Medicare Supplement

How Medicare Supplement coverage works for Lincoln residents

# Medicare Supplement insurance, explained: what Medigap does and doesn't…

LINCOLN, Neb. — If you're new to Medicare or helping a parent sort through the mail piling up on the kitchen table, you've probably run into the word "Medigap." It sounds like jargon, but the idea behind it is pretty simple: Original Medicare pays most of your hospital and doctor bills, but not all of them. A Medigap policy is designed to help fill some of those leftover costs.

Here in Lincoln, where Original Medicare is a common choice among older adults, understanding how Medigap works — and what those standardized letter plans (A, B, D, G, K, L, M, N) actually mean — can save you a lot of second-guessing.

What Medigap is (and isn't)

Medicare Supplement insurance, better known as Medigap, is private insurance you can buy to work alongside Original Medicare (Part A and Part B). It doesn't replace Medicare. It sits on top of it and helps pay some of the out-of-pocket costs Medicare leaves behind — things like coinsurance, copayments, and deductibles.

A few important ground rules from Medicare.gov:

• You must already be enrolled in Part A and Part B to buy a Medigap policy.
• Medigap only works with Original Medicare. If you're on a Medicare Advantage plan, you generally can't use a Medigap policy at the same time.
• Medigap does not include prescription drug coverage. For drugs, you'd add a separate Part D plan.
• Medigap policies are individual — each spouse needs their own.

Medigap also doesn't cover most long-term care, dental, vision, hearing aids, or private-duty nursing.

How the standardized letters work

This is the part that trips people up. In most states, including Nebraska, Medigap plans are standardized by the federal government and labeled with letters: A, B, D, G, K, L, M, and N. (Plans C and F are still around, but only for people who were eligible for Medicare before January 1, 2020.)

Here's the key thing to remember: every Plan G sold by one company covers the exact same benefits as every Plan G sold by another company. The letter tells you the benefits. What can differ from company to company is the price, the customer service, and how they handle rate increases over time.

So when you compare Medigap policies, you're really comparing two things:

1. Which letter plan matches the coverage you want. 2. Which company offers that letter at a price and reputation you're comfortable with.

You can see a side-by-side chart of what each letter covers at Medicare.gov's "Compare Medigap benefits" tool.

What Medigap typically helps pay for

Depending on the letter you choose, a Medigap policy may help cover:

• Part A hospital coinsurance and extra hospital days after Medicare's benefits run out
• Part B coinsurance or copayments (usually the 20% Medicare doesn't pay)
• The first three pints of blood in a medical setting
• Hospice care coinsurance
• Skilled nursing facility coinsurance
• Part A deductible
• Foreign travel emergency care (up to plan limits, on some plans)

Higher-letter plans like G generally cover more of these gaps; plans like K and N cover less but often come with lower premiums. There's no "one right answer" — it depends on how you use health care and how predictable you want your costs to be.

Timing matters: the Medigap Open Enrollment window

This is where a lot of Lincoln readers get burned, so it's worth slowing down.

Your Medigap Open Enrollment Period is a one-time, six-month window that starts the month you're 65 or older and enrolled in Part B. During this window, insurance companies can't turn you down or charge you more because of your health history. That's called guaranteed issue.

Outside that window, in most cases, insurers in Nebraska can use medical underwriting — meaning they can look at your health and either raise your rate or deny coverage. That doesn't mean you can never switch later; it just means the rules get stricter. This is different from the Medicare Advantage Annual Enrollment Period (Oct. 15 – Dec. 7), which does not apply to Medigap.

The local picture in Lancaster County

Lincoln sits in Lancaster County, and like the rest of Nebraska, Medigap plans here follow the same federal letter standardization. Multiple insurance companies are licensed to sell Medigap policies in the county, which is why the same Plan G can show up with several different price tags.

For a personalized look at what's available and what it costs, Nebraska's SHIP program — called Nebraska SHIIP (Senior Health Insurance Information Program) — offers free, unbiased counseling. They don't sell anything, and they can walk Lincoln residents through the letter plans without a sales pitch attached.

Medigap vs. Medicare Advantage — a quick reminder

People sometimes mix these up. Medicare Advantage (Part C) is a bundled alternative to Original Medicare, usually with its own network and often with drug coverage built in. Medigap is not an alternative to Medicare — it's an add-on to Original Medicare. You pick one path or the other. Both are legitimate; they just work very differently.