Medicare Supplement
Medigap, Explained: What Medicare Supplement Actually Covers
AUBURN, Maine — If you're new to Medicare, or helping a parent sort through it, you've probably heard the term "Medigap." It sounds like jargon, but the idea behind it is pretty simple: Original Medicare doesn't pay for everything, and Medigap plans are designed to help fill in some of what's left over.
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Click to call 855-729-3240Key takeaways
- Medigap policies are standardized by letter (like A, B, G, or N), so a plan with the same letter must offer the same core benefits no matter which company sells it.
- The best time to buy a Medigap policy is during your six-month Medigap Open Enrollment Period, which starts the month you turn 65 or older and enroll in Part B, since insurers generally can't deny you or charge more for health conditions during that window.
- You cannot have both a Medicare Advantage plan and a Medigap policy at the same time, so it helps to think about how you use care and whether you prefer predictable costs before choosing.
- Medigap does not cover prescription drugs, so people who want drug coverage alongside Original Medicare and Medigap need to add a separate Part D plan.
Here's a plain-English guide to how Medicare Supplement insurance works, what the standardized letters mean, and how to think through whether it fits your situation.
What Medigap actually does
Medicare Supplement insurance — often called Medigap — is private insurance that works alongside Original Medicare (Part A and Part B). After Medicare pays its share of a covered service, your Medigap policy can help pick up some of the remaining costs, like coinsurance, copays, and deductibles.
A few important things to know up front:
- Medigap only works with Original Medicare. It does not work with Medicare Advantage plans.
- Medigap does not include prescription drug coverage. If you want drug coverage, you'd add a stand‑alone Part D plan.
- Medigap doesn't cover things Medicare itself doesn't cover, like most dental, vision, hearing aids, or long-term custodial care.
For the official rundown, Medicare.gov has a clear overview under "Medicare Supplement Insurance (Medigap)."
How the "letter plans" work
This is where people get tripped up. Medigap plans are standardized by the federal government and labeled with letters: A, B, C, D, F, G, K, L, M, and N. (Plans C and F are generally only available to people who became eligible for Medicare before January 1, 2020.)
Here's the key point: a Plan G from one insurance company must offer the same core benefits as a Plan G from any other company. The letter tells you what the plan covers. The company sets the premium and handles customer service.
So when you compare two Plan G policies, you're really comparing:
- The monthly premium
- The insurance company's reputation and service
- How the company prices policies as you age
Massachusetts, Minnesota, and Wisconsin standardize their Medigap plans a little differently, but Maine follows the standard federal letter system.
Why timing matters more than most people realize
The best window to buy a Medigap policy is your Medigap Open Enrollment Period — the six months that start the month you're 65 or older and enrolled in Part B.
During that window, you have what's called "guaranteed issue" rights. That means an insurer generally can't turn you down or charge you more because of health conditions.
Outside that window, in most states, insurers can use medical underwriting. They can ask health questions, and they can decline your application or charge more. Maine has some additional consumer protections around Medigap, but the safest bet is still to understand your rights before your initial window closes. The Maine Bureau of Insurance and your local SHIP counselor can walk you through the specifics.
Medigap vs. Medicare Advantage — a quick reality check
People sometimes ask whether Medigap and Medicare Advantage are two flavors of the same thing. They aren't.
- Medicare Advantage (Part C) replaces the way you get your Original Medicare benefits. It's an all‑in‑one plan from a private insurer, often with drug coverage and extra benefits, usually with network rules.
- Medigap works with Original Medicare. You keep Original Medicare, see any provider that accepts Medicare, and let the Medigap policy help with certain out-of-pocket costs.
You cannot have both a Medicare Advantage plan and a Medigap policy at the same time. If you're weighing the two, it's worth thinking about how you use care, whether you travel, and whether you prefer predictable monthly costs or lower premiums with more variable out-of-pocket costs.
Auburn is in Androscoggin County, where a mix of Medicare Advantage plans and stand-alone Part D plans are available each year. Availability changes annually, so it's worth checking the Plan Finder at Medicare.gov during the Annual Enrollment Period (October 15 – December 7).
What Medigap won't do — and where Part D fits in
Medigap doesn't cover your prescriptions. That's where Part D comes in — a separate prescription drug plan you buy from a private insurer.
For 2026, a few Part D program facts worth knowing:
- The annual out-of-pocket cap for covered Part D drugs is $2,100.
- The maximum Part D deductible is $615.
- The old "donut hole" coverage gap has been eliminated as of 2025; Part D now has three phases.
- The Medicare Prescription Payment Plan lets you spread your drug costs across the calendar year in monthly installments if you'd rather not pay large amounts at the pharmacy counter.
- Higher-income enrollees may pay an IRMAA surcharge on Part B and Part D. For 2026, IRMAA generally begins above $109,000 in income for a single filer.
None of that is Medigap — but it's part of the full picture if you're going the Original Medicare + Medigap + Part D route.
How to think through your decision
There's no single right answer, but a few honest questions help:
1. Do you prefer being able to see any provider that accepts Medicare, including specialists out of state? 2. Do you want predictable monthly costs, even if the premium is higher? 3. Are you still in your Medigap Open Enrollment window, where you can't be turned down for health reasons? 4. How do you plan to get drug coverage — a stand‑alone Part D plan, or through another source like retiree coverage or VA benefits?
If you can answer those, you're most of the way there. A local SHIP counselor can help you compare specifics without trying to sell you anything.
By the numbers
Medicare Part B premium, 2006–2026
The standard monthly Part B premium has climbed from $88.50 in 2006 to $202.90 in 2026. Hover any point for that year’s premium.
Source: CMS. Standard premium shown; in some hold-harmless years many existing enrollees paid less. Confirm at Medicare.gov.
By the numbers
How people get Medicare in Androscoggin County
(MA penetration in Androscoggin County)
MA penetration from CMS enrollment data; Medigap share is an estimate. U.S. average is about 54% Medicare Advantage. These are area-level figures, not plan-specific.
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The parts of Medicare
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When can you enroll? An interactive year
Enrollment windows are federal and the same nationwide. Confirm your personal dates at Medicare.gov or 1-800-MEDICARE.
Good to know
Frequently asked questions
Is Medigap the same as Medicare Advantage?
Does Medigap cover prescription drugs?
Can I switch from Medicare Advantage to Original Medicare with a Medigap plan later?
- CMS — Medicare basics (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.