Medicare Supplement

The logic behind Medigap letter plans for Syracuse residents

SYRACUSE, N.Y. — If you've ever tried to make sense of Medicare Supplement Insurance — better known as Medigap — you've probably run into a wall of letters: Plan A, Plan G, Plan N, Plan K. It looks like alphabet soup, but there's a real logic behind it, and understanding that logic can save you from a costly enrollment mistake.

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

What Medigap Is — and What It Isn't

Medigap is private insurance that works alongside Original Medicare (Part A and Part B). It helps pay some of the out-of-pocket costs Original Medicare leaves behind — things like coinsurance, copayments, and deductibles.

A few things Medigap is not:

• It is not Medicare Advantage. Medicare Advantage (Part C) replaces the way you get your Original Medicare benefits. Medigap works with Original Medicare, not instead of it.
• It is not a drug plan. Medigap policies sold today don't include prescription drug coverage. For that, you'd need a separate Part D plan.
• It is not for both spouses. Each person needs their own Medigap policy.

If you're enrolled in a Medicare Advantage plan, you generally can't also use a Medigap policy — the two aren't designed to work together.

How the Standardized Letter Plans Work

Here's the part that trips people up. In most states, including New York, Medigap plans are standardized by the federal government. That means a Plan G sold by one company covers the exact same set of benefits as a Plan G sold by another company. The letter is the benefit package.

What can differ between companies? The price, the customer service, and sometimes extra perks. But the core coverage under each letter is fixed by law.

The letters currently offered are A, B, C, D, F, G, K, L, M, and N. A few notes:

• Plans C and F are only available to people who became eligible for Medicare before January 1, 2020. If you aged into Medicare after that, these two aren't options for you.
• Plans K and L have lower premiums but include an annual out-of-pocket limit before they pay 100%.
• Plan N typically has lower premiums than Plan G but may include small copays for some office and emergency room visits.

Every Medigap plan must cover, at a minimum, Part A hospital coinsurance and an extra 365 days of hospital coverage after Medicare benefits are used up. From there, coverage expands depending on the letter.

What Medigap Doesn't Cover

Even the most generous Medigap plan has gaps of its own. Medigap generally does not cover:

• Prescription drugs (you need Part D)
• Routine dental, vision, or hearing care
• Long-term care in a nursing home
• Hearing aids or eyeglasses
• Private-duty nursing

If any of those matter to you, you'll want to plan for them separately.

Enrollment: The Window That Matters Most

The best time to buy a Medigap policy is during your Medigap Open Enrollment Period — a one-time, six-month window that starts the month you're 65 and enrolled in Part B. During this window, insurers can't turn you down or charge you more because of your health.

Miss this window, and in most states insurers can use medical underwriting — meaning they can look at your health history and decide whether to sell you a policy and at what price.

New York is different. New York is one of a small number of states that requires "guaranteed issue" and "community rating" year-round for Medigap. That means insurers in New York generally can't refuse you or charge more based on age or health. It's a real consumer protection — but premiums here also tend to reflect it. For personalized guidance in Syracuse, contact New York's SHIP program, called HIICAP (Health Insurance Information, Counseling and Assistance Program).

How Medigap Fits With the Rest of Medicare in 2026

A few program-wide facts worth keeping in mind as you weigh your options:

• Part D now has a $2,100 out-of-pocket cap on prescription drug costs in 2026, with a maximum deductible of $615.
• The old coverage gap ("donut hole") has been eliminated as of 2025 — Part D now works in three phases.
• The Medicare Prescription Payment Plan lets you spread your drug costs across the calendar year in monthly installments if you choose.
• IRMAA surcharges — extra amounts on Part B and Part D premiums — begin above $109,000 in income for a single filer in 2026.
• Annual Enrollment runs October 15 through December 7, and Medicare Advantage Open Enrollment runs January 1 through March 31.

Medigap itself doesn't follow the Annual Enrollment calendar — you can apply anytime — but changes to your Part D or Advantage coverage do.

A Word About Local Availability

Syracuse is in Onondaga County, where Medigap policies are sold by a range of private insurers licensed in New York. Because plans are standardized by letter, the smartest comparison is often price and company reputation for a given letter — not the benefit list, which won't change between carriers.