Medicare Supplement

Why a Plan G Is a Plan G, No Matter the Insurer

McKINNEY, Texas — If you have shopped for a Medicare Supplement policy in Collin County, you have probably noticed something strange: two insurers can sell a "Plan G," charge very different premiums, and yet promise the exact same benefits. That is not a marketing trick. It is the way Medigap is designed.

Medicare SupplementMcKinney, TX

Medicare Supplement Insurance, better known as Medigap, is sold by private insurance companies to help pay some of the out-of-pocket costs Original Medicare leaves behind — things like the Part A hospital deductible and the 20% coinsurance under Part B. To make comparing policies easier, the federal government requires these plans to follow standard designs identified by letters.

Here is what those letters mean, and what to keep in mind before you pick one.

What Medigap actually does

Original Medicare (Part A and Part B) pays a large share of your hospital and doctor bills, but not all of it. You are still responsible for deductibles, coinsurance and, in some cases, copays. Medigap steps in to cover some or all of those remaining costs, depending on which lettered plan you buy.

Medigap does not replace Medicare. It works alongside it. When you go to the doctor, Medicare pays its share first, and then your Medigap policy pays its share of what is left, based on the plan letter you chose.

One important note: Medigap does not include prescription drug coverage. To get help with drug costs, you would enroll in a stand-alone Part D plan. In 2026, Part D has a $2,100 out-of-pocket cap and a maximum deductible of $615.

How the standardized letters work

In most states, including Texas, Medigap plans are sold using letters: A, B, C, D, F, G, K, L, M and N. (Plans C and F are only available to people who became eligible for Medicare before Jan. 1, 2020.)

Here is the key idea: the federal government sets the benefits inside each letter. So Plan G from Insurer A covers exactly the same things as Plan G from Insurer B. What can differ is the price, the customer service, and how the insurer handles billing — not the benefits.

That is why comparing Medigap is really about comparing premiums and the company behind the policy, once you have picked a letter that fits your needs.

The most common letter choices

Two letters get the most attention today:

• Plan G covers most out-of-pocket costs under Original Medicare after you pay the annual Part B deductible.
• Plan N is similar but leaves some smaller copays and, in certain cases, excess charges for you to pay.

Plans K and L cap your yearly out-of-pocket spending but pay a smaller share of some services along the way. Plans A, B, D and M offer different mixes of coverage. Because the benefits inside each letter are set by federal rules, you can look up any plan letter on Medicare.gov and see exactly what it covers.

When you can buy Medigap

Timing matters more with Medigap than most people realize. Your Medigap Open Enrollment Period is a one-time, six-month window that starts the month you are 65 or older and enrolled in Medicare Part B. During that window, insurers must sell you any Medigap policy they offer at their best available rate, regardless of your health history.

Outside that window, insurers in Texas can generally use medical underwriting. That means they can ask health questions and, in many cases, charge more or decline coverage based on your answers. There are some limited exceptions called "guaranteed issue" rights — for example, if certain other coverage ends.

Medigap vs. Medicare Advantage

This one trips up a lot of readers in McKinney, which is in Collin County, where both Medicare Advantage plans and Medigap policies are widely available. You have to choose one path:

• With Original Medicare + Medigap + Part D, you use your red, white and blue Medicare card and can generally see any provider in the country that accepts Medicare.
• With Medicare Advantage, a private plan takes over your Part A and Part B benefits, usually through a network, and often includes drug coverage.

You cannot use a Medigap policy to pay costs under a Medicare Advantage plan. If you switch from Advantage back to Original Medicare, you may or may not be able to buy Medigap without underwriting, depending on your situation.

What to check before you enroll

Because the benefits within each letter are identical, the shopping questions are simpler than they look:

• Which letter matches how you want to handle out-of-pocket costs?
• What is the monthly premium, and how has the insurer raised premiums in past years?
• Does the insurer offer any household or other discounts?
• Are you inside your six-month Medigap Open Enrollment Period, or will underwriting apply?

For personalized help, contact the Texas State Health Insurance Assistance Program (SHIP), known in Texas as the Health Information, Counseling and Advocacy Program (HICAP). Counselors there do not sell insurance.