Medicare Supplement

Which Medigap letters can Durham buyers still get?

Durham, N.C. — If you have Original Medicare and you're looking at a Medicare Supplement policy, the alphabet soup can feel like a lot. Plan A, Plan G, Plan N, Plan G-High Deductible — what's the difference, and which ones can you even buy in North Carolina today? The good news: Medigap is federally standardized, so a Plan G in Durham covers the same benefits as a Plan G anywhere else in the state. What changes is who sells it, how they price it, and the rules that shape when you can switch.

Medicare SupplementDurham, NC

Here's a plain-language walk-through for people living in Durham County.

What Medigap actually does

Medigap is private insurance that pays some of the costs Original Medicare leaves behind — things like the Part A hospital deductible, coinsurance, and (with some letters) the Part B deductible. It does not add new benefits like dental or vision, and it does not include drug coverage.

Because Medigap sits on top of Original Medicare, you keep the same red, white and blue card and see any provider in the country that accepts Medicare. You cannot use a Medigap policy with a Medicare Advantage plan.

The standardized letters you can buy in North Carolina

Medigap plans are standardized by the federal government, which means the benefits inside Plan G, for example, are the same no matter which company sells it. In North Carolina, the letters available to people newly eligible for Medicare are:

• Plan A
• Plan B
• Plan D
• Plan G
• Plan G-High Deductible
• Plan K
• Plan L
• Plan M
• Plan N

Plans C and F are still in force for people who were eligible for Medicare before January 1, 2020, but they are closed to anyone who became eligible after that date. (A quick side note: Massachusetts, Minnesota and Wisconsin standardize their Medigap plans differently. North Carolina follows the federal letters.)

Each letter covers a different mix of Medicare's cost-sharing. Some, like Plan G, cover most gaps after you pay the Part B deductible. Others, like Plans K and L, pay a percentage of costs and include an out-of-pocket limit. Plan N has small copays for some office visits and emergency room trips. The high-deductible version of Plan G has a lower premium but you pay more up front before benefits kick in.

How Medigap pairs with Part D

Medigap does not cover prescription drugs. If you want drug coverage, you sign up for a stand-alone Medicare Part D plan.

Two 2026 numbers worth knowing:

• The Part D out-of-pocket cap is $2,100 for 2026.
• The Part D maximum deductible is $615.

The old coverage gap — the "donut hole" — was eliminated as of 2025, so Part D now works in three phases instead of four. If drug costs are hard to plan for month to month, you can ask your Part D plan about the Medicare Prescription Payment Plan, which spreads your out-of-pocket drug costs across the calendar year.

Higher earners pay an IRMAA surcharge on Part B and Part D. For 2026, IRMAA starts above $109,000 in income for a single filer.

The rules that shape your choice

A few state and federal rules matter more than the letter you pick:

Your Medigap Open Enrollment Period. This is the six-month window that starts the month you're 65 and enrolled in Part B. During it, you have a guaranteed right to buy any Medigap policy sold in North Carolina at the best available rate for your age, regardless of your health.

After that window. Outside Open Enrollment and specific federal guaranteed-issue situations, an insurer in North Carolina can use medical underwriting — meaning they can ask health questions and decide whether to offer you a policy. Some states have extra protections (like "birthday rules" that let you switch each year without underwriting). For a current read on what North Carolina allows, check with the North Carolina Department of Insurance or the state SHIP.

How premiums are set. Insurers use different pricing methods — issue-age, attained-age or community-rated — and that affects how your premium may change over time. Ask the insurer which method a policy uses before you sign.

Finding insurers and prices in Durham

Durham is in Durham County, and Medigap is regulated at the state level, so any company licensed to sell Medigap in North Carolina can sell to Durham residents. To see who's actually offering policies and what they charge:

• Use the Medigap policy search on Medicare.gov — enter your Durham ZIP code and you'll see every letter available and every insurer selling it.
• Ask the North Carolina Department of Insurance for its Medigap rate guide, which lists premiums by company and age.
• Call the North Carolina SHIP (Seniors' Health Insurance Information Program) for free, unbiased counseling.

The table on this page also lists the standardized plans by letter so you can compare benefits side by side.

Enrollment dates to keep in mind

Medigap has its own six-month Open Enrollment Period tied to your 65th birthday and Part B start date — it is not on the fall calendar. But two Medicare dates come up often and are worth remembering:

• Annual Enrollment Period: October 15 – December 7 (for Part D and Medicare Advantage).
• Medicare Advantage Open Enrollment: January 1 – March 31.

These windows matter for your Part D drug plan and, if you ever leave Medicare Advantage to return to Original Medicare, for the timing of getting a Medigap policy.