Medicare Supplement

A Millsboro reader's guide to Medigap: how the lettered plans line up

MILLSBORO, Del. — If you have Original Medicare and the "what if I get a big bill?" question keeps nagging at you, Medicare Supplement insurance — better known as Medigap — is the piece of the puzzle worth understanding. Medigap policies help pay some of the out-of-pocket costs Original Medicare leaves behind, like coinsurance, copayments and certain deductibles.

Medicare SupplementMillsboro, DE

A plain-English look at Medicare Supplement insurance

Millsboro is in Sussex County, where residents can shop Medigap policies sold by private insurers licensed in Delaware. The policies themselves are standardized by the federal government, which means a Plan G from one company covers the same core benefits as a Plan G from another. That standardization is the part many people miss — and it changes how you shop.

What Medigap actually does

Original Medicare pays a big share of your hospital and doctor costs, but not all of it. There are deductibles, coinsurance percentages, and — importantly — no yearly cap on what you might spend out of pocket. Medigap policies step in to pay some or all of those leftover costs, depending on which lettered plan you buy.

Depending on the plan, Medigap can help with:

• Part A hospital coinsurance and an extra 365 hospital days after Medicare runs out
• Part B coinsurance or copayments
• The first three pints of blood each year
• Hospice care coinsurance
• Skilled nursing facility coinsurance
• The Part A deductible (and, on some plans, the Part B deductible)
• Limited foreign travel emergency care on certain plans

What Medigap does not cover: prescription drugs, routine dental, routine vision, hearing aids, long-term custodial care, or private-duty nursing. Drugs are handled through a separate Part D plan.

How the standardized letters work

In most states, including Delaware, Medigap plans are sold under letter names: A, B, C, D, F, G, K, L, M and N. Each letter is a federally set package of benefits. That's the key idea — a "Plan G" from Insurer 1 and a "Plan G" from Insurer 2 offer the same core benefits. What can differ between companies is the premium, customer service, and extras like household discounts.

A few points worth knowing:

• Plan F and Plan C are only available to people who were eligible for Medicare before January 1, 2020. If you became eligible on or after that date, those two aren't on the menu for you.
• Plans K and L have lower premiums but ask you to share more of the cost until you hit a yearly out-of-pocket limit.
• Plan N generally has lower premiums than Plan G but may include small copays for some office and emergency room visits.
• High-deductible versions of some plans exist, where you pay costs up to a set deductible before the plan kicks in.

Because the benefits inside a letter are fixed by law, comparing Medigap really comes down to comparing prices and the company behind the policy.

When you can buy — and why timing matters

The friendliest time to buy Medigap is your Medigap Open Enrollment Period: a one-time, six-month window that starts the month you're 65 or older and enrolled in Medicare Part B. During that window, insurers cannot turn you down or charge you more because of your health.

Outside that window, in most states insurers can use medical underwriting — meaning your health history can affect whether you're accepted or what you pay. Some states have added protections; Delaware residents can check with the state's insurance department or SHIP counselor for specifics.

There are also "guaranteed issue" situations — for example, if certain other coverage ends — that let you buy some Medigap plans without underwriting. These rules are narrow and time-limited, so it helps to ask before you make changes.

Medigap vs. Medicare Advantage: not the same thing

This trips a lot of people up. Medicare Advantage (Part C) is a different way to get your Medicare benefits, through a private plan that replaces Original Medicare's payment structure. Medigap only works with Original Medicare. You cannot use a Medigap policy to pay Medicare Advantage cost-sharing, and you generally can't have both at the same time.

If you're weighing the two paths, the decision usually comes down to how you want costs and networks to work, and whether you want your drug coverage bundled in or bought separately.

Where drugs, and the 2026 numbers, fit in

Medigap doesn't include drug coverage, so most people with Original Medicare add a stand-alone Part D plan. For 2026, Medicare has confirmed a $2,100 annual out-of-pocket cap on covered Part D drugs and a maximum deductible of $615. The old "donut hole" coverage gap has been eliminated as of 2025, leaving three payment phases. Medicare also offers the optional Medicare Prescription Payment Plan, which lets you spread drug costs across the year in monthly amounts instead of paying big bills at the pharmacy counter.

Higher-income enrollees may also owe IRMAA surcharges on Part B and Part D premiums; for 2026, those begin above $109,000 in income for a single filer.

What to do next in Millsboro

If you're weighing Medigap here in Sussex County, a few no-pressure steps:

1. Confirm you're enrolled in Part A and Part B (Medigap requires both). 2. Note whether you're in your 6-month Medigap Open Enrollment window. 3. Decide on a letter based on how much cost-sharing you want to handle yourself. 4. Then — and only then — compare prices from insurers licensed to sell that letter in Delaware.

The Annual Enrollment Period (Oct. 15 – Dec. 7) and the Medicare Advantage Open Enrollment Period (Jan. 1 – March 31) apply to Advantage and Part D plans, not Medigap. Medigap has its own timing rules, which is another reason it pays to slow down and ask questions.