Medicare Supplement

Medigap in Palatine: What the Letter Plans Actually Cover

PALATINE, Ill. — If you've ever looked at your Medicare paperwork and wondered why there's still a bill after Medicare pays its share, you're not alone. That leftover amount is exactly what Medicare Supplement insurance — usually called Medigap — is designed to help with.

Medigap doesn't replace Original Medicare. It works alongside it, picking up some of the out-of-pocket costs Parts A and B leave behind. Here's a plain-language look at what these plans do, how the lettered options work, and where Palatine residents can get unbiased help.

What Medigap Is (and Isn't)

Medigap is private insurance you can buy to go with Original Medicare (Part A and Part B). It helps pay costs like coinsurance, copayments, and some deductibles that Original Medicare doesn't cover on its own.

A few things Medigap is not:

• It's not Medicare Advantage. In fact, you can't have both at the same time.
• It's not a drug plan. Medigap doesn't include Part D prescription coverage — you'd add that separately.
• It doesn't usually cover things like routine dental, vision, hearing aids, or long-term care.

If you travel or split time between states, one nice feature is that Medigap works with any doctor or hospital in the U.S. that accepts Medicare — there are no plan networks.

The Standardized Letters, Explained

Here's the part that trips people up: Medigap plans are sold by private insurance companies, but the benefits inside each lettered plan are set by federal rules. That means Plan G from one company covers the same core benefits as Plan G from another company. The price and customer service can differ, but the coverage inside a given letter is standardized.

In most states, including Illinois, Medigap plans are labeled with letters: A, B, C, D, F, G, K, L, M, and N. Two of those — Plan C and Plan F — are only available to people who became eligible for Medicare before January 1, 2020. Everyone newer to Medicare chooses from the remaining letters.

Each letter covers a different mix of things like:

• Part A hospital coinsurance and extra hospital days
• Part B coinsurance or copayments
• The first three pints of blood
• Skilled nursing facility coinsurance
• Part A deductible
• Foreign travel emergency care (on some plans)

Plans K and L work a little differently — they cover a percentage of certain costs and include an annual out-of-pocket limit. Medicare.gov has a side-by-side chart that shows exactly which benefits each letter covers.

When You Can Buy a Medigap Policy

Timing matters more with Medigap than most people realize. Your Medigap Open Enrollment Period is a one-time, six-month window that starts the month you're 65 or older and enrolled in Part B. During this window, you have a federal right to buy any Medigap plan sold in your state, at the best available rate, regardless of your health history.

Outside that window, insurers in most states can use medical underwriting — meaning they can look at your health and charge more, or turn you down. That's why financial counselors often say: don't sleep on your Medigap window.

Illinois has some additional protections in certain situations (like losing other coverage), but the safest bet is to know your six-month clock.

How Medigap Fits With Part D and Local Choices

Because Medigap doesn't include drug coverage, most people who choose this route also sign up for a stand-alone Part D prescription drug plan. A few 2026 numbers worth knowing:

• Part D has a new $2,100 out-of-pocket cap on covered drugs in 2026.
• The maximum Part D deductible is $615.
• The old "donut hole" coverage gap is gone — Part D now has three phases.
• If your drug costs hit hard early in the year, the Medicare Prescription Payment Plan lets you spread them out monthly.

Palatine is in Cook County, where Medicare beneficiaries have a wide range of stand-alone Part D plans and Medicare Advantage plans to choose from — but remember, Medigap and Medicare Advantage are two different paths, and you pick one or the other.

How to Decide If Medigap Is Right for You

There's no single "right" answer here — it depends on your budget, your doctors, how often you travel, and how much predictability you want in your medical bills. A few questions to ask yourself:

• Do I want to see any doctor in the country who takes Medicare, without network rules?
• Am I okay paying a monthly premium in exchange for fewer surprise bills?
• Do I have doctors I want to keep who may or may not be in a plan's network?
• Do I expect frequent care, or want protection in case something big happens?

Higher-income enrollees should also know about IRMAA, the income-related surcharge that begins above $109,000 for a single filer in 2026. It affects Part B and Part D premiums, not Medigap directly, but it's part of the overall cost picture.

FAQs From Palatine Readers

Q: Can I switch from Medicare Advantage to Medigap later? A: You can try, but outside of specific guaranteed-issue situations, insurers may use medical underwriting. That's why the initial six-month Medigap window is so valuable.

Q: Does Medigap cover my prescriptions? A: No. You'd need a separate Part D plan for drug coverage.

Q: If two companies sell "Plan G," is one better than the other? A: The covered benefits are identical by law. What differs is the premium, how the company raises rates over time, and customer service. Comparing prices for the same letter is fair game.

Q: When are the big Medicare deadlines I should have on my calendar? A: Medicare's Annual Enrollment Period runs Oct. 15 – Dec. 7, and the Medicare Advantage Open Enrollment Period is Jan. 1 – March 31. Medigap has its own six-month window tied to your Part B start date.

Where to Get Trustworthy Help

Medigap decisions are personal, and the wrong move — especially missing your open enrollment window — can be hard to undo. Before you sign anything, get free, unbiased guidance:

• Medicare.gov has the official Medigap comparison tool and benefits chart.
• 1-800-MEDICARE (1-800-633-4227) is available 24/7.
• Illinois SHIP (Senior Health Insurance Program) offers free one-on-one counseling for Palatine and Cook County residents. Counselors don't sell anything — they just explain your options.

Take your time, ask questions, and match your coverage to your life — not the other way around.