Supplemental Health Insurance · Real Costs · Medigap · CMS Data · Medicare.gov
What Medigap actually costs at 65, 70, and 75 — by plan, by state, and what nobody tells you about the one enrollment window you can never get back.
💡 Why this is more complicated than it looks — read this first
“Supplemental health insurance for seniors” means different things depending on your situation. If you’re on Original Medicare (Parts A and B), you’re likely looking at Medigap — private insurance that fills in what Medicare leaves behind: deductibles, coinsurance, copays. If you’re on Medicare Advantage instead, Medigap is not available to you at all. These are two completely separate paths, and which one you’re on determines everything that follows.
Here’s what’s changed recently that makes this more urgent: Medicare Part B premiums jumped 9.7% in 2026 to $202.90/month, and the Part B annual deductible rose to $283. Without supplemental coverage, Original Medicare leaves you exposed to 20% of all outpatient costs with no annual cap — meaning a single serious illness or surgery could cost you tens of thousands of dollars out of pocket. That’s the gap Medigap closes. Understanding what it costs, which plan fits your situation, and — critically — the one enrollment window you can never recover if you miss it, is what this guide covers.
✅ The short version
Most seniors pay $100 to $300 per month for Medigap coverage, with the national average sitting around $166/month for the most popular plan (Plan G) at age 65. The range is enormous — identical coverage can cost $354/month in New York or $120/month in Texas. The best time to buy is during your guaranteed 6-month window when you first turn 65 and enroll in Part B — outside that window, insurers can deny you or charge you more based on health history, and there is no annual open enrollment for Medigap in most states.
💰 What supplemental coverage actually costs — real numbers
These are national averages. Your actual premium depends on your age, ZIP code, gender, tobacco use, and which carrier you choose. Identical Plan G coverage from two different insurers in the same ZIP code can differ by $50–$100 per month — which is why shopping is essential.
📋 Plan G · Most Popular · Age 65
~$166/mo
National average for a 65-year-old nonsmoker. Covers everything Original Medicare doesn’t pay except the $283 Part B deductible. Your only predictable annual out-of-pocket expense is that one deductible — nothing else. No network restrictions.
📋 Plan N · Budget Pick · Age 65
~$123/mo
About $43/month less than Plan G. Saves you $516/year if you have few doctor visits. Trade-off: up to $20 copay for office visits, $50 for ER visits, and no coverage for Part B excess charges. Healthy seniors who visit the doctor infrequently often come out ahead.
📋 High-Deductible Plan G · Lowest Premium
$40–$70/mo
Same coverage as Plan G — but you pay the first $2,870 of Medicare-covered costs out of pocket before Medigap kicks in. Best for very healthy seniors who rarely use healthcare and want catastrophic-only protection at minimal monthly cost.
📋 Plan G · Age 75 · How much more
~$238/mo
Rates rise with age — an average of $49/month more by age 75 vs. 65, roughly $588 more per year. Attained-age plans (most states) increase annually. Community-rated states like NY and CT charge the same regardless of age — but start much higher.
🏛️ Part B Premium · What you already pay
$202.90/mo
9.7% jump in 2026. This is separate from Medigap. All Medicare enrollees pay this unless income-based surcharges (IRMAA) apply, pushing it as high as $689.90/mo for very high earners.
⚠️ Without supplement · 20% exposure
Unlimited
Original Medicare covers 80% of outpatient costs after the Part B deductible — leaving you with 20% and no annual cap. A $200,000 surgery means $40,000 out of pocket. Medigap eliminates this exposure.
🗺️ State range · Same Plan G
$120–$354/mo
New York community-rating laws push Plan G to $354/month. Texas shoppers often find $120–$170. State rules are the single biggest cost factor outside your age and health. Always get quotes specific to your ZIP code.
⚠️ The number most people forget to add up
Your true monthly Medicare cost in 2026 includes: Part B premium ($202.90) + Medigap premium ($100–$300) + Part D drug plan premium ($20–$80). That’s $322 to $582 per month total before you see a single doctor. Knowing that number upfront helps you budget accurately and choose the right coverage tier for your income.
📋 Key questions — tap any to open the answer
These are the questions seniors search for most — and get incomplete answers to. Direct answers here, without the runaround.
1What does “supplemental health insurance” actually cover that Medicare doesn’t?▼
The Part A hospital deductible ($1,736 per benefit period) · The Part B annual deductible ($283) · 20% Part B coinsurance on all outpatient costs · Hospital coinsurance after day 60 · Skilled nursing facility coinsurance after day 20 · Part B excess charges from doctors who don’t accept Medicare assignment
Original Medicare is not free once you use it. It covers about 80% of approved costs, but there’s no annual out-of-pocket maximum — meaning unlimited 20% exposure on outpatient care if you have a prolonged illness. The Part A deductible ($1,736 per hospital benefit period, not per year) resets every time you’re admitted after a 60-day break, so a serious condition that requires multiple hospitalizations can trigger it several times in one year. Medigap eliminates or sharply reduces all of these gaps. Depending on which plan you choose, you may pay nothing beyond your monthly premium and the single Part B deductible — turning an unpredictable annual healthcare bill into a fixed, plannable number.
2Is Medigap worth it — or should I just take Medicare Advantage instead?▼
Medigap Plan G: higher monthly premium, no networks, no copays, predictable total annual cost · Medicare Advantage: lower or $0 premium, networks, copays, annual out-of-pocket max of $4,000–$8,000+ · Medigap wins on total cost for seniors with chronic conditions; Medicare Advantage can work for healthy seniors who stay in-network
The $0 premium advertised on Medicare Advantage plans misleads a lot of people. You still pay Part B ($202.90), and every time you use care, you face copays, coinsurance, and an annual out-of-pocket maximum that can be $4,000–$8,000 or more. For a senior who uses healthcare regularly — ongoing specialist care, hospitalizations, physical therapy — Medigap Plan G’s $166/month premium often produces a lower total annual cost than Medicare Advantage’s copay structure. A landmark KFF analysis found that roughly 90% of Medicare Advantage enrollees — about 22.4 million people — would face medical underwriting if they tried to switch to Medigap after their initial enrollment window, effectively locking them out. The biggest risk of choosing Medicare Advantage first is discovering you want Medigap later and being unable to get it at any reasonable price.
3What is the 6-month Medigap window and why does missing it hurt so much?▼
One-time, 6-month window starting when you’re 65 AND enrolled in Part B · During it: guaranteed acceptance, no health questions, no premium surcharges for pre-existing conditions · After it: insurers can deny you, charge more, or exclude conditions · There is no annual Medigap open enrollment in most states
This is the most consequential deadline in all of senior healthcare, and it gets almost no attention. The Medigap Open Enrollment Period (OEP) gives you guaranteed issue rights for exactly six months. During those six months, any insurer must sell you any Medigap plan they offer in your state, at their standard age-based rate, regardless of your health history. The moment that window closes, those protections disappear in most states. Insurers can medically underwrite you — meaning they can deny your application entirely, charge higher premiums, or impose waiting periods for pre-existing conditions. If you spent your 6-month window on Medicare Advantage because the $0 premium was appealing, and now want Medigap because your health has changed, you may be effectively locked out. Only 21 states provide any additional annual Medigap enrollment protections beyond the initial window. Don’t confuse Medigap enrollment with the annual Medicare Open Enrollment (October 15 – December 7) — those are different things entirely.
4Can I switch Medigap plans later to save money?▼
Yes — but outside your OEP, you’ll likely face medical underwriting · Insurers can decline to cover you or charge more based on current health · If you’re healthy, switching to save money may work · If your health has changed since you enrolled, it may not · 21 states have additional protections — check yours
Switching Medigap plans outside your OEP is possible in most states, but it’s not a right — it’s subject to the insurer’s approval based on your current health. If you’re still in excellent health and want to downgrade from Plan G to Plan N to save $40/month, an insurer may approve you at standard rates and the switch makes financial sense. If you’ve developed significant health conditions since enrolling, an insurer may decline your application, and you’d have to stay on your current plan. This is why the initial plan choice during your OEP matters so much — it’s not easily reversible. In the 21 states with additional Medigap protections, you may have more flexibility; check with your state’s Department of Insurance. Also note: even if you successfully switch carriers for the same plan, you’re switching to the new carrier’s current rate, which may or may not be lower depending on how premiums have moved.
5Do Medigap premiums go up every year?▼
Yes — most plans raise premiums annually, though the rate varies by carrier and pricing method · 3 pricing methods exist: attained-age (most common — rises every year), issue-age (locked at your age when you buy), and community-rated (same for all ages, but often starts high) · Medigap premiums overall rose ~10% in 2026
How a carrier prices its Medigap plan determines how premiums behave over time — and carriers are not required to make this obvious. Attained-age pricing is the most common method: your premium starts based on your current age and increases each year as you get older. Issue-age pricing locks your rate based on your age at enrollment — it still increases for inflation, but not for age. Community-rated plans charge everyone the same regardless of age (New York uses this model, which is why Plan G starts so much higher there). The practical implication: a plan with a very low starting premium that uses attained-age pricing may end up costing more in your 80s than an issue-age plan that started higher. When comparing quotes, ask which pricing method each carrier uses — it affects the total cost over a decade or more of enrollment.
6I’m on Medicare Advantage — can I switch to Medigap now?▼
You can try — but unless you have guaranteed issue rights, you’ll face medical underwriting · Guaranteed issue rights are triggered by: your plan leaving the area, losing coverage through no fault of your own, or moving out of the plan’s service area · During Medicare Advantage Open Enrollment (Jan 1–Mar 31) you can switch to Original Medicare — then apply for Medigap, but underwriting likely applies
Switching from Medicare Advantage back to Original Medicare plus Medigap is possible, but it’s not as clean as the sales pitch for Advantage plans suggests. You can drop your Medicare Advantage plan and return to Original Medicare during the Medicare Advantage Open Enrollment Period (January 1–March 31) or the annual Open Enrollment Period (October 15–December 7). But when you then apply for a Medigap plan, most states allow insurers to medically underwrite you — and they often will. Guaranteed issue rights (which bypass underwriting) apply in specific situations: your Advantage plan is discontinued or leaves your area, the plan commits to fraud, or you’re in your trial period for a new Advantage plan. If none of those apply, expect underwriting. If you’re in good health, you may pass it fine. If you’ve developed conditions since leaving Medigap, you may struggle. A Medicare counselor through your state’s SHIP program can help you navigate your specific situation for free.
7Does Medigap cover prescription drugs?▼
No — not at all · Medigap plans sold after 2006 include no prescription drug coverage · You need a separate Part D drug plan ($20–$80/month) · Without Part D, you face a permanent penalty of 1% per month for every month you go without creditable drug coverage after turning 65
This trips up a surprising number of people who buy Medigap thinking they’re fully covered. Medigap handles what Medicare Parts A and B leave behind — hospital costs, doctor visits, outpatient services. Prescription drugs are a completely separate program (Part D), sold separately by private insurers approved by Medicare. The 2026 Part D out-of-pocket cap is $2,100 — meaning once you spend $2,100 on covered drugs in a year, you pay nothing more for the rest of the year. Part D premiums average $20–$80/month depending on your plan and location, plus income-based surcharges (IRMAA) if your modified adjusted gross income exceeds $109,000 (single) or $218,000 (joint). Don’t skip Part D because your drug costs seem low right now — the late-enrollment penalty is permanent and adds up to a significant lifelong cost.
8What’s IRMAA and how does it affect what I pay?▼
IRMAA is an income-based surcharge added to your Part B and Part D premiums · Based on your tax return from 2 years ago · Singles earning over $109,000; joint filers over $218,000 · At the highest bracket, Part B alone costs $689.90/month instead of $202.90 · You can appeal IRMAA if your income has dropped due to retirement, spouse’s death, or other qualifying events
IRMAA (Income-Related Monthly Adjustment Amount) catches many newly retired seniors by surprise, because it’s based on income from two years before — often a high-earning working year that no longer reflects their retirement income. If you retired in 2024 and your 2024 income was high, your 2026 Part B premium will reflect that even if your current income is much lower. The good news: you can appeal. File Form SSA-561-U2 with the Social Security Administration and explain the qualifying life event — retirement, death of a spouse, divorce, reduction of work hours. SSA will use your current income instead of the two-year-old figure. Many retirees successfully reduce their IRMAA this way and the savings can be significant: dropping from the second IRMAA tier to the base rate saves $81.20 per month on Part B alone.
9Can I get supplemental coverage if I’m under 65 and on Medicare due to disability?▼
Federal law does not require insurers to sell Medigap to under-65 Medicare beneficiaries · Only 33 states require it, and most with significantly higher premiums · Some states restrict it to certain plans (like Plan A only) · When you turn 65, your guaranteed enrollment window opens and you can get any plan at standard age-based rates
If you’re under 65 and receiving Medicare because of a disability, you may have limited Medigap options depending on your state. Federal guaranteed issue rights begin at 65 — before that, coverage depends entirely on where you live. In states that require it, premiums can run significantly higher than age-65 rates, sometimes two to three times as much. If you’re currently on Medicare due to disability and your state doesn’t require insurers to offer Medigap, you may need to rely on the coverage Medicare Advantage provides until your 65th birthday, when your full six-month guaranteed-issue Medigap window opens. Contact your state SHIP (State Health Insurance Assistance Program) counselor — free, unbiased, and able to tell you exactly what your state requires for under-65 Medigap access.
📄 Which plan — honest breakdown of your real options
Ten Medigap plan letters exist, but three account for most new enrollee decisions. The comparison below focuses on what actually matters: monthly cost, what you’ll still pay out of pocket, and who each plan realistically fits.
Plan G — Most comprehensive, most popular
~39% of new enrollees
~$166/mo at 65 · $120–$354 depending on state
Plan G covers everything Original Medicare doesn’t pay except one thing: the annual Part B deductible ($283 in 2026). Once you’ve paid that single deductible in January, your out-of-pocket costs for the rest of the year are essentially zero for any Medicare-covered service — no copays, no coinsurance, no surprises. You can see any doctor in the country who accepts Medicare, with no referrals required and no network to worry about. This is the plan that turns “I’ll think about going to the doctor” into “I’ll just go.” It replaced Plan F as the top choice after Plan F became unavailable to new Medicare enrollees in 2020.
✅ Covers all gaps except $283 Part B deductible
✅ Any Medicare-accepting doctor — no network
✅ Covers Part B excess charges
✅ Foreign travel emergency (80% up to $50,000 lifetime)
⚠️ Highest premium of the three main options
Plan N — Strong coverage, lower monthly cost
Healthy, infrequent users
~$123/mo at 65 · Saves ~$516/yr vs Plan G
Plan N gives you most of what Plan G does at roughly $40–$80 less per month — with two meaningful trade-offs. Office visit copays: up to $20 each time you see a doctor (waived for preventive care). ER copays: $50 per ER visit (waived if you’re admitted). The third difference: Plan N doesn’t cover Part B excess charges — the amount (up to 15% above Medicare’s approved rate) that doctors who don’t accept Medicare assignment can legally bill. Excess charges are increasingly rare since most doctors accept assignment, but they’re not zero. Run this math for your situation: if you see the doctor more than 26 times a year, Plan G’s higher premium is almost certainly cheaper than Plan N’s copays. Fewer visits? Plan N typically wins on total annual cost.
✅ Same hospital and outpatient coverage as Plan G
✅ ~$40–$80/mo less than Plan G
⚠️ Up to $20 copay per doctor visit
⚠️ $50 ER copay (waived if admitted)
⚠️ No coverage for Part B excess charges
High-Deductible Plan G — Lowest premium, catastrophic coverage
Very healthy · Rarely use healthcare
$40–$70/mo · $2,870 deductible before benefits kick in
Same coverage as standard Plan G — but nothing kicks in until you’ve spent $2,870 out of pocket on Medicare-approved costs in a calendar year. If you hit that threshold (which resets January 1), the plan pays everything from there. The $40–$70 monthly premium is the lowest available in the Medigap market. The math works for seniors who are genuinely healthy, use healthcare rarely, and want protection against a catastrophic event without paying $166/month for coverage they’ll likely never touch. The risk: if you have an unexpected health event early in the year, you’ll absorb the full $2,870 before getting any Medigap benefit. Some seniors pair this with a Health Savings Account strategy during the transition into Medicare.
✅ Lowest monthly premium in the Medigap market
✅ Same coverage as Plan G once deductible is met
⚠️ $2,870 out of pocket before Medigap pays anything
⚠️ Only works financially if you rarely use healthcare
Plan F — Still exists, but not for most new seniors
Pre-2020 Medicare eligibility only
Higher premiums than Plan G · Covers $283 Part B deductible too
Plan F was the gold-standard Medigap plan for decades — it covers literally everything, including the Part B deductible that Plan G leaves behind. The catch: as of January 1, 2020, Plan F is no longer available to anyone who became eligible for Medicare after that date. If you were eligible for Medicare (turned 65) before January 1, 2020, you may still be able to enroll in Plan F if a carrier in your area offers it. The premium savings of Plan G versus Plan F are often larger than the $283 deductible difference, making Plan G the better mathematical choice for most people anyway. But if you’re in a high-cost-use year and on Plan F already, staying put rather than switching may make sense.
✅ Covers 100% of all Medicare-approved costs including Part B deductible
⚠️ Available only if you were Medicare-eligible before January 1, 2020
⚠️ Usually costs more than Plan G for less mathematical value
Plans K and L — Cost-sharing options with out-of-pocket caps
Lower premiums · You share costs
Plan K: ~$80–$130/mo · Plan L: ~$120–$170/mo
Plans K and L split certain Medicare costs with you rather than covering them in full — which is why their premiums are lower than Plan G or N. Plan K covers 50% of many costs (coinsurance, deductibles) with an annual out-of-pocket maximum of $7,060. Plan L covers 75% with a $3,530 out-of-pocket cap. Neither covers Plan B excess charges or foreign travel emergency care. These plans make sense in a narrow range of situations — mostly seniors who want a premium lower than Plan N but are comfortable managing cost-sharing up to the cap. For most seniors, the simplicity and predictability of Plan G or Plan N is easier to manage on a fixed income than tracking shared-cost percentages throughout the year.
✅ Lower premium than Plan G or N
✅ Annual out-of-pocket cap protects against catastrophic cost
⚠️ You pay 25–50% of many Medicare costs until you hit the cap
⚠️ More complexity to track than Plan G’s simple structure
⏰ The enrollment window — what it is and what happens if you miss it
This is the part of Medigap that most financial planning conversations don’t cover clearly enough — and where the consequences of a misunderstanding can last a lifetime.
🚨 The window you cannot recover
Your Medigap Open Enrollment Period is exactly six months, starting on the first day of the month in which you are both 65 or older AND enrolled in Medicare Part B. If you turn 65 in June and your Part B starts June 1, your window runs June 1 through November 30 — and then it’s gone. There is no annual Medigap enrollment period. No way to get back the guarantees that window provided. Outside of it, insurers in most states can deny your application entirely or charge you significantly more.
⚠️ The Medicare Advantage trap
The most common reason people miss this window is choosing Medicare Advantage during their initial enrollment because the $0 premium looks attractive. Years later, when their health needs more coverage, they want to switch to Medigap — and discover they now face medical underwriting. A KFF analysis found that approximately 90% of Medicare Advantage enrollees would face underwriting if they tried to move to Medigap after their initial window. That’s not a theoretical risk — it affects tens of millions of seniors. If you’re currently approaching 65, think carefully about which direction you choose before your window opens.
✅ Guaranteed issue rights — when you can get in outside the window
Certain qualifying events trigger a new set of guaranteed issue rights — allowing you to buy specific Medigap plans without underwriting even after your OEP has ended. These include: your Medicare Advantage plan being discontinued or leaving your area, the plan committing fraud, you moving outside the plan’s service area, or being in your first 12 months on a Medicare Advantage trial and choosing to return to Original Medicare. Contact your state’s SHIP (State Health Insurance Assistance Program) counselor — free, unbiased advice — to determine whether your situation qualifies.
🗺️ The 21 states with extra protections
If you live in one of the approximately 21 states with additional Medigap enrollment rules, you may have more flexibility than the federal baseline. Some states allow switching plans or carriers on your policy anniversary. A few allow choosing a lower-cost plan without underwriting after a certain age or period. These protections vary enormously state by state — contact your state’s Department of Insurance or SHIP counselor to find out exactly what your state provides. Don’t rely on what you read online unless it specifies your exact state, because the rules are not uniform nationally.
❓ Your situation — direct guidance
I’m turning 65 soon — what should I do first?
APPROACHING 65
The sequence matters. Step 1: Enroll in Medicare Part B during your Initial Enrollment Period (the 7-month window: 3 months before your birthday month, your birthday month, and 3 months after). This triggers your Medigap OEP. If you’re still working with employer coverage from a company with 20+ employees, you can delay without penalty — but get written documentation. Step 2: Compare Medigap plans in your ZIP code. Plan G is the most popular starting point, but get quotes for Plan N and High-Deductible Plan G too — the difference in monthly cost is real. Step 3: Add a Part D drug plan. Even if you take few or no medications, enrolling prevents the permanent late-enrollment penalty. Start this process 3–4 months before turning 65, not after.
📋 Enroll Part B → triggers your 6-month Medigap window
🔍 Get Plan G, N, and HDG quotes from 3+ carriers
💊 Add Part D even if you take no drugs — avoid penalty
I have a chronic condition — which plan gives me the most protection?
CHRONIC CONDITIONS
Plan G is almost always the right answer for someone who uses healthcare frequently or has ongoing specialist care, physical therapy, lab work, or medications that require doctor oversight. The math is straightforward: your only Medicare-related out-of-pocket expense after January’s $283 Part B deductible is your monthly premium. Every specialist visit, every outpatient procedure, every follow-up is covered at 100%. If your health conditions are causing 10 or more medical visits per year, Plan G’s slightly higher monthly premium compared to Plan N saves you money. You also gain complete freedom to see any specialist in the country who accepts Medicare — no referrals, no network, no prior authorizations for Medicare-covered services.
✅ Plan G: $283 deductible, then nothing else all year
🏥 Any Medicare doctor — no networks, no referrals
📋 Covers specialist visits, outpatient procedures, lab work
I’m on a fixed income and can’t afford $166/month
BUDGET CONSTRAINTS
There are legitimate lower-cost options — and some that sound low-cost but create big risks. High-Deductible Plan G at $40–$70/month is legitimate Medigap coverage with a $2,870 annual deductible before benefits begin. If you rarely need healthcare, this can provide catastrophic protection at a manageable monthly cost. Plan N at ~$123/month is another tier down from Plan G. Beyond Medigap, check whether you qualify for Medicare Savings Programs — government programs that can pay your Part B premium and other Medicare costs if your income and assets fall below certain thresholds. These are federally funded but state-administered, and many seniors who qualify don’t know they exist. Contact your state Medicaid office or call 1-800-MEDICARE to ask specifically about Medicare Savings Programs, Extra Help, and any state pharmaceutical assistance programs in your area.
💰 HDG Plan G: $40–$70/mo — lowest Medigap premium
🏛️ Medicare Savings Programs: may pay your Part B premium
📞 1-800-MEDICARE: ask about all assistance programs
I travel frequently or spend winters somewhere else
TRAVEL / SNOWBIRD
Medigap is one of the biggest advantages for seniors who travel domestically. Because it covers you with any Medicare-accepting provider anywhere in the country — not a regional network — you can see doctors in Florida in January and New York in July with identical coverage and zero additional cost. This is one of the starkest differences from Medicare Advantage, which uses networks typically tied to a specific county or region. Most Medigap plans also include foreign travel emergency coverage at 80% after a $250 deductible, up to a $50,000 lifetime maximum — a meaningful layer of protection for international travel, though travelers who go abroad frequently should consider a separate travel medical policy for anything beyond emergency coverage.
✅ Any Medicare doctor nationwide — no regional network
✈️ Foreign travel emergency: 80% up to $50,000 lifetime
⚠️ Medicare Advantage networks often don’t travel with you
I missed my enrollment window — what can I do now?
MISSED WINDOW
You have more options than you might think, though none of them are as clean as acting during the OEP. First, check if you have guaranteed issue rights. If your Medicare Advantage plan was discontinued, left your area, or you’re in your first 12 months of an Advantage plan trial, you may qualify. Second, check your state. If you’re in one of the ~21 states with additional Medigap protections, you may have an annual window to switch. Third, apply anyway. If you’re in good health with no significant conditions, applying for Medigap through underwriting may still result in an approval at reasonable rates. You’re not automatically denied — underwriting means you’re screened, not necessarily rejected. Fourth, consider Medicare Advantage as an interim solution if Medigap isn’t accessible. Contact your state’s free SHIP counselor before making any decision — they can review your specific situation and identify options you may not have considered.
📋 Check for guaranteed issue rights first
🗺️ Check your state’s additional protections (~21 states)
✅ Apply anyway if healthy — underwriting isn’t automatic rejection
📞 SHIP counselor: free, unbiased help — shipcta.org
📊 Plan comparison — coverage vs. cost at a glance
| Plan | Avg monthly cost at 65 | Part B deductible covered? | Excess charges covered? | Best for |
|---|---|---|---|---|
| Plan G | ~$166/mo | ❌ You pay $283/yr | ✅ Yes | Most seniors — best coverage, most predictable cost |
| Plan N | ~$123/mo | ❌ You pay $283/yr | ❌ No | Healthy seniors, infrequent doctor visits, budget-conscious |
| High-Ded. Plan G | ~$40–$70/mo | ❌ Part of $2,870 deductible | ✅ After deductible | Very healthy, low healthcare use, want catastrophic protection only |
| Plan F | Higher than Plan G | ✅ Yes | ✅ Yes | Pre-2020 Medicare eligibles only — not available to new enrollees |
| Plan K | ~$80–$130/mo | ❌ 50% covered | ❌ No | Those who want lower premiums and can manage 50% cost-sharing to $7,060 cap |
| Plan L | ~$120–$170/mo | ❌ 75% covered | ❌ No | Those who want 75% cost-sharing to $3,530 cap with lower premium than Plan G |
📍 Find free help near you
Your state’s SHIP (State Health Insurance Assistance Program) provides free, unbiased Medicare counseling from trained volunteers who have no financial interest in which plan you choose. Tap a button to find resources near you.
✅ Before you decide — 5 things to do first
- Know your enrollment window and protect it. Your Medigap OEP is 6 months starting when you enroll in Part B. During this window, no insurer can deny you or charge extra for health conditions. After it, most can. Do not let this window close without making a Medigap decision.
- Get at least 3 ZIP-code-specific quotes for the same plan. Because Medigap plan letters are standardized, Plan G from Carrier A covers exactly the same things as Plan G from Carrier B. Price is the only variable. Comparison tools at medicare.gov and through your state SHIP will show you the full carrier range in your area — the spread can be $50–$100/month for identical coverage.
- Ask each carrier what pricing method they use. Attained-age, issue-age, and community-rated plans behave very differently over a decade. A cheap starting premium from an attained-age carrier may become expensive by your 80s. Ask the question before you commit.
- Add Part D separately — don’t skip it. No Medigap plan covers prescription drugs. Part D is a separate enrollment, and missing it by 63+ days creates a permanent per-month penalty for every month you go without creditable coverage. Even if you take no prescription drugs right now, enroll.
- Call your state’s SHIP program before making any decision. SHIP counselors are trained volunteers with no financial interest in what you choose — they’re not selling anything. They can walk you through your exact state’s rules, compare plans in your ZIP code, explain enrollment periods, and help you appeal IRMAA. It’s free and genuinely useful. Find your SHIP at shipcta.org or call 1-800-MEDICARE.
🔗 Key resources:
🏛️ Medicare.gov plan compare tool
🤝 Free SHIP counselors: shipcta.org
📞 1-800-MEDICARE: 24/7 help line
📋 Compare quotes: medicare.gov/find-a-plan
💊 Part D enrollment: medicare.gov
💰 Savings programs: medicare.gov/basics/costs/help
📑 IRMAA appeal: SSA Form SSA-561-U2
🗺️ State DOI contacts: naic.org/state_web_map
📊 KFF Medicare data: kff.org/medicare
🏥 CMS cost data: cms.gov
This guide is for informational purposes only and is not affiliated with, endorsed by, or compensated by any insurance carrier, Medicare, CMS, AARP, or any government program. Medicare costs, Medigap premiums, plan availability, and enrollment rules change annually and vary significantly by state, ZIP code, age, gender, tobacco use, and insurer. All premium ranges cited reflect published national averages from multiple 2025–2026 analyses and may not reflect quotes available in your area. IRMAA thresholds, Part B premiums, and Part D out-of-pocket caps cited are confirmed CMS figures for 2026 and are subject to annual adjustment. Nothing in this guide constitutes financial, legal, or insurance advice. Always verify current enrollment periods, plan availability, and premiums directly with a licensed insurance agent or your state’s free SHIP Medicare counseling program before making coverage decisions. Medicare.gov and 1-800-MEDICARE are the official government sources for plan information.