Medicare Supplement

Same letter, same rules: how Medigap plans really compare

In Springfield, Ohio, shopping for a Medicare Supplement policy — better known as Medigap — can feel like reading a menu written in code. Plan G. Plan N. High-deductible G. Plans K and L. The letters look random, but there's a system behind them, and once you know the rule, comparing policies gets a lot simpler.

Here's the key idea: in most of the country, the federal government sets what each lettered Medigap plan must cover. That means Plan G from one insurer covers the same gaps as Plan G from another. The letter — not the company — defines the benefits.

Why the letters exist in the first place

Before standardization, Medigap policies were a confusing patchwork. Congress fixed that by requiring insurers to sell plans that match set benefit templates, each labeled with a letter. Today, according to CMS, an insurer selling "Plan G" in Ohio must include the exact benefits federal rules assign to Plan G. Another company's Plan G will include those same benefits. The paperwork, customer service, and price may differ — but the coverage floor does not.

Springfield is in Clark County, and this federal rule applies here just as it does anywhere else in Ohio.

What Plan G covers — and its high-deductible cousin

Plan G is one of the more comprehensive standardized options available to people newly eligible today. Under federal standards, it covers Part A coinsurance and hospital costs, Part B coinsurance or copayments, the first three pints of blood, hospice coinsurance, skilled nursing facility coinsurance, and the Part A deductible. It also covers foreign travel emergency care up to plan limits. The one thing Plan G does not cover is the Part B deductible — you pay that yourself before the plan's Part B benefits kick in.

High-deductible Plan G covers the same benefits, but you must first meet a yearly deductible set by federal rule before the plan begins paying. The deductible amount is updated each year and is published on medicare.gov.

What Plan N covers

Plan N includes most of the same benefits as Plan G with two notable differences. You may owe a copayment of up to $20 for some office visits and up to $50 for emergency room visits that don't lead to being admitted. Plan N also does not cover Part B excess charges — the amount some providers can bill above the Medicare-approved rate. Like Plan G, Plan N does not cover the Part B deductible.

How Plans K and L are different

Plans K and L work on a cost-sharing model. Instead of covering most gaps in full, they pay a set percentage — K pays 50% of certain costs, and L pays 75%. You pay the rest until you hit that year's out-of-pocket limit, which is set by federal rule and adjusted annually. After you reach that limit and meet the Part B deductible, the plan pays 100% of covered Part B services for the rest of the calendar year. Both plans still fully cover Part A hospital coinsurance under their federal standards.

Plans C and F, and the three-state exception

Plans C and F used to be popular because they covered the Part B deductible. Under federal law, they are closed to people who became eligible for Medicare on or after January 1, 2020. If you were eligible before that date, you may still be able to buy them, depending on state rules and insurer availability.

There's one more wrinkle worth knowing: Massachusetts, Minnesota, and Wisconsin standardize their Medigap plans differently from the other 47 states. If you're moving to or from one of those states, the letter labels won't line up the same way.

What this means when you compare policies in Clark County

Because the federal letter locks in the benefits, comparing Medigap policies in Springfield really comes down to a few non-benefit factors: the insurer's premium, how the premium is priced as you age, the company's customer service reputation and financial strength, and whether you qualify for guaranteed-issue protections based on your enrollment timing or a qualifying event.

The Medigap Open Enrollment Period — the six months starting the month you're 65 or older and enrolled in Part B — is when you generally have the strongest rights to buy any Medigap policy sold in your state without medical underwriting. Outside that window, insurers may be allowed to consider your health history.