Medicare Supplement

Medigap in Shelbyville: how the A-through-N letters work

If you have Original Medicare (Part A and Part B), the program pays most of your covered hospital and doctor bills — but not all of it. You're still on the hook for things like the Part A hospital deductible, the 20% coinsurance under Part B, and other cost-sharing that has no yearly cap.

What Medigap actually does

That's the gap Medigap is built to fill. A Medicare Supplement policy is sold by a private insurance company and works alongside Original Medicare. When Medicare pays its share of an approved claim, your Medigap plan picks up some or all of what's left, depending on which lettered plan you bought.

Medigap is a different product from a Medicare Advantage (Part C) plan. You can't have both at the same time — Medigap only works with Original Medicare.

How the standardized letters work

Here in Shelbyville — and everywhere outside Massachusetts, Minnesota, and Wisconsin, which have their own systems — Medigap plans are standardized by the federal government. That means each lettered plan has the same core benefits no matter which company sells it.

The letters currently sold to new enrollees are A, B, D, G, K, L, M, and N. Plans C and F are still held by some people who were eligible for Medicare before January 1, 2020, but they're no longer sold to newly eligible enrollees because they covered the Part B deductible, which is no longer allowed for new plans.

Because the benefits inside a letter are identical from carrier to carrier, the main things that vary between companies are the premium, customer service, and how they raise rates over time. That's why comparing quotes for the same letter matters.

What Medigap typically covers — and what it doesn't

Depending on the letter you pick, a Medigap policy may help pay for:

• Part A hospital coinsurance and an extra 365 days after Medicare benefits are used up
• Part B coinsurance or copays
• The first three pints of blood each year
• Hospice coinsurance
• Skilled nursing facility coinsurance
• The Part A deductible
• Foreign travel emergency care (up to plan limits)

Some letters (like K and L) pay a percentage of these costs and include an annual out-of-pocket limit. Plan N uses small copays for some office and ER visits.

Medigap generally does not cover prescription drugs, routine dental, vision, hearing aids, long-term custodial care, or private-duty nursing. For drug coverage, you'd enroll in a stand-alone Part D plan. The Part D maximum deductible is $615 in 2026, and out-of-pocket drug spending is capped at $2,100 for the year.

Local context for Shelbyville

Shelbyville is in Bedford County, where residents on Medicare can choose between staying on Original Medicare (and optionally adding a Medigap policy and a Part D drug plan) or enrolling in a Medicare Advantage plan. Medigap availability, pricing, and rules are regulated at the state level in Tennessee, so what's offered here follows Tennessee's rules.

If you're comparing options, remember: Medigap letters are standardized, but premiums are not. Two companies can charge very different rates for the exact same Plan G.

When to buy — the timing matters

The single most important date for most people is the start of their Medigap Open Enrollment Period. This is a one-time, six-month window that begins the month you're 65 or older and enrolled in Part B.

During that window, you have a "guaranteed issue" right: insurers must sell you any Medigap plan they offer at their best available rate, and they can't turn you down or charge more because of your health history.

Outside that window, in most states insurers can use medical underwriting — meaning they can review your health and potentially deny coverage or charge more. There are a few limited situations (called guaranteed issue rights) that reopen protections, such as losing certain other coverage.

How to decide which letter fits

There's no single "right" Medigap letter — it depends on how you like to pay for care. A few honest questions to ask yourself:

• Do you prefer higher predictability (a bigger premium, fewer surprises) or lower premiums with some cost-sharing when you use care?
• Do you travel outside the U.S. often enough to want foreign travel emergency coverage?
• Do you want an out-of-pocket maximum built in, or are you comfortable without one?
• Are you newly eligible, or are you switching from another plan and possibly facing underwriting?

Once you know the letter, compare premiums from several carriers licensed in Tennessee for that same letter.

Where to get unbiased help

For personal questions, don't rely on a sales call. Free, unbiased help is available:

• Medicare.gov — the official site for comparing plans and reading the "Choosing a Medigap Policy" guide
• 1-800-MEDICARE (1-800-633-4227), open 24/7
• Tennessee SHIP (State Health Insurance Assistance Program) — free one-on-one counseling for Tennessee residents