Medicare Supplement

Medigap, Explained: What It Covers and How the Letters Work

PROVO, Utah — If you've ever tried to read a Medicare Supplement brochure and felt your eyes glaze over, you're not alone. The good news for folks here in Provo: Medigap plans are more straightforward than they look, once you understand how the letter system works and what these policies are actually designed to do.

Here's a plain-English guide to help you avoid the most common mistakes.

What Medigap Actually Does

Medicare Supplement insurance — often called Medigap — is a private policy that works alongside Original Medicare (Part A and Part B). It doesn't replace Medicare. Instead, it helps pay some of the out-of-pocket costs that Original Medicare leaves behind, such as coinsurance, copayments, and deductibles.

Think of it as a second layer of coverage that kicks in after Medicare pays its share. When you go to the doctor or hospital, Medicare pays first, and your Medigap plan picks up part or all of what's left, depending on the letter you choose.

One important note: Medigap only works with Original Medicare. If you're enrolled in a Medicare Advantage plan, you cannot use a Medigap policy at the same time.

How the Standardized Letters Work

In most states, Medigap plans are sold using standardized 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 January 1, 2020.)

Here's the key thing to understand: a Plan G from one company covers exactly the same benefits as a Plan G from another company. The letter defines the benefits by law. What can differ is the monthly premium and the customer service you get.

That means shopping for Medigap is less about comparing benefits and more about comparing prices and the insurer's reputation.

What Medigap Does Not Cover

This is where many people get tripped up. Medigap plans generally do not cover:

• Prescription drugs (you'll need a separate Part D plan)
• Dental, vision, or hearing care
• Long-term care (like a nursing home stay beyond what Medicare covers)
• Private-duty nursing
• Eyeglasses or hearing aids

If you want drug coverage, you'll need to enroll in a stand-alone Part D plan. For 2026, Part D has an out-of-pocket cap of $2,100 and a maximum deductible of $615. The old "donut hole" has been eliminated since 2025, so drug costs are structured in three simpler phases now.

The Enrollment Window That Matters Most

Timing is everything with Medigap. Your Medigap Open Enrollment Period is a one-time, six-month window that starts the month you turn 65 and are enrolled in Part B.

During this window, you have a guaranteed issue right. That means insurers cannot deny you coverage or charge you more because of health conditions. Miss it, and in most cases insurers can use medical underwriting — which may mean higher premiums or being turned down entirely.

This is the single most common Medigap mistake we hear about: waiting too long, then being surprised at how much harder (and pricier) it is to get in later.

Provo and Utah County: What's Available

Provo is in Utah County, where Medigap plans are offered by multiple private insurers. Because the benefits inside each letter plan are standardized by federal law, the differences you'll see locally are in premiums, household discounts, and whether the insurer prices policies based on age.

To compare what's sold in your ZIP code, use the plan finder at medicare.gov — it lists policies available in Utah County and shows premium ranges side by side.

Avoiding the Most Common Mistakes

A few pitfalls worth knowing:

• Assuming Medigap covers drugs. It doesn't. You still need Part D.
• Missing your six-month open enrollment window. After it closes, you can be underwritten.
• Trying to have both Medigap and Medicare Advantage. You can't use them together.
• Comparing letters instead of prices. A Plan N is a Plan N — shop the premium and the company.