Medicare Supplement

Medigap basics for Coventry: what each letter plan covers

If you live in Coventry and you're new to Medicare — or helping a parent sort through the mail — you've probably heard the term "Medigap." It's another name for Medicare Supplement insurance, and it's one of the most misunderstood pieces of the Medicare puzzle.

Coventry, R.I. — Making sense of Medicare Supplement insurance

Medigap doesn't replace Original Medicare. It works alongside it, helping pay some of the out-of-pocket costs that Parts A and B leave behind. Here's a plain-language look at what it does, what the letters mean, and the mistakes to avoid.

What Medigap actually does

Original Medicare (Part A and Part B) pays a large share of your hospital and doctor costs — but not all of them. You're still on the hook for things like the Part A hospital deductible, Part B coinsurance (usually 20%), and other cost-sharing that has no yearly limit on its own.

A Medigap policy, sold by private insurance companies, helps fill those gaps. Depending on the letter plan you pick, it may cover:

• The Part A hospital deductible and coinsurance
• Part B coinsurance or copays
• The first three pints of blood
• Hospice care coinsurance
• Skilled nursing facility coinsurance
• Some foreign travel emergency care

What Medigap does not cover: prescription drugs, dental, vision, hearing aids, long-term custodial care, or private-duty nursing. For drug coverage, you'd add a separate Part D plan.

How the standardized letters work

Here's the part that confuses people most. Medigap plans are standardized by the federal government and labeled with letters: A, B, C, D, F, G, K, L, M, and N. (Plans E, H, I, and J are no longer sold.)

Because the letters are standardized, Plan G from one company covers the same core benefits as Plan G from another company. What can differ is the premium, the company's customer service, and how they handle rate increases over time.

A few things worth knowing:

• Plans C and F are only available to people who were eligible for Medicare before January 1, 2020. If you became eligible after that, those two are off the table.
• Plans K and L have lower premiums but include out-of-pocket limits and cost-sharing before benefits kick in fully.
• Plan N has lower premiums than Plan G but adds small copays for some office and emergency room visits.

You can compare the standardized benefits side by side on Medicare.gov's plan finder tool.

When to enroll — and why timing matters

The best window to buy a Medigap policy is your Medigap Open Enrollment Period: the six months that start the month you're 65 or older and enrolled in Part B. During that window, insurance companies can't turn you down or charge more because of health problems.

Miss that window, and in most states — including Rhode Island — insurers can use medical underwriting. That means they can ask about your health, charge you more, or deny coverage entirely. This is one of the costliest mistakes new Medicare beneficiaries make.

Rhode Island does offer some added consumer protections, so it's worth checking with the state's SHIP counselors (see below) before assuming you're stuck.

Medigap vs. Medicare Advantage — not the same thing

This is where a lot of Coventry residents get tripped up. You cannot have both a Medicare Advantage plan and a Medigap policy at the same time. They're two different ways of getting Medicare:

• Original Medicare + Medigap + Part D = traditional route, with a supplement to fill gaps.
• Medicare Advantage (Part C) = a private plan that bundles Parts A, B, and usually D together, with its own network and rules.

Coventry is in Kent County, where residents have access to both Original Medicare (which works with any doctor nationwide who accepts Medicare) and a range of Medicare Advantage plans offered by private carriers. Which path fits better depends on your doctors, your prescriptions, how much you travel, and your budget.

Common mistakes to avoid

1. Waiting too long to buy Medigap. The guaranteed-issue window is short. Once it closes, your options narrow. 2. Assuming all Plan Gs (or Ns, or Ks) are equal in price. Benefits are standardized; premiums are not. Shop around. 3. Forgetting about Part D. Medigap doesn't cover drugs. If you skip Part D when first eligible without other creditable coverage, you may face a lifelong late-enrollment penalty. 4. Switching from Medicare Advantage back to Original Medicare without checking Medigap rules. You may be subject to underwriting depending on timing and circumstances.

A quick FAQ

Q: Can I keep my doctors with a Medigap policy? A: Medigap works with Original Medicare, so any doctor or hospital in the U.S. that accepts Medicare will accept your Medigap plan. There's no network.

Q: Do Medigap premiums go up over time? A: Yes, most do. How they're rated (community-rated, issue-age, or attained-age) affects how they change. Ask the insurer which pricing method they use before you sign up.

Q: I already have a Medicare Advantage plan. Can I add Medigap? A: No. Medigap only works with Original Medicare. If you want a Medigap policy, you'd first need to switch back to Original Medicare — and possibly face underwriting.

Q: Does Medigap cover the new $2,100 Part D drug cap for 2026? A: No. That cap applies to your Part D drug plan, which is separate. Medigap covers medical costs, not prescriptions.

Where to get trustworthy, personal help

Medicare decisions are personal, and no article can replace one-on-one guidance. For free, unbiased help in Rhode Island:

• Medicare.gov — the official source for plan comparisons and benefit details.
• 1-800-MEDICARE (1-800-633-4227) — available 24/7.
• Rhode Island SHIP (State Health Insurance Assistance Program), part of the state's Office of Healthy Aging — free counseling for Coventry residents and other Rhode Islanders.

Take your time, ask questions, and don't let a mailer or a phone call rush you into a decision that lasts a year — or longer.