Medicare Supplement

Medigap benefits are identical by law: a Hampton guide to Medicare

# Medicare Supplement insurance, explained: what Medigap does and doesn't…

HAMPTON, Va. — If you're on Original Medicare and the words "20% coinsurance with no cap" make you nervous, you're not alone. That's the gap Medicare Supplement insurance — usually called Medigap — is designed to help fill. And because Medigap plans are sold by private insurers but standardized by the federal government, the coverage behind each lettered plan is the same no matter which company sells it.

Here's what Hampton readers should know about how Medigap works, what those letters mean, and where it fits alongside the rest of Medicare in 2026.

What Medigap actually does

Original Medicare pays a big share of your hospital and doctor bills, but it leaves you responsible for deductibles, coinsurance, and copays — and there's no yearly out-of-pocket maximum built into Parts A and B. That's the "gap."

A Medigap policy is private insurance you buy on top of Original Medicare to help pay some of those leftover costs. Depending on the letter you pick, it may help cover the Part A hospital deductible, the daily coinsurance for longer hospital stays, the Part B coinsurance (that 20% share), the first three pints of blood, hospice coinsurance, and — with some plans — emergency care during foreign travel.

Medigap does not cover prescription drugs, dental, vision, hearing aids, long-term care, or private-duty nursing. Those need separate coverage.

How the standardized letters work

In most states, including Virginia, Medigap plans are sold using standardized letters: A, B, D, G, K, L, M, N, and a high-deductible version of G. (Plans C and F are still around, but new enrollees generally aren't eligible for them if they became Medicare-eligible on or after January 1, 2020.)

Standardization means the benefits inside each letter are set by federal rules. Two Plan Ns from two different companies pay the same kinds of claims the same way. What can differ is the monthly premium, the company's customer service, and how they price policies over time.

Plan G and Plan N tend to be the most talked-about among newer enrollees because they offer broader cost-sharing help. Plans K and L work more like traditional insurance, with cost-sharing percentages and a yearly out-of-pocket limit. You can compare each letter's benefits side by side on medicare.gov.

Medigap vs. Medicare Advantage — pick one lane

This is the part that trips people up. Medigap only works with Original Medicare. If you're enrolled in a Medicare Advantage plan (Part C), you cannot use a Medigap policy — and it's actually illegal for someone to sell you one on top of an Advantage plan.

Hampton is in Hampton City, where residents can choose between Original Medicare (often paired with a Medigap and a stand-alone Part D plan) or a Medicare Advantage plan that bundles hospital, medical, and usually drug coverage together. Both paths are valid; they just work very differently on cost-sharing, provider networks, and extra benefits.

Timing matters: your one-time Medigap window

The single most important date for Medigap shoppers is the start of your Medigap Open Enrollment Period. It's a six-month window that begins the first month you're 65 or older and enrolled in Part B. During that window, insurers must sell you any Medigap plan they offer at their best available rate, regardless of your health history.

Outside that window, in most cases, carriers can use medical underwriting — meaning they can charge you more or turn you down based on health conditions. Virginia has some limited protections, but the six-month window is where you have the strongest rights nationwide.

This is separate from Medicare's Annual Enrollment Period (October 15 – December 7) and the Medicare Advantage Open Enrollment Period (January 1 – March 31), which apply to Advantage and Part D plans, not Medigap.

Don't forget drug coverage

Because Medigap doesn't include prescription drugs, most people on Original Medicare pair it with a stand-alone Part D plan. A few 2026 Part D facts worth knowing:

• The Part D out-of-pocket cap is $2,100 for the year.
• The maximum Part D deductible is $615.
• The old "donut hole" coverage gap is gone as of 2025 — Part D now has three phases.
• The Medicare Prescription Payment Plan lets you spread your drug costs across the calendar year in monthly installments instead of paying all at once at the pharmacy.
• IRMAA surcharges (higher premiums based on income) begin above $109,000 for a single filer in 2026.

Where Hampton residents can get unbiased help

Medigap is a long-term decision — the plan you pick can stay with you for years. Before you sign anything, it's worth talking to someone who isn't paid to sell you a specific policy.

• medicare.gov — compare Medigap letters, Part D plans, and Advantage plans in your ZIP.
• 1-800-MEDICARE (1-800-633-4227), available 24/7.
• Virginia Insurance Counseling and Assistance Program (VICAP) — Virginia's SHIP, which offers free, one-on-one Medicare counseling to Hampton residents.