Medicare Supplement

Medigap in Boulder City: how the standardized letter plans are built and what they pay

Medicare Supplement Insurance — better known as Medigap — is one of the most misunderstood pieces of the Medicare puzzle. In Boulder City, where many residents lean on Original Medicare for its wide provider access, a Medigap policy is often the piece that makes the math predictable. But the letters (A, B, D, G, K, L, M, N, and for some, C and F) confuse almost everyone the first time through. Here's what the letters mean, what Medigap does, and what it does not.

Medicare SupplementBoulder City, NV

What Medigap actually is

Medigap is private insurance you buy to help pay the out-of-pocket costs that Original Medicare leaves behind — things like the Part A hospital deductible, Part B coinsurance, and extra hospital days after Medicare's coverage runs out. It rides alongside Original Medicare. Medicare pays its share first, and your Medigap policy pays some or all of what's left, depending on the letter you chose.

Boulder City is in Clark County, where residents can shop Medigap policies from any insurer licensed to sell them in Nevada. Availability and pricing are set by the insurer and the state, not by the federal government.

Why the letters exist

Before the 1990s, Medigap was a mess of non-comparable policies. Congress fixed that by standardizing the benefits into lettered plans. Today, if you compare a Plan G from Insurer A and a Plan G from Insurer B, the covered benefits are identical by law. What can differ is the premium, the customer service, whether the insurer offers extras like a gym benefit, and how rates rise over time.

That standardization is the single most useful fact when you shop. You are not comparing benefits — you are comparing price and the company behind the policy.

What each letter generally covers

There are 10 standardized Medigap plans sold today. Here is the shape of them, in plain terms:

• Plan A: The basic package — Part A coinsurance and hospital costs, Part B coinsurance, the first three pints of blood, and hospice coinsurance.
• Plan B: Everything in A, plus the Part A deductible.
• Plan D: Broader than A and B; includes skilled nursing facility coinsurance and some foreign travel emergency care.
• Plan G: The most comprehensive plan available to people newly eligible for Medicare. Covers nearly every gap except the Part B deductible.
• Plan K and Plan L: Cost-sharing plans that pay a percentage (50% or 75%) of certain costs, with an annual out-of-pocket limit.
• Plan M and Plan N: Middle-ground options; Plan N has small copays for some office and ER visits.
• Plans C and F: Only available if you were eligible for Medicare before January 1, 2020. These are the two plans that cover the Part B deductible, which is why they were closed to newer enrollees.

What Medigap does not do

This is where readers get tripped up. Medigap does not cover:

• Prescription drugs. You need a separate Part D plan. In 2026, Part D has a $2,100 annual out-of-pocket cap, a maximum deductible of $615, and the old coverage gap ("donut hole") is gone. The Medicare Prescription Payment Plan also lets you spread drug costs across the year if that helps your budget.
• Routine dental, vision, or hearing.
• Long-term care in a nursing home.
• Anything paired with Medicare Advantage. You cannot use a Medigap policy with an Advantage plan. It's one or the other.

Timing matters more than most people realize

Your Medigap Open Enrollment Period is a one-time, six-month window that begins the month you're 65 and enrolled in Part B. During that window, insurers must sell you any Medigap plan they offer at their best available rate, regardless of your health. Outside that window, in most states including Nevada, insurers can use medical underwriting — meaning they can charge more or decline you based on your health history.

There are limited "guaranteed issue" situations later (for example, if certain other coverage ends), but the safest time to lock in a policy is that first six-month window.

Two other dates to keep on the calendar, though they are for Part D and Medicare Advantage, not Medigap: the Annual Enrollment Period runs October 15 through December 7, and the Medicare Advantage Open Enrollment Period runs January 1 through March 31.

A note on income and Part B

Medigap premiums are what you pay the insurer. Separately, higher-income enrollees pay an income-related surcharge on their Part B (and Part D) premium, called IRMAA. For 2026, IRMAA starts above $109,000 in income for a single filer. It doesn't change what Medigap covers, but it affects your total monthly Medicare bill.