Medicare Supplement

Puyallup guide to Medicare Supplement plans A through N

PUYALLUP, Wash. — If you've ever tried to make sense of Medicare Supplement insurance, you've probably run into a wall of letters: Plan A, Plan G, Plan N, and more. It looks confusing, but there's a method behind it — and once you understand how Medigap works, the rest gets a lot easier.

Here's a plain-English look at what Medicare Supplement plans do, what they don't do, and how those standardized letters fit together.

What Medigap Is — and What It Isn't

Medicare Supplement insurance, often called Medigap, is a private policy that helps pay some of the out-of-pocket costs that Original Medicare (Part A and Part B) leaves behind. Think deductibles, coinsurance, and copays — the "gaps" in the name.

A Medigap policy works with Original Medicare. It is not the same as a Medicare Advantage (Part C) plan, which replaces the way you get your Medicare benefits. You can't have both a Medigap policy and a Medicare Advantage plan at the same time.

Medigap also does not include prescription drug coverage. If you want help paying for medications, you'd add a stand-alone Part D drug plan.

How the Standardized Letters Work

Here's the part that trips people up. Medigap plans are sold by private insurance companies, but the benefits inside each lettered plan are set by federal law. That means Plan G from one company covers the same core benefits as Plan G from another company. The price and customer service can differ — the benefits cannot.

The plans currently sold are labeled 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.) Each letter offers a different combination of coverage for things like:

• Part A hospital coinsurance and extra hospital days
• Part B coinsurance or copays
• The first three pints of blood
• Skilled nursing facility coinsurance
• Part A and Part B deductibles (varies by plan)
• Foreign travel emergency care (varies by plan)

Plans K and L work a little differently — they cover a percentage of certain costs until you hit a yearly out-of-pocket limit, and then they pay 100% for the rest of the year.

What Medigap Doesn't Cover

Medigap is helpful, but it isn't a catch-all. Standardized Medigap policies generally do not cover:

• Prescription drugs (you need a separate Part D plan)
• Long-term care (like a nursing home stay that isn't skilled care)
• Vision, dental, or hearing care
• Private-duty nursing
• Eyeglasses or hearing aids

If any of those matter to you, they need a different solution — sometimes another product, sometimes a program like Medicaid or a state assistance program.

Timing Matters: The Medigap Open Enrollment Window

The single most important thing to know about buying a Medigap policy is timing. Your Medigap Open Enrollment Period is a six-month window that starts the first month you're 65 and enrolled in Medicare Part B. During that window, you have a guaranteed right to buy any Medigap policy sold in your state, regardless of your health history.

Outside that window, insurance companies in most states can use medical underwriting — meaning they can charge you more or turn you down based on your health. A few states have extra protections, but Washington's rules are their own animal, so it's worth checking with your state insurance office before you assume anything.

A Note on Local Availability

Puyallup is in Pierce County, where the mix of Medicare options — Original Medicare with a Medigap policy, or a Medicare Advantage plan — is the same set of choices available across the country. Medigap policies are sold by private insurers licensed in Washington, and the specific companies offering each lettered plan can vary. You can compare policies sold in your ZIP code using the plan finder at medicare.gov.

Keep in mind that Medicare Advantage plans have their own enrollment calendar — the Annual Enrollment Period runs October 15 through December 7, and the Medicare Advantage Open Enrollment Period runs January 1 through March 31. Medigap doesn't follow that same calendar; you can apply for a Medigap policy any time, but protections against medical underwriting depend on when you apply.

How Medigap Fits with Part D and the 2026 Drug Cost Cap

Because Medigap doesn't include drug coverage, most people who choose Medigap also enroll in a stand-alone Part D prescription drug plan. Part D has some meaningful updates for 2026: a $2,100 annual out-of-pocket cap on covered drugs, a maximum deductible of $615, and the coverage gap (the old "donut hole") is gone — replaced with a simpler three-phase structure that took effect in 2025.

There's also the Medicare Prescription Payment Plan, an optional program that lets you spread your drug costs across the year in monthly payments instead of paying big amounts at the pharmacy counter.

Higher-income beneficiaries should also know about IRMAA — the income-related surcharge on Part B and Part D premiums. For 2026, IRMAA begins for single filers with income above $109,000.