deductible of $615. The old "donut hole" coverage gap was eliminated in 2025, so Part D now has three phases instead of four. If drug costs land in big lumps, the Medicare Prescription Payment Plan lets you spread them across the year.

A note for readers in three states

If you have family in Massachusetts, Minnesota, or Wisconsin, know that those three states standardize Medigap plans differently. The letter chart described above does not apply the same way there. Everywhere else — including California — the federal letters are the rule.