Medicare Supplement

Medigap in Peoria: What Medicare Supplement Really Covers

PEORIA, Ill. — If you have Original Medicare (Part A and Part B), you already know it doesn't pay for everything. There are deductibles, coinsurance, and other out-of-pocket costs that can add up quickly, especially after a hospital stay.

Medicare Supplement insurance, explained

That's where Medicare Supplement insurance — often called Medigap — comes in. Medigap is private insurance designed to fill some of the gaps Original Medicare leaves behind. Here in Peoria, it's one of the choices many people weigh when they're first getting used to how Medicare works.

This guide walks through what Medigap does, what those standardized "letter" plans mean, and where to get local help.

What Medigap actually does

Medigap works alongside Original Medicare. When Medicare pays its share of a covered service, your Medigap policy can pay some or all of what's left — things like Part A hospital coinsurance, Part B coinsurance, and, depending on the plan, the Part A deductible.

A few important points about how these policies work:

• Medigap only works with Original Medicare. You cannot use a Medigap policy to pay costs under a Medicare Advantage plan.
• You pay a monthly premium to the private insurer, on top of your Part B premium.
• Medigap generally does not cover prescription drugs. For that, most people add a stand-alone Part D drug plan.
• It also doesn't cover long-term care, most dental, vision, hearing aids, or private-duty nursing.

How the standardized "letter" plans work

Medigap policies sold today are standardized by the federal government and labeled with letters — Plan A, B, D, G, K, L, M, and N. (Plans C and F are no longer available to people who became eligible for Medicare on or after January 1, 2020.)

Here's the part that trips people up: within a given letter, the benefits are the same no matter which insurer sells it. A Plan G from one company covers the same core items as a Plan G from another. What can differ is the premium, customer service, and any extra perks the company chooses to include.

That standardization is meant to make comparison shopping easier. Instead of decoding dozens of different benefit charts, you're really comparing price and company for the same set of benefits.

Two states — Massachusetts, Minnesota, and Wisconsin — standardize their Medigap plans differently, but Illinois follows the federal letter system.

Peoria-area context

Peoria is in Peoria County, where Medicare beneficiaries generally have two broad paths: stay with Original Medicare (often paired with a Medigap policy and a Part D drug plan), or choose a Medicare Advantage plan that bundles coverage together.

Medigap availability and pricing in Peoria County are regulated at the state level in Illinois. That means the letter plans you see advertised locally follow the same federal benefit rules as anywhere else in the state — but premiums for the same letter plan can vary quite a bit from one insurer to the next.

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, 6-month window that starts the month you're 65 or older and enrolled in Part B. During this window, you have a "guaranteed issue" right — insurers must sell you any Medigap policy they offer, at their best available rate, and can't turn you down or charge more because of health problems.

Outside that window, in most cases, insurers in Illinois can use medical underwriting. That means they can look at your health history and either charge more or decline coverage, except in certain limited "guaranteed issue" situations (for example, if a plan you had ends coverage in your area).

This is separate from Medicare's Annual Enrollment Period (Oct. 15 – Dec. 7) and the Medicare Advantage Open Enrollment Period (Jan. 1 – March 31), which apply to Advantage and Part D plans — not to Medigap.

How Medigap fits with 2026 drug coverage

Because Medigap doesn't include prescription coverage, most people with a Medigap policy also enroll in a stand-alone Part D plan. A few 2026 numbers worth knowing:

• The Part D out-of-pocket cap is $2,100 for 2026. Once you hit that, you pay $0 for covered drugs the rest of the year.
• The Part D maximum deductible is $615.
• The old "donut hole" coverage gap is gone as of 2025 — Part D now has three phases instead of four.
• The Medicare Prescription Payment Plan lets you spread your drug costs into monthly payments through the year, at no extra cost, if that helps with cash flow.
• IRMAA surcharges (extra amounts on Part B and Part D) begin above $109,000 in income for a single filer in 2026.

Quick FAQ

Do I need both Medigap and Medicare Advantage? No — and it's actually against the rules for someone to sell you a Medigap policy if you're on a Medicare Advantage plan. You pick one path or the other.

Does Medigap cover dental, vision, or hearing aids? Generally, no. Some insurers sell separate dental, vision, or hearing policies, but those are not part of standardized Medigap coverage.

If I move within Illinois, does my Medigap plan travel with me? Yes. Medigap policies aren't tied to a network, so they work with any doctor or hospital nationwide that accepts Original Medicare. That's one reason snowbirds often like them.

Can I switch Medigap plans later? You can apply anytime, but outside your initial 6-month open enrollment (or a guaranteed-issue situation), insurers in Illinois can typically use medical underwriting to decide whether to accept you and what to charge.

Where to get straight answers

Medigap decisions are personal — the "right" choice depends on your health, budget, doctors, and how you like to handle risk. Before you sign anything, use official, unbiased sources:

• Medicare.gov — plan finder, Medigap policy search, and the official Medicare & You handbook.
• 1-800-MEDICARE (1-800-633-4227), available 24/7.
• Illinois SHIP (Senior Health Insurance Program) — free, one-on-one Medicare counseling from trained volunteers, including help serving the Peoria area.

Taking an hour with a SHIP counselor before enrollment season can save you months of second-guessing later.