Medicare Supplement

What Medicare Supplement Covers for Silver Spring Households

SILVER SPRING, Md. — If you have Original Medicare (Part A and Part B), you've probably noticed something uncomfortable: Medicare pays a big share of your medical bills, but not all of it. Deductibles, coinsurance, and hospital costs can pile up quickly. That's the gap a Medicare Supplement policy — often called Medigap — is designed to help fill.

Medicare Supplement insurance, explained for Silver Spring readers

Medigap isn't a Medicare Advantage plan, and it isn't drug coverage. It's a separate policy, sold by private insurance companies, that pays some of the out-of-pocket costs Original Medicare leaves behind. Here's a plain-English guide to how it works, what the letters mean, and where to get help locally.

What Medigap actually does

Medigap works alongside Original Medicare. When you go to the doctor or hospital, Medicare pays its share first. Then your Medigap policy kicks in and helps cover things like:

• Part A hospital coinsurance and extra hospital days
• Part B coinsurance or copays
• The first three pints of blood
• Skilled nursing facility coinsurance (depending on the letter plan)
• Part A and Part B deductibles (depending on the letter plan)
• Some emergency care during foreign travel (depending on the letter plan)

What Medigap does not cover: prescription drugs, dental, vision, hearing aids, long-term care, or private-duty nursing. For prescriptions, you'd add a separate Part D drug plan.

One more important rule: you cannot use a Medigap policy with a Medicare Advantage plan. Medigap is only for people who keep Original Medicare.

How the standardized letter plans work

Here's the part that trips people up. In most states, including Maryland, Medigap plans are standardized by letter — Plans A, B, C, D, F, G, K, L, M, and N. (Plans C and F are only available to people who became eligible for Medicare before January 1, 2020.)

Standardization means that Plan G from one insurance company covers the exact same things as Plan G from another insurance company. The benefits inside each letter are set by federal rules. What can differ is the price, the customer service, and whether the company offers extras like a fitness benefit.

So when you compare Medigap policies, you're really comparing prices and companies for the same set of benefits — not different benefit designs.

A quick tour of the most popular letters:

• Plan G — Covers nearly everything except the Part B deductible. Popular with people who want predictable costs.
• Plan N — Similar to G but with some small copays for office and emergency visits, usually at a lower premium.
• Plans K and L — Cost-sharing plans with lower premiums and an annual out-of-pocket limit.
• High-deductible Plan G — Lower premium, but you pay a set deductible before it starts paying.

The full benefit chart is on Medicare.gov, and it's worth a look before you shop.

The best time to buy: your Medigap Open Enrollment

This is one of the most important things to understand about Medigap: timing matters a lot.

Your Medigap Open Enrollment Period is a six-month window that starts the month you're 65 or older and enrolled in Part B. During this window, insurance companies must sell you any Medigap policy they offer, at the best available rate, regardless of your health.

Miss that window, and in most cases, insurers can use medical underwriting — meaning they can charge you more or deny coverage based on your health history. Maryland has some additional protections in certain situations, but the six-month window is still your strongest guarantee.

Silver Spring in context

Silver Spring is in Montgomery County, where residents have a wide field of Medicare choices to sort through — including Original Medicare paired with a Medigap policy, Medicare Advantage plans, and standalone Part D drug plans. Because Medigap is regulated at the state level, the letter plans available in Silver Spring are the same ones offered across Maryland, though prices vary by carrier and by your age when you enroll.

If you're weighing Original Medicare plus Medigap versus a Medicare Advantage plan, it helps to think about your priorities: predictable costs and freedom to see any doctor who accepts Medicare (Medigap's strength), or lower monthly premiums with a network and often built-in extras (Medicare Advantage's approach).

2026 numbers worth knowing

Even if you go the Medigap route, some Medicare-wide 2026 figures affect your overall costs:

• Part D out-of-pocket cap: $2,100 for the year. Once you hit it, you pay $0 for covered drugs.
• Part D maximum deductible: $615.
• The old "donut hole" coverage gap 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 installments if you choose.
• IRMAA income-based surcharges on Part B and Part D premiums begin above $109,000 for a single filer in 2026.
• Annual Enrollment Period: October 15 – December 7. Medicare Advantage Open Enrollment: January 1 – March 31. (Note: Medigap has its own enrollment rules, separate from these.)