Medicare Supplement

How Medigap's Lettered Plans Work in St. Paul

ST. PAUL — If you have Original Medicare (Part A and Part B), you've probably noticed it doesn't cover every dollar of your care. There are deductibles, coinsurance, and other out-of-pocket costs that can add up over the year.

Medigap in plain English

That's the gap Medicare Supplement Insurance — often called Medigap — is designed to help fill. It's private insurance that works alongside Original Medicare to pay some of the costs Medicare leaves behind.

Here in St. Paul, Medigap works a little differently than it does in most of the country. We'll get to that in a minute.

What the letters actually mean

In most states, Medigap policies are sold in standardized plans labeled by 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.)

"Standardized" is the key word. It means:

• Plan G from Company X covers the same things as Plan G from Company Y.
• The letter tells you the benefits. The company sets the price and the customer service.
• If two carriers both sell Plan N, the coverage is identical — only the premium, the company's reputation, and how they handle claims may differ.

This design comes straight from federal rules, and Medicare explains the standardized benefits on medicare.gov. The letters exist so shoppers can compare apples to apples.

Why St. Paul is different: Minnesota is a "waiver" state

Here's where St. Paul residents need to pay attention. Minnesota is one of three states — along with Wisconsin and Massachusetts — that does not use the letter system.

Instead, Minnesota standardizes Medigap policies its own way. Carriers here typically sell a Basic Plan and an Extended Basic Plan, and you can add optional riders (for things like the Part A deductible, Part B deductible, or additional coverage) to customize the policy.

So if you're sitting in St. Paul reading a national article about "Plan G" or "Plan N," those exact letters aren't sold to Minnesotans. The concept of standardized benefits still applies — the packaging is just different.

For details on how Minnesota's version works, the Minnesota Department of Commerce and the Senior LinkAge Line (Minnesota's SHIP) are the two most reliable sources.

What Medigap does — and doesn't — do

Medigap generally helps with costs like the Part A hospital deductible, Part B coinsurance, skilled nursing coinsurance, and (depending on the policy) other charges you'd otherwise pay yourself.

What Medigap does not do:

• It does not cover prescription drugs. For that, you'd need a separate Part D drug plan. (In 2026, Part D has a maximum deductible of $615 and a new out-of-pocket cap of $2,100 for covered drugs.)
• It does not work with Medicare Advantage. Medigap only pairs with Original Medicare. If you're on a Medicare Advantage plan, you can't also use a Medigap policy.
• It does not typically cover dental, vision, hearing aids, or long-term care.

When you can buy one matters a lot

The best window to buy Medigap is your Medigap Open Enrollment Period — the six months that begin 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 states, carriers can use medical underwriting. Minnesota has some additional consumer protections that go beyond the federal minimum, which is another reason to talk to a local counselor before making a change.

Ramsey County resources

St. Paul is in Ramsey County, and residents here have free, unbiased help available:

• Senior LinkAge Line (Minnesota's official SHIP): 1-800-333-2433
• Medicare: 1-800-MEDICARE (1-800-633-4227) or medicare.gov
• Minnesota Department of Commerce for insurance questions

These counselors don't sell anything. They walk you through your options.