Medicare Supplement

Medigap in Dover, Delaware: What Medicare Supplement Really Covers

DOVER, Del. — If you have Original Medicare and keep hearing about "Medicare Supplement" or "Medigap," you're not alone. These are private insurance policies designed to help pay some of the out-of-pocket costs Original Medicare leaves behind — things like coinsurance, copays, and hospital deductibles. They don't replace Medicare. They work alongside it.

Medigap, explained for Dover readers

Here in Dover, retirees juggling Bayhealth appointments, specialists in Wilmington, or a winter trip south often ask the same thing: what does Medigap actually do, and how do those letter plans work? Let's walk through it in plain English.

What Medigap does — and doesn't — cover

Medigap policies fill in the "gaps" in Part A (hospital) and Part B (medical) coverage. Depending on the letter plan you choose, that can include:

• The Part A hospital deductible and coinsurance
• Part B coinsurance or copays (usually the 20% Medicare doesn't pay)
• The first three pints of blood
• Hospice coinsurance
• Skilled nursing facility coinsurance
• Some foreign travel emergency care (on certain plans)

Here's what Medigap does not cover: prescription drugs, dental, vision, hearing aids, long-term custodial care, or private-duty nursing. For prescriptions, you'd add a stand-alone Part D drug plan. For dental and vision, you'd need separate coverage.

One more important point: Medigap only works with Original Medicare. You can't use a Medigap policy to pay costs under a Medicare Advantage plan.

The standardized letter plans

This is where it gets easier than it looks. In most states, including Delaware, Medigap policies are standardized by letter — Plans A, B, C, D, F, G, K, L, M, and N. That means Plan G from one insurance company covers the exact same things as Plan G from another company. The benefits are set by federal rules.

What can differ between carriers? The price, the customer service, and how they handle rate increases over time. But the coverage inside a lettered plan is identical.

A few things worth knowing:

• Plans C and F are only available to people who were eligible for Medicare before January 1, 2020. If you became eligible after that date, those two are off the table.
• Plan G and Plan N are the most common choices for newer enrollees.
• Plans K and L have lower premiums but higher out-of-pocket shares.
• High-deductible versions of Plan G and Plan F exist for people who want lower premiums and are comfortable paying more upfront before coverage kicks in.

When you can buy a Medigap policy in Delaware

Timing matters more with Medigap than almost anything else in Medicare. Your best window is your Medigap Open Enrollment Period — the six months that begin the month you're 65 and enrolled in Part B. During that window, insurers must sell you any Medigap policy they offer, at their best available rate, regardless of your health history.

Miss that window, and in most cases insurers in Delaware can use medical underwriting — meaning they can ask about your health, charge you more, or turn you down — unless you qualify for a guaranteed issue right (for example, if a plan you had is ending).

That's why Medigap decisions often deserve more thought than people realize at 65. You may not get the same shot later.

How Medigap fits with the rest of Medicare

Dover is in Kent County, where residents can choose between staying with Original Medicare (and optionally adding a Medigap policy and a Part D drug plan) or enrolling in a Medicare Advantage plan. You can't pair Medigap with Medicare Advantage — it's one path or the other.

A few 2026 program facts worth keeping in mind as you compare:

• Part D now has an annual out-of-pocket cap of $2,100.
• The Part D deductible can be no higher than $615.
• The old coverage gap ("donut hole") is gone as of 2025.
• The Medicare Prescription Payment Plan lets you spread drug costs across the year in monthly installments.
• IRMAA income-based surcharges start above $109,000 for a single filer.
• Annual Enrollment runs Oct. 15 – Dec. 7; Medicare Advantage Open Enrollment runs Jan. 1 – March 31.