Medicare Supplement

What Medigap Covers That Medicare Leaves to Grand Rapids

GRAND RAPIDS, Mich. — If you've ever looked at a Medicare mailer and felt lost in a sea of letters — Plan A, Plan G, Plan N — you're not alone. Medicare Supplement insurance, better known as Medigap, is one of the most misunderstood corners of the Medicare world. It doesn't replace Medicare. It works alongside it, helping pay some of the out-of-pocket costs that Original Medicare leaves behind.

Grand Rapids seniors, here's what Medigap actually does

Here's a plain-English guide to what Medigap does, what it doesn't, and how those standardized letter plans work.

What Medigap is — and what it isn't

Medigap is private insurance you can buy to go with Original Medicare (Part A and Part B). After Medicare pays its share of a covered service, your Medigap policy picks up some or all of what's left — things like coinsurance, copayments, and deductibles.

A few important things Medigap does not do:

• It does not cover prescription drugs. For that, you need a separate Part D plan.
• It does not work with Medicare Advantage. You can have one or the other, not both.
• It does not cover most dental, vision, hearing, or long-term care.
• It does not cover services Medicare itself doesn't cover.

Think of Medigap as a supplement to the gaps in Original Medicare — which is exactly where the nickname comes from.

How the standardized letters work

Here's the part that trips people up. In most states, including Michigan, Medigap plans are standardized by the federal government. That means Plan G from one company covers the exact same benefits as Plan G from another company. The benefits are set. Only the price and the customer service differ.

There are currently 10 standardized plans, labeled with letters: 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.)

Each letter offers a different combination of benefits, such as:

• Part A hospital coinsurance and hospital costs after Medicare benefits are used up
• Part B coinsurance or copayment
• The first three pints of blood for a covered procedure
• Skilled nursing facility coinsurance
• Part A deductible
• Foreign travel emergency coverage (up to plan limits)

Some plans, like K and L, share costs with you up to an out-of-pocket limit. Others, like G, cover almost everything except the Part B deductible.

You can compare exactly what each letter covers using the plan finder at medicare.gov.

When you can buy Medigap — timing really matters

This is the piece most people wish they'd known earlier. Your best window to buy a Medigap policy is the six-month Medigap Open Enrollment Period, which begins the month you're 65 or older and enrolled in Part B.

During that six-month window, insurance companies can't turn you down or charge you more because of your health. Outside that window, in most cases, they can — through a process called medical underwriting. There are limited "guaranteed issue" rights in certain situations, but the six-month window is the cleanest path.

Grand Rapids is in Kent County, where seniors have a wide range of Medigap carriers to choose from. Because benefits are standardized, comparing carriers really comes down to price, financial stability, and how they handle customer service.

Medigap vs. Medicare Advantage — a quick reality check

You can't have both. Medicare Advantage (Part C) bundles your Part A, Part B, and usually Part D into one plan from a private insurer, often with extra benefits but with network rules. Medigap keeps you on Original Medicare, lets you see any doctor who accepts Medicare, and helps pay your share of the bill.

Neither is universally "better." It depends on your health, budget, travel habits, and preferred doctors. This is exactly the kind of question your local SHIP counselor can help you think through — free of charge and without a sales pitch.

A few 2026 numbers worth knowing

Even if Medigap is your focus, these program-level facts affect your overall Medicare picture next year:

• Part D out-of-pocket cap: $2,100 for 2026 — a real ceiling on what you'll pay for covered drugs.
• Part D maximum deductible: $615.
• The donut hole is gone (as of 2025); Part D now has three phases.
• Medicare Prescription Payment Plan: an optional way to spread drug costs into monthly payments.
• IRMAA (higher-income surcharges) begins above $109,000 in income for a single filer in 2026.
• Annual Enrollment Period: Oct. 15 – Dec. 7. Medicare Advantage Open Enrollment: Jan. 1 – March 31.