Medicare Supplement

How Medigap standardizes Medicare coverage in Richmond

RICHMOND, Virginia — If you've started looking into Medicare, you've probably seen letters like Plan G, Plan N, or Plan K attached to something called Medigap. Those letters aren't random. They're part of a system designed to make shopping for extra coverage a little easier — once you know how to read them.

Here's a plain-English guide to what Medicare Supplement Insurance does, how the standardized letters work, and where Richmond residents can turn for one-on-one help.

What Medigap Is — and What It Isn't

Medigap, also called Medicare Supplement Insurance, is a policy sold by private insurance companies that helps pay some of the costs Original Medicare (Part A and Part B) doesn't cover. Think of things like coinsurance, copayments, and deductibles.

A Medigap policy works alongside Original Medicare. It is not the same thing as a Medicare Advantage plan (Part C), and you can't have both at the same time. Medigap also doesn't include prescription drug coverage — for that, you'd add a separate Part D plan.

According to Medicare.gov, you generally need to be enrolled in Part A and Part B to buy a Medigap policy, and you pay a monthly premium to the insurance company on top of your Part B premium.

Why the Letters Exist

Before the federal government stepped in, Medigap policies were confusing to compare. Two plans with similar names could cover very different things. So Medicare created a set of standardized plans, each labeled with a letter.

Today, the plans available in most states are labeled A, B, C, D, F, G, K, L, M, and N. Every plan with the same letter must cover the same core benefits — no matter which insurance company sells it. A Plan G from one carrier covers the same things as a Plan G from another carrier.

What can differ is the price. Insurance companies set their own premiums, so it pays to compare.

What the Letters Generally Cover

Each lettered plan offers a different mix of coverage. Some pay nearly all of your out-of-pocket costs under Original Medicare. Others cover less but come with lower premiums. A few (Plans K and L) include an annual out-of-pocket limit.

A couple of important notes from Medicare.gov:

• Plans C and F are only available to people who became eligible for Medicare before January 1, 2020. If you turned 65 after that date, those two aren't options for you.
• Massachusetts, Minnesota, and Wisconsin standardize their Medigap plans differently. Virginia follows the standard federal lettering.

Because the benefits inside each letter are set by federal rules, the real shopping question becomes: which letter fits your health needs and budget, and which company offers it at a fair price?

Timing Matters: The Medigap Open Enrollment Period

One of the most important things to understand about Medigap is when you buy it.

Your Medigap Open Enrollment Period is a one-time, six-month window that starts the month you're 65 or older and enrolled in Part B. During this window, you have a "guaranteed issue" right — insurance companies can't turn you down or charge you more because of your health history.

Miss this window, and in most states (including Virginia), insurers can use medical underwriting. That means they can review your health and potentially deny coverage or charge higher premiums. This is one of the most common — and costly — mistakes new enrollees make.

How Medigap Fits With the Rest of 2026 Medicare

Medigap is only one piece of the puzzle. For 2026, a few program-level facts are worth knowing:

• The Part D out-of-pocket cap is $2,100.
• The Part D maximum deductible is $615.
• The coverage gap ("donut hole") is gone as of 2025 — Part D now has three phases.
• The optional Medicare Prescription Payment Plan lets you spread drug costs across the year in monthly installments.
• IRMAA income surcharges start above $109,000 for a single filer in 2026.
• Annual Enrollment runs Oct. 15 – Dec. 7, and Medicare Advantage Open Enrollment runs Jan. 1 – March 31.

Richmond is in Richmond city, where the specific number of Medicare Advantage and Part D plans available is set at the county level. Medigap, on the other hand, is regulated at the state level through the Virginia Bureau of Insurance.

A Short FAQ

Q: Can I switch Medigap plans later if my needs change? A: You can apply to switch at any time, but outside of your initial open enrollment window or a guaranteed-issue situation, insurance companies in Virginia can use medical underwriting. Approval isn't guaranteed.

Q: Does Medigap cover prescription drugs? A: No. Medigap policies sold today do not include drug coverage. If you want help paying for prescriptions, you'd enroll in a separate Part D plan.

Q: Can I have both Medigap and a Medicare Advantage plan? A: No. Medigap is designed to work with Original Medicare only. It's actually illegal for someone to sell you a Medigap policy if you're enrolled in a Medicare Advantage plan, unless you're switching back to Original Medicare.

Q: Are Medigap premiums the same everywhere? A: No. Even though benefits within a letter are standardized, premiums vary by company, location, age, and how the insurer prices its policies. Comparing quotes matters.

Where to Get Trusted Help

Medigap decisions are personal, and the right choice depends on your health, budget, and how often you travel. Before you sign anything, use official resources:

• Medicare.gov — Compare Medigap policies available in your ZIP code.
• 1-800-MEDICARE (1-800-633-4227) — Available 24/7 for questions.
• Virginia Insurance Counseling and Assistance Program (VICAP) — Virginia's SHIP offers free, unbiased Medicare counseling to Richmond residents. Call 1-800-552-3402.

Taking a little time to understand the letters now can save a lot of confusion later — and help you feel confident about the coverage you choose.