Medicare Supplement
Medigap in San Diego: What Those Letter Plans Really Cover
SAN DIEGO — If you have Original Medicare (Part A and Part B), you've probably noticed something uncomfortable: Medicare pays a lot, but it doesn't pay everything. There are deductibles, coinsurance amounts, and no yearly limit on what you could owe out of pocket.
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Click to call 855-729-3240Key takeaways
- Medigap is private insurance that helps pay costs Original Medicare leaves behind, like deductibles and coinsurance, but you can't have both Medigap and a Medicare Advantage plan at the same time.
- In most states, Medigap plans are standardized letters (A, B, C, D, F, G, K, L, M, N), so a given letter offers the same basic benefits no matter which company sells it, though premiums and extras can vary; Plans C and F are only open to people eligible for Medicare before January 1, 2020.
- The best time to buy a Medigap policy is during your six-month Medigap Open Enrollment Period, which starts the first day of the month you're 65 or older and enrolled in Part B, because insurers can't deny coverage or charge more based on health during that window.
- Outside that enrollment window, insurers in most states can use medical underwriting, though California's Birthday Rule offers an extra yearly chance to switch Medigap plans with equal or lesser benefits without health questions.
The point of a Medigap plan
That's the gap Medicare Supplement insurance — often called Medigap — is designed to fill. A Medigap policy is sold by a private insurance company and works alongside Original Medicare. When Medicare pays its share of a covered service, your Medigap plan picks up some or all of what's left, depending on the letter plan you choose.
Medigap is not the same thing as a Medicare Advantage plan (Part C). In fact, it's illegal for anyone to sell you a Medigap policy if you're already enrolled in Medicare Advantage. The two are different roads, and you pick one.
How the "letter plans" work
Here's the part that trips people up. In most states, Medigap plans are standardized and named with letters: A, B, C, D, F, G, K, L, M, and N. (Plans C and F are only available to people who were eligible for Medicare before January 1, 2020.)
Standardized means the benefits inside each letter are set by federal rules. Plan G sold by one company covers the same things as Plan G sold by another company. What can differ is the monthly premium, the customer service, and any extra perks the insurer chooses to add.
That's why comparing Medigap plans is really a two-step process:
1. Decide which letter matches the level of coverage you want. 2. Then compare companies offering that letter in your area.
You can review the benefits chart for each letter at Medicare.gov's Medigap section.
What Medigap generally helps with
Depending on the letter you pick, a Medigap policy may help pay for:
- Part A hospital coinsurance and extra hospital days after Medicare benefits are used up
- Part B coinsurance or copayments
- The first three pints of blood each year
- Part A hospice care coinsurance
- Skilled nursing facility coinsurance
- Part A and, in some plans, Part B deductibles
- Limited emergency care during foreign travel (in certain plans)
Some letters, like K and L, share costs with you up to a yearly out-of-pocket limit, then pay 100% after that. Plan N uses small copays for some office and emergency room visits.
What Medigap does NOT cover
This is where readers sometimes get surprised, so it's worth being plain. Medigap policies generally do not cover:
- Prescription drugs. For that, you'd need a separate Part D drug plan. In 2026, Part D has a $2,100 annual out-of-pocket cap and a maximum deductible of $615, and the old "donut hole" coverage gap has been eliminated as of 2025. Medicare also offers an optional Medicare Prescription Payment Plan that spreads drug costs across the year.
- Routine dental, vision, or hearing care
- Long-term care (like ongoing help in a nursing home)
- Private-duty nursing
- Eyeglasses and hearing aids
If those things matter to you, you'll want to think about how to cover them separately.
Timing matters more than most people realize
The best window to buy a Medigap policy is your Medigap Open Enrollment Period — the six months that begin the first day of the month you're both 65 or older and enrolled in Part B. During this window, insurers cannot deny you coverage or charge you more because of your health.
Outside that window, in most states, insurers can use medical underwriting. That means past or current health conditions can affect whether you get a policy and what you pay.
California has an additional protection worth knowing about: the California Birthday Rule. Each year around your birthday, you have a set window to switch to another Medigap plan with equal or lesser benefits from any carrier, without medical underwriting. The California Department of Insurance and your local SHIP counselor can walk you through the details.
The local picture in San Diego
San Diego is in San Diego County, where Medicare beneficiaries have access to a wide range of private Medicare options, including Medicare Advantage plans, standalone Part D drug plans, and Medigap policies from multiple carriers. Availability of specific Medigap letters and pricing is set at the state and county level and can change year to year.
To see the Medigap policies currently sold in your ZIP code, use the plan finder at Medicare.gov or call 1-800-MEDICARE (TTY 1-877-486-2048), which is available 24 hours a day, seven days a week.
For free, unbiased one-on-one help in San Diego County, you can reach HICAP (California's SHIP program), which serves local Medicare beneficiaries with counselors who don't sell insurance and aren't paid on commission.
By the numbers
Medicare Part B premium, 2006–2026
The standard monthly Part B premium has climbed from $88.50 in 2006 to $202.90 in 2026. Hover any point for that year’s premium.
Source: CMS. Standard premium shown; in some hold-harmless years many existing enrollees paid less. Confirm at Medicare.gov.
By the numbers
How people get Medicare in San Diego County
(MA penetration in San Diego County)
MA penetration from CMS enrollment data; Medigap share is an estimate. U.S. average is about 54% Medicare Advantage. These are area-level figures, not plan-specific.
Explore
The parts of Medicare
Explore
When can you enroll? An interactive year
Enrollment windows are federal and the same nationwide. Confirm your personal dates at Medicare.gov or 1-800-MEDICARE.
Good to know
Frequently asked questions
Do I need a Medigap plan if I already have Medicare Advantage?
Does Medigap cover my prescriptions?
Can I switch Medigap plans later?
- CMS — Medicare basics (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.