Medicare Supplement

The Letter System Behind Medigap Coverage in Lacey

LACEY, Wash. — If you've started shopping for a Medicare Supplement policy, you've probably noticed something odd: the plans are labeled with letters. Plan A, Plan G, Plan N, and a few others. It can feel like alphabet soup at first, but there's a good reason behind it — and once you understand the system, comparing coverage gets a lot easier.

Here's a plain-language look at what Medigap does, how the letters work, and where to turn for help here in Thurston County.

What Medigap actually does

Medigap — also called Medicare Supplement Insurance — 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, like coinsurance, copayments, and certain deductibles.

You pay a monthly premium to the insurance company for a Medigap policy, on top of your Part B premium. In return, the policy picks up a share of the bills after Medicare pays its portion.

A few key points from Medicare.gov:

• Medigap only works with Original Medicare. If you're enrolled in a Medicare Advantage plan, you generally can't use a Medigap policy at the same time.
• Medigap policies don't include prescription drug coverage. For that, you'd add a stand-alone Part D drug plan.
• Each Medigap policy covers one person. Spouses need their own policies.

Why the letters exist

Back in 1990, Congress standardized Medigap plans so shoppers wouldn't have to compare hundreds of confusing benefit combinations. Today, in most states, Medigap policies come in 10 standardized types, each labeled with a letter: A, B, C, D, F, G, K, L, M, and N.

Here's the important part: the benefits inside each letter plan are set by federal law. A Plan G sold by one insurance company covers the same core benefits as a Plan G sold by another. The company logo on the card changes; the underlying coverage doesn't.

What can differ between companies:

• The monthly premium
• Customer service and extras (like fitness perks or 24-hour nurse lines)
• How the company sets and adjusts rates over time

That means shopping Medigap is largely about price and service once you've picked a letter.

A quick tour of the letters

Each letter offers a different mix of benefits. Some cover almost everything Original Medicare leaves behind; others cover less in exchange for a lower premium. Common building blocks across the plans include:

• Part A hospital coinsurance and extra hospital days
• Part B coinsurance or copayments
• Blood (first three pints)
• Hospice care coinsurance
• Skilled nursing facility coinsurance (in most letter plans)
• Part A deductible (in most letter plans)
• Foreign travel emergency care (in some letter plans)

Two notes worth remembering:

• Plans C and F are no longer available to people who became eligible for Medicare on or after January 1, 2020. If you were eligible before that date, you may still be able to buy or keep them.
• Plans K and L have annual out-of-pocket limits and cover a smaller share of certain costs, which usually means lower premiums.

For a side-by-side chart of exactly what each letter covers, Medicare's official comparison tool at Medicare.gov is the most reliable source.

When you can buy a Medigap policy

Timing matters a lot with Medigap. 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:

• Insurance companies must sell you any Medigap policy they offer.
• They can't charge you more or turn you down because of health problems.

Outside that window, in most cases, insurers can use medical underwriting — meaning your health history can affect whether you're approved and what you'll pay. A few states have extra protections, so it's worth asking questions before you switch.

What this looks like in Lacey

Lacey is in Thurston County, and Washington residents have access to a range of Medigap carriers licensed by the state's Office of the Insurance Commissioner. Because Medigap benefits are federally standardized, the letter you choose in Lacey covers the same things it would anywhere else in the country — but premiums and available carriers can vary by ZIP code.

Washington also has some unique Medigap rules that don't apply in most other states, especially around switching between plans after your initial enrollment window. That's another good reason to talk with an unbiased local counselor before making changes.

Where to get free, unbiased help

You don't have to figure this out alone, and you don't have to call a salesperson to get answers. Free help is available:

• Medicare.gov — official plan finder, benefit charts, and rulebooks
• 1-800-MEDICARE (1-800-633-4227) — 24/7 phone support
• Washington SHIBA — the state's SHIP (State Health Insurance Benefits Advisors) program, which offers free, one-on-one Medicare counseling to Lacey and Thurston County residents