Medicare Supplement

Why Medigap Uses Plan Letters in Williston, N.D.

WILLISTON, N.D. — If you have Original Medicare and you've started shopping for extra coverage, you've probably seen a lineup of letters: Plan A, Plan B, Plan G, Plan N. Those letters aren't a grade. They're the government's way of making Medicare Supplement Insurance — better known as Medigap — easier to compare.

Here in Williston, where winters are long and a single hospital stay can rattle a household budget, understanding what Medigap does (and doesn't do) is one of the most useful things you can learn before the next enrollment window.

What Medigap actually does

Original Medicare — Part A (hospital) and Part B (doctor and outpatient) — pays most of your covered care, but not all of it. You're still responsible for things like the Part A hospital deductible, the 20% coinsurance on most Part B services, and various copays.

Medigap is private insurance that fills in some of those gaps. You pay a monthly premium to the insurance company, and in return the plan picks up part or all of certain costs Medicare doesn't cover.

A few important boundaries:

• Medigap only works with Original Medicare. It does not work with Medicare Advantage.
• Medigap does not cover prescription drugs. You'd buy a stand-alone Part D plan for that.
• Medigap generally doesn't cover long-term care, dental, vision, or hearing aids.

Why the plans are labeled with letters

Back in 1990, Congress told insurance companies to stop inventing their own Medigap policies and instead sell a standardized menu. Today, in most states — including North Dakota — Medigap plans come in ten lettered versions: A, B, C, D, F, G, K, L, M, and N.

Here's the key idea: the letter defines the benefits. Plan G sold by one carrier covers the same core set of gaps as Plan G sold by any other carrier. The price and customer service can differ, but the covered benefits are set by federal rules.

This is what makes apples-to-apples shopping possible. Once you decide which letter fits your situation, you're really just comparing premiums, company reputation, and how rates might change over time.

A note on Plans C and F

If you became eligible for Medicare on or after January 1, 2020, you can't buy Plan C or Plan F. Those two plans covered the Part B deductible, and federal law now prohibits new Medigap policies from doing so for newly eligible enrollees. People who were already eligible before that date can still keep or buy them.

When you can buy Medigap

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

Outside that window, in most cases, insurers can use medical underwriting. That means they can ask about your health and either deny coverage or charge higher premiums. A few situations, called "guaranteed issue rights," give you another shot — for example, if certain other coverage ends involuntarily.

North Dakota does not have its own state law expanding those rights beyond the federal minimums, so timing matters here more than in some other states.

How Medigap fits with other Medicare choices

Williston is in Williams County, where residents choosing Medicare generally pick one of two paths:

1. Original Medicare + (optional) Medigap + (optional) Part D. You keep the federal program, add a Medigap letter plan for cost-sharing, and add a stand-alone drug plan. 2. Medicare Advantage (Part C). A private plan bundles Parts A and B, and usually drug coverage, into one policy. You cannot use Medigap with an Advantage plan.

Neither path is universally "right." It depends on your doctors, your prescriptions, your travel habits, and your budget. Williams County has multiple Medicare Advantage and Part D options available; you can see the current count for your ZIP code on Medicare's Plan Finder at medicare.gov.

Key dates to keep on the 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.
• Your personal Medigap Open Enrollment Period: the six months starting when you're 65 and enrolled in Part B.

Medigap itself doesn't run on the fall AEP calendar — you can apply any time — but if you're switching between Original Medicare and Advantage, those federal dates matter.