Medicare Supplement

What Original Medicare leaves behind: Medigap in Herriman

HERRIMAN, Utah — If you're new to Medicare, or helping a parent sort through the mail piling up on the kitchen counter, the word "Medigap" probably keeps showing up. It sounds like jargon, but the idea behind it is simple: Original Medicare doesn't pay for everything, and a Medicare Supplement policy — often called Medigap — is designed to help cover some of what's left.

Here's a plain-English look at what Medigap does, what it doesn't do, and how those confusing letter names (Plan A, Plan G, Plan N and the rest) actually work.

What Medigap is — and what it isn't

Medigap is private insurance you can buy to work alongside Original Medicare (Part A and Part B). After Medicare pays its share of a covered service, your Medigap policy can pick up some or all of the leftover costs — things like coinsurance, copayments, and deductibles.

A few things Medigap is not:

• It is not Medicare Advantage (Part C). Medicare Advantage is a different way to get your Medicare benefits, offered through private plans. You can't have both a Medicare Advantage plan and a Medigap policy at the same time.
• It is not a drug plan. Medigap sold today does not include Part D prescription drug coverage. If you want drug coverage, you generally sign up for a stand-alone Part D plan.
• It is not a replacement for Medicare. You must be enrolled in Part A and Part B to buy and use a Medigap policy.

How the standardized letters work

This is the part that trips people up. In most states, Medigap policies are standardized by the federal government. That means Plan G from one insurance company covers the same core benefits as Plan G from another. The price can differ, and customer service can differ, but the benefits inside a given letter plan are the same.

Today, the plans sold to new enrollees are labeled with letters: A, B, D, G, K, L, M, and N. (Plans C and F are still held by some people, but they're generally not available to people who became eligible for Medicare on or after Jan. 1, 2020, because those plans covered the Part B deductible.)

Each letter is a different bundle of benefits. For example:

• Every Medigap plan helps with Part A hospital coinsurance and adds extra hospital days after Medicare's benefits are used up.
• Some plans also help with the Part B deductible, skilled nursing facility coinsurance, or foreign travel emergency care.
• Plans K and L pay a percentage of certain costs rather than 100%, and they include a yearly out-of-pocket limit.

You can compare the standardized benefits side by side at medicare.gov.

When you can buy a Medigap policy

Timing matters more with Medigap than most people realize.

Your best window is the Medigap Open Enrollment Period — a one-time, six-month window that starts the month you're 65 and enrolled in 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, in most states, insurance companies can use medical underwriting. That means they can ask health questions and, in some cases, charge you more or turn you down. A few states have stronger consumer protections, so it's worth checking Utah's rules with the Utah Insurance Department or your local SHIP counselor before you shop.

Note: The fall Annual Enrollment Period (Oct. 15 – Dec. 7) and the Medicare Advantage Open Enrollment Period (Jan. 1 – March 31) are for Medicare Advantage and Part D changes — not Medigap. Medigap has its own timing rules.

What Medigap does not cover

Medigap is helpful, but it has real limits. It generally does not cover:

• Prescription drugs (you'll want a separate Part D plan)
• Routine dental, vision, or hearing care
• Hearing aids or eyeglasses
• Long-term custodial care in a nursing home
• Private-duty nursing

Also worth knowing for 2026: Part D — the drug coverage piece — now has a $2,100 annual out-of-pocket cap on covered prescriptions, and the maximum Part D deductible is $615. The old "donut hole" coverage gap was eliminated in 2025, so Part D now works in three phases instead of four. Medicare also offers the Medicare Prescription Payment Plan, which lets you spread your drug costs across the year in monthly installments if that helps your budget.

Higher-income beneficiaries may pay an IRMAA surcharge on Part B and Part D premiums; for 2026, IRMAA generally starts above $109,000 in income for a single filer.

Medigap and where you live

Medigap policies work anywhere in the U.S. that accepts Original Medicare, which is one reason some people who split time between states or travel often prefer them. Herriman is in Salt Lake County, and while Medicare Advantage plan availability is set at the county level, Medigap is regulated at the state level. That means the plans you can buy — and the rules for switching — depend on Utah's insurance laws, not on your ZIP code.