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Medicare Supplement Plans Explained

If you’re comparing Medicare supplement plans, this guide ranks the top options and shows how to choose the right fit.

We’ll break down coverage, costs, who each plan is best for, and key rules so you can enroll with confidence.

How Medicare Supplement (Medigap) works

Medicare Supplement Insurance (Medigap) helps pay Original Medicare’s out-of-pocket costs—like deductibles, copays, and coinsurance. You keep your red-white-and-blue Medicare card and can see any provider nationwide who accepts Medicare.

Medigap plans are standardized by letter (A–N). For example, Plan G from one insurer must cover the same benefits as Plan G from another; only the price, service, and underwriting differ. You can’t use Medigap with Medicare Advantage—it's one or the other. For a quick coverage chart, see Medicare’s official comparison tool: Compare Medigap plans.

Medigap doesn’t cover outpatient drugs, routine dental/vision/hearing, or long-term care. If you need prescriptions, you’ll add a separate Part D plan.

Most Medigap plans let you see any Medicare-participating provider without referrals. Some plans include limited foreign travel emergency coverage (80% after a small deductible, up to a lifetime cap).

Top 5 Medicare supplement plans (ranked best to worst)

“Best” depends on your budget, health usage, and eligibility. Below is a practical ranking based on overall value, breadth of coverage, availability to new enrollees, and typical premiums.

#1: Plan G — Best overall coverage for most people

Why it ranks first: Plan G delivers the most comprehensive coverage available to people new to Medicare today. It covers virtually all Medicare gaps except the Part B deductible.

  • Covers: Part A hospital deductible and coinsurance, skilled nursing facility coinsurance, Part B coinsurance, Part B excess charges, hospice coinsurance/copays, first 3 pints of blood, and foreign travel emergency (80% to plan limits).
  • Does not cover: Medicare Part B annual deductible (e.g., $240 in 2024).

Who it fits: People who want predictable costs and nationwide flexibility, especially frequent specialists or travelers. After you meet the Part B deductible, most Part A/B cost-sharing is paid by Plan G.

Cost picture: Premiums vary widely by age, location, and pricing method, but Plan G typically sits in the mid-to-higher premium tier. Many find the extra premium worth the reduced surprises throughout the year.

Example: If you see several specialists early in the year, you’ll pay up to the Part B deductible first; after that, covered Part B coinsurance is paid by Plan G for the rest of the year.

#2: Plan N — Strong value with modest copays

Why it ranks second: Plan N can cost notably less than Plan G while still covering hospital costs and most Part B coinsurance. In exchange, you accept small copays and a couple of gaps.

  • Covers: Part A deductible/coinsurance, skilled nursing facility coinsurance, most Part B coinsurance, hospice coinsurance/copays, first 3 pints of blood, and foreign travel emergency.
  • Member costs: Up to $20 copay for most office visits and up to $50 for ER visits that don’t lead to admission; the Part B deductible still applies.
  • Important gap: Plan N does not cover Part B excess charges (the extra up to 15% some providers may bill if they don’t accept assignment).

Who it fits: Budget-conscious enrollees who don’t mind occasional copays and who mostly see providers that accept Medicare assignment (no excess charges). You can verify assignment status with providers or review Medicare’s guidance on assignment and excess charges.

Cost picture: Often 10–30% less than Plan G in the same market. If your doctors accept assignment, the trade-off can be very cost-effective.

#3: High-Deductible Plan G — Lowest premiums, higher risk

Why it ranks third: High-Deductible G (HD-G) offers the same benefits as standard Plan G after you meet a calendar-year high deductible. For 2024, that deductible is $2,800.

  • Covers: The same categories as Plan G, but only after you first pay Medicare-approved cost-sharing up to the annual HD deductible; then it functions like regular Plan G for the rest of the year.
  • Does not cover: Part B deductible is included in the HD amount you must meet.

Who it fits: Healthy, low-utilization beneficiaries or HSA-minded retirees who prefer very low premiums and are comfortable self-insuring the first several thousand dollars.

Cost picture: Premiums can be a fraction of standard Plan G—often one-third to one-half the price—making it attractive if you rarely need care. Confirm the current deductible in Medicare’s official guide: Choosing a Medigap Policy (PDF).

#4: Plan F — Richest coverage, but only if you’re eligible

Why it ranks fourth: Plan F covers everything Plan G does plus the Part B deductible, making it the richest Medigap option. However, it’s only available if you were first eligible for Medicare before January 1, 2020.

  • Covers: Part A and B deductibles, coinsurance/copays, Part B excess charges, skilled nursing facility coinsurance, hospice cost-sharing, first 3 pints of blood, and foreign travel emergency.

Who it fits: Legacy-eligible beneficiaries who value the most predictable out-of-pocket costs and don’t mind paying a higher premium for “first-dollar” coverage.

Cost picture: Premiums are typically higher than Plan G. If you qualify and use care frequently, the peace of mind can be worth it; otherwise, Plan G may deliver better value.

#5: Plan A — Essential basics at the lowest price point

Why it ranks fifth: Plan A includes Medigap’s core benefits but omits major items like the Part A hospital deductible and skilled nursing facility coinsurance. It’s the minimalistic option.

  • Covers: Part B coinsurance, Part A coinsurance (hospital days 61–90 and lifetime reserve), hospice coinsurance/copays, and first 3 pints of blood.
  • Does not cover: Part A deductible, skilled nursing facility coinsurance, Part B deductible, or excess charges, among others.

Who it fits: Beneficiaries seeking the lowest possible premium who are comfortable with higher potential hospital costs, or who have other coverage that helps with inpatient expenses.

Costs, pricing methods, and what drives your premium

Even though benefits are standardized, premiums are not. Insurers use different pricing methods and underwriting rules, which means two people can pay very different amounts for the same letter plan.

  • Community-rated (no-age-rated): Everyone pays the same base rate regardless of age. Increases are due to inflation/claims, not your birthday.
  • Issue-age-rated: Your starting premium is based on the age you are when you buy; it won’t increase due to aging (but can rise for other reasons).
  • Attained-age-rated: Starts lower at 65 but rises as you age, in addition to other increases.

Other factors: tobacco use, ZIP code, household discounts, and carrier rate history. Always compare multiple insurers offering the same letter plan and review the standardized benefits chart in Medicare’s official comparison tool.

Enrollment timing and eligibility rules

Medigap Open Enrollment: You get a 6-month window that begins the first month you’re 65 or older and enrolled in Part B. During this period, you can buy any plan sold in your area with no medical underwriting. See Medicare’s overview of the Open Enrollment Period.

Guaranteed issue rights: In certain situations—like losing employer coverage or switching from Medicare Advantage under specific circumstances—you can buy some Medigap plans without health questions. Rules vary by scenario; consult Medicare’s page on guaranteed issue rights.

After your window: You can apply anytime, but medical underwriting may apply and you could be denied or charged more based on health. Many states have additional protections—talk to your State Health Insurance Assistance Program (SHIP) for free, unbiased help.

Important: Medigap covers only Original Medicare. If you choose a Medicare Advantage plan, you can’t use Medigap at the same time. Drug coverage requires a standalone Part D plan.

How to choose the right plan in your area

  • Start with the letter, not the logo: Decide between G, N, HD-G (or F if eligible) based on benefits and your risk tolerance. Benefits are identical for a given letter, no matter the insurer.
  • Confirm your doctors’ billing practices: If considering Plan N, ask whether your providers accept Medicare assignment to avoid possible excess charges.
  • Compare pricing methods and discounts: Community/issue-age pricing can age more gracefully than attained-age. Ask about household or EFT discounts.
  • Check carrier stability and rate history: A slightly higher initial premium from a stable carrier can be cheaper over time than a low teaser rate with steep increases.
  • Use official tools and free counseling: Start with Medicare’s Medigap lookup to see plans and insurers in your ZIP: Find Medigap plans near you, and contact SHIP for personalized guidance.

Quick FAQs

Do Medigap plans cover prescription drugs? No. Add a separate Part D plan for outpatient prescriptions.

Can I switch Medigap plans later? Usually yes, but outside protected periods you may face underwriting. Some states have special switching rules—ask SHIP.

Is foreign travel covered? Several plans (G, N, F) include limited emergency coverage abroad—generally 80% after a small deductible, up to a lifetime maximum.

Sources and further reading