Medicare Supplement

Medigap in Rome: How Medicare Supplement Letters Work

ROME, N.Y. — If you're new to Medicare, or helping a parent sort through mail that keeps arriving in Rome mailboxes, you've probably seen the word "Medigap." It sounds like jargon, but the idea is simple: Medigap — also called Medicare Supplement insurance — helps pay some of the costs Original Medicare leaves behind. Here's a plain-language look at what it does, what it doesn't, and how those standardized letters (A, B, G, N, and the rest) actually work.

What Medigap is — and isn't

Medigap is private insurance you can buy to go alongside Original Medicare (Part A and Part B). It helps cover things like coinsurance, copayments, and, in some cases, deductibles that Original Medicare doesn't pay.

A few things Medigap is not:

• It is not Medicare Advantage. Medicare Advantage (Part C) replaces the way you get your Medicare benefits; Medigap works with Original Medicare.
• It is not drug coverage. Medigap policies sold today do not include Part D. If you want prescription coverage, you enroll in a separate Part D plan.
• It is not long-term care, dental, vision, or hearing coverage. Those need to be handled separately.

You can't have Medigap and Medicare Advantage at the same time. That's one of the most common — and most expensive — mix-ups people make.

How the standardized letters work

This is the part that trips people up. In most states, including New York, Medigap policies are standardized by the federal government and 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.)

Here's what "standardized" really means: Plan G from one insurance company covers exactly the same things as Plan G from any other insurance company. The benefits inside each letter are set by Medicare, not by the carrier. What can differ is the price and the customer service.

So if you're comparing Medigap policies, you're really doing two things:

1. Deciding which letter (level of coverage) fits your needs. 2. Comparing prices and companies offering that same letter.

The higher-coverage letters generally have higher premiums. Lower-coverage or cost-sharing letters (like K, L, and N) usually have lower premiums but leave you paying more at the point of care.

When you can buy Medigap matters — a lot

This is where Rome residents can make a costly mistake without realizing it.

You have a one-time Medigap Open Enrollment Period that starts the month you're 65 and enrolled in Part B, and lasts six months. During this window, insurance companies must sell you any Medigap policy they offer at the best available rate, and they cannot turn you down or charge you more because of your health.

Outside that window, in most states, insurers can use medical underwriting — meaning they can ask about your health and potentially deny you or charge more. New York has some additional consumer protections that go beyond federal rules, so if you're past your open enrollment window, it's worth asking specifically what applies in your situation before you assume you're stuck.

What Medigap does not fix

Even a generous Medigap plan won't help with:

• Prescription drugs. That's Part D. For 2026, Part D has a $2,100 annual out-of-pocket cap on covered drugs, a maximum deductible of $615, and the old "donut hole" coverage gap is gone as of 2025. There's also an optional Medicare Prescription Payment Plan that lets you spread drug costs across the year.
• Routine dental, vision, and hearing. Original Medicare generally doesn't cover these, and Medigap follows Original Medicare's lead.
• Long-term custodial care in a nursing home.
• IRMAA surcharges. If your income is above $109,000 as a single filer in 2026, you'll pay higher Part B and Part D premiums regardless of what Medigap plan you have.

How this fits with plans available around Rome

Rome is in Oneida County, where both Medicare Advantage plans and stand-alone Part D plans are offered by multiple carriers each year. Medigap availability is regulated at the state level in New York, so the letters you can shop are consistent, but the companies offering them and the premiums they charge can change. If you're weighing Medigap vs. Medicare Advantage, remember: they're different roads, not different brands of the same road.

Key dates to keep on your calendar:

• Medicare Annual Enrollment Period: October 15 – December 7 (for Part D and Medicare Advantage changes).
• Medicare Advantage Open Enrollment Period: January 1 – March 31 (for people already in a Medicare Advantage plan).
• Medigap Open Enrollment: your personal six-month window starting when you're 65 and enrolled in Part B.