Medicare Supplement

What Medicare Supplement covers for Des Moines residents

DES MOINES — If you have Original Medicare (Part A and Part B), you already know it doesn't pay for everything. Deductibles, coinsurance, and hospital costs can add up quickly, and Original Medicare has no yearly out-of-pocket limit. That's the gap Medicare Supplement insurance — often called Medigap — is designed to help fill.

What Medigap is — and what it isn't

A Medigap policy is private insurance you buy in addition to Original Medicare. It helps pay some of the costs Medicare leaves behind, like the Part A hospital coinsurance or the Part B 20% coinsurance. It is not Medicare Advantage, and it is not a drug plan. If you want prescription coverage alongside Medigap, you'd typically add a stand-alone Part D plan.

How the standardized letters work

Here's the part that trips people up. Medigap plans in most states — Iowa included — are sold in standardized versions labeled with letters: A, B, C, D, F, G, K, L, M, and N. The letters aren't rankings. They're just labels for benefit packages that the federal government has standardized.

That means Plan G from one insurance company covers the same core benefits as Plan G from another company. What can differ is the monthly premium, the customer service, and extras a carrier might tack on. So when you shop Medigap, you're really comparing prices and companies for the same set of benefits within a given letter.

A few things worth knowing:

• Plans C and F are only available if you were eligible for Medicare before January 1, 2020. Newer enrollees generally can't buy them.
• Plan G has become a common choice for people who became eligible more recently, because it covers nearly everything Plan F did except the Part B deductible.
• Plans K, L, and N use cost-sharing (you pay part of the coinsurance) in exchange for lower premiums.
• Massachusetts, Minnesota, and Wisconsin standardize their plans differently. Iowa follows the standard letter system.

What Medigap does not cover

Medigap is helpful, but it isn't everything-insurance. Standardized Medigap policies generally don't cover:

• Prescription drugs (you need a separate Part D plan)
• Routine dental, vision, or hearing care
• Long-term custodial care in a nursing home
• Hearing aids or eyeglasses

Also important: you can't have both Medigap and a Medicare Advantage plan at the same time. They're built for different paths through Medicare, and it's illegal for someone to sell you a Medigap policy if you're on Medicare Advantage (unless you're switching back to Original Medicare).

Timing matters — especially your one-time open enrollment

This is the part many Des Moines residents wish they'd known earlier. Your Medigap Open Enrollment Period is a one-time, six-month window that starts the month you're 65 and enrolled in Part B. During that window, insurance companies can't turn you down or charge you more because of health conditions.

Outside that window, in most cases, carriers can use medical underwriting — meaning they can ask about your health and decide whether to sell you a policy and at what price. Iowa does not have a broad guaranteed-issue rule beyond the federal protections, so timing your enrollment carefully really counts.

How this fits with the rest of Medicare in Polk County

Des Moines is in Polk County, where residents can choose between staying with Original Medicare (often paired with a Medigap policy and a stand-alone Part D drug plan) or enrolling in a Medicare Advantage plan. Both paths are legitimate. Medigap tends to appeal to people who want predictable out-of-pocket costs and the freedom to see any provider nationwide who accepts Medicare. Medicare Advantage tends to appeal to people who like bundled coverage and extra benefits, and are comfortable with a plan network.

A few 2026 program facts worth remembering as you compare:

• Part D now has a $2,100 annual out-of-pocket cap on covered drugs.
• The Part D maximum deductible is $615 in 2026.
• The old coverage gap ("donut hole") was eliminated in 2025 — Part D now has three phases.
• The Medicare Prescription Payment Plan lets you spread drug costs across the year in monthly payments if that helps your budget.
• IRMAA income-related surcharges for Part B and Part D begin above $109,000 for a single filer in 2026.
• Annual Enrollment runs October 15 – December 7; Medicare Advantage Open Enrollment runs January 1 – March 31.

Medigap itself doesn't follow the fall Annual Enrollment calendar the way Part D and Medicare Advantage do — you can apply for Medigap any time of year, but outside your one-time open enrollment window you may face underwriting.

How to decide if Medigap is right for you

Start with a few honest questions:

1. Do I travel or spend part of the year outside Iowa? Medigap works with any provider nationwide that accepts Medicare, which some snowbirds value. 2. How do I feel about predictable monthly premiums versus paying more only when I use care? Medigap generally means higher premiums and lower surprises. 3. Do I have chronic conditions where I'd want to lock in coverage now, during my guaranteed-issue window? 4. Am I okay adding a separate Part D plan for drug coverage?

There's no single right answer, and no plan is "best" for everyone. It depends on your health, your budget, your providers, and how you like to handle risk.