Medicare Supplement

Medicare Supplement Basics Racine Shoppers Should Know

RACINE, Wis. — If you've been shopping for Medicare coverage, you've probably seen letters like Plan G, Plan N, or Plan K floating around. Those letters refer to Medicare Supplement Insurance, better known as Medigap — private policies that help pay some of the costs Original Medicare doesn't cover.

Understanding what Medigap actually does

Medigap is not the same as Medicare Advantage, and mixing the two up is one of the most common — and costly — mistakes new enrollees make. Here's a plain-language walk-through of how the standardized letters work, and what to think about if you live in Racine.

What Medigap covers (and what it doesn't)

Original Medicare — Part A (hospital) and Part B (doctor and outpatient) — pays most, but not all, of your covered medical bills. You're still on the hook for deductibles, coinsurance, and copays, and there's no yearly out-of-pocket cap built into Original Medicare.

That's the gap Medigap fills. Depending on the letter you pick, a Medigap policy can help pay:

• Your Part A hospital coinsurance and some extra hospital days
• Your Part B coinsurance or copays
• The first three pints of blood
• Hospice care coinsurance
• Skilled nursing facility coinsurance
• Part A and (in some plans) Part B deductibles
• Foreign travel emergency care (in some plans)

What Medigap does not cover: prescription drugs (you'd add a separate Part D plan), dental, vision, hearing aids, or long-term care. And you cannot have a Medigap policy and a Medicare Advantage plan at the same time — it's one road or the other.

Why the letters are "standardized"

Here's the part that trips people up. In most states, Medigap plans are standardized by the federal government. That means Plan G sold by one insurance company must offer the exact same benefits as Plan G sold by another. The price and customer service can differ, but the covered benefits cannot.

The currently sold letters for people newly eligible for Medicare are A, B, D, G, K, L, M, and N. (Plans C and F are still available, but only to people who became eligible for Medicare before January 1, 2020.) Plans K and L include an annual out-of-pocket limit, after which they pay 100% for the rest of the year.

So when you compare "Plan G" from Carrier 1 to "Plan G" from Carrier 2, you're truly comparing apples to apples on benefits.

A quick note for Racine readers: Wisconsin is one of three states (along with Massachusetts and Minnesota) that standardizes Medigap differently. Instead of the letter system, Wisconsin uses a base plan with optional riders you can add on. If a national article or ad shows you "Plan G" pricing, that framework doesn't apply the same way here. Talk to someone familiar with Wisconsin's version before you compare.

Timing matters more than most people realize

The single biggest mistake in Medigap is missing your Medigap Open Enrollment Period. This is a one-time, six-month window that starts the month you're 65 and enrolled in Part B. During this window, insurers must sell you any Medigap policy they offer at their best available rate — no health questions, no denials.

Outside that window, in most cases, insurers can use medical underwriting. That means they can charge you more or turn you down based on your health. There are limited "guaranteed issue" situations later on, but they're narrower than people assume.

If you're approaching 65 in Racine, mark your calendar. It's a use-it-or-lose-it protection.

How Medigap fits with Part D and 2026 rules

Because Medigap doesn't include drug coverage, most people pair it with a standalone Part D prescription drug plan. Some important 2026 program figures to keep in mind:

• The Part D out-of-pocket cap is $2,100 for 2026. Once you hit that, you pay $0 for covered drugs the rest of the year.
• The Part D maximum deductible is $615.
• The old coverage gap ("donut hole") was eliminated in 2025. Part D now has three phases instead of four.
• The Medicare Prescription Payment Plan lets you spread drug costs across the year in monthly payments instead of paying big amounts at the pharmacy counter.
• IRMAA — higher Part B and Part D premiums for higher earners — kicks in above $109,000 in income for a single filer in 2026.

Racine is in Racine County, where multiple standalone Part D plans and Medicare Advantage plans are offered each year. Availability is set at the county level, so your options are the same whether you live in downtown Racine, Mount Pleasant, or Caledonia.

Common mistakes to avoid

• Assuming Medigap and Medicare Advantage are the same thing. They're different products with different rules. You can only have one.
• Waiting past your six-month Medigap Open Enrollment window. After it closes, health underwriting usually applies.
• Forgetting to add Part D. Medigap does not cover prescriptions. Going without creditable drug coverage can mean a lifelong late-enrollment penalty.
• Comparing only premiums. With standardized benefits, service, rate history, and financial strength of the insurer matter, too.
• Applying national Medigap info to Wisconsin. Our state's system is structured differently.