Medicare Supplement

Medigap in Happy Valley, Oregon: how the letters work

Happy Valley, Oregon — If you've ever looked at Medicare Supplement insurance and felt like you were staring at alphabet soup, you're not alone. Plans labeled A, B, D, G, K, L, M, and N — with a couple of older ones still floating around — can leave anyone's head spinning. Here's a plain-language walk through what Medigap does, what it doesn't, and how those letters 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 that Original Medicare leaves behind — things like coinsurance, copayments, and, depending on the plan, the Part A hospital deductible.

A few things Medigap is not:

• It is not Medicare Advantage. You can't have both at the same time.
• It is not a drug plan. Medigap does not include Part D prescription coverage. If you want drug coverage, you'll enroll in a stand-alone Part D plan separately.
• It is not a replacement for Medicare. You still need Part A and Part B, and you still pay your Part B premium.

How the standardized letters work

Here's the part that trips people up. In most states, Medigap plans are standardized by the federal government. That means Plan G from one insurance company covers the exact same benefits as Plan G from another company. The letter defines the benefits.

What can differ between companies is:

• The monthly premium
• Customer service and how the company handles claims
• Whether they offer extras like a fitness perk

So if two carriers both sell Plan N, the coverage is identical. You're really shopping on price and service.

The currently sold plans are A, B, D, G, K, L, M, and N. Plans C and F are still held by people who had them before 2020, but they're generally not available to people who became eligible for Medicare on or after January 1, 2020, because they covered the Part B deductible — which newer enrollees can no longer have covered by Medigap.

(Note: Massachusetts, Minnesota, and Wisconsin standardize their Medigap plans a little differently.)

What Medigap typically helps with

Depending on the letter you choose, Medigap can help with:

• Part A hospital coinsurance and extra hospital days after Medicare runs out
• Part B coinsurance or copays (usually 20% of the Medicare-approved amount)
• The first three pints of blood
• Hospice coinsurance
• Skilled nursing facility coinsurance (on most plans)
• The Part A deductible (on most plans)
• Foreign travel emergency care (on some plans)

Plans K and L work a little differently — they cover a percentage of costs (50% or 75%) until you hit a yearly out-of-pocket limit, then pick up 100% after that. Plan N has small copays for some office and ER visits.

What Medigap does not cover

Medigap generally does not cover:

• Prescription drugs (that's Part D)
• Routine dental, vision, or hearing
• Long-term care (like a nursing home stay for custodial care)
• Private-duty nursing
• Eyeglasses or hearing aids

For 2026, keep in mind that Part D — the drug side — has its own protections separate from Medigap: a $2,100 annual out-of-pocket cap on covered drugs, a maximum deductible of $615, and the coverage gap ("donut hole") is gone as of 2025. There's also the optional Medicare Prescription Payment Plan, which lets you spread drug costs across the year in monthly payments.

The enrollment window that matters most

The single most important thing to know about Medigap is the Medigap Open Enrollment Period. It's a **six-month window that starts the month you're 65 or older and enrolled in Part B**. During this window, you have a "guaranteed issue" right — insurers can't turn you down or charge you more because of your health.

Outside that window, in most states, insurance companies can use medical underwriting. That means they can ask health questions and either deny coverage or charge a higher premium. A few states have more generous rules; your local SHIP can tell you what applies in Oregon.

This is different from the Medicare Annual Enrollment Period (October 15 – December 7) and Medicare Advantage Open Enrollment (January 1 – March 31), which involve Advantage and Part D plans, not Medigap.

How Medigap availability looks locally

Happy Valley is in Clackamas County, where a range of insurance carriers offer standardized Medigap plans. Because the benefits inside each letter plan are set by federal rules, the shopping question isn't really "which plan has the best benefits" — it's "which company offers the letter I want at a price and service level I'm comfortable with."

You can compare policies sold in your ZIP code using the plan finder at medicare.gov.

How to decide which letter fits

A few questions to think through:

1. How much predictability do you want? Plans that cover more up front (like Plan G) tend to have higher premiums but fewer surprises. Plans K, L, and N shift more risk to you in exchange for lower premiums. 2. Do you travel abroad? If yes, look for plans that include foreign travel emergency coverage. 3. Are you newly eligible or were you eligible before 2020? That determines whether Plans C and F are on the table for you. 4. What's your budget over time? Premiums can rise. A plan that looks affordable today may look different in five years.

This is a good moment to call in help — free help. Oregon's SHIBA program (the state's SHIP) offers unbiased counseling from trained volunteers.