Medicare Supplement Insurance: What It Covers and How It Works
Are you worried about high medical costs even though you have Medicare? You’re not alone. Many seniors assume Original Medicare (Parts A and B) pays for everything, but that’s not true. Medicare has gaps in coverage, meaning you could end up with out-of-pocket costs for hospital stays, doctor visits, or treatments.
That’s where Medicare Supplement Insurance, also known as Medigap, comes in. Medigap helps cover the costs that Medicare doesn’t, such as copayments, coinsurance, and deductibles. It gives you more predictable medical expenses and peace of mind. At Legacy Insurance, we guide seniors through their options, helping them compare affordable Medicare Supplement plans that match their budget and health needs.
In this guide, we’ll explain how Medicare Supplement Insurance works, what it covers, what it doesn’t, and how to choose a plan that makes sense for your lifestyle.
What Is Medicare Supplement Insurance?
Medicare Supplement Insurance (Medigap) is private insurance designed to work alongside Original Medicare. It helps pay for the "gaps" in coverage that Medicare doesn’t handle. These include expenses like hospital coinsurance, Part B copayments, and deductibles.
Key Benefits of Medigap:
- Helps lower your out-of-pocket costs for medical services
- Works only with Original Medicare, not Medicare Advantage
- Lets you visit any doctor or hospital in the U.S. that accepts Medicare
- Offers multiple plan options to fit your needs and budget
Without Medigap, you could face high bills for hospital stays, skilled nursing care, or outpatient visits. These expenses can be especially hard to manage on a fixed income.
How Medigap Works with Medicare
Medicare Supplement Insurance doesn’t replace Medicare. Instead, it works with it to give you better coverage.
Here’s how it works:
- Medicare pays first – it covers around 80% of approved medical services.
- Your Medigap plan pays next – it helps cover the remaining costs.
- You pay less out of pocket – Medigap reduces or eliminates what you owe.
Example: You have a hospital stay that costs $10,000.
- Medicare pays 80% = $8,000
- Without Medigap, you pay the remaining $2,000
- With Medigap, most or all of that $2,000 is covered
That kind of support makes a big difference when you’re facing unexpected health issues.
What Medigap Covers
While plan coverage varies by type (Plan A, G, N, etc.), most Medigap policies help cover:
- Medicare Part A hospital coinsurance and hospital costs
- Medicare Part B coinsurance or copayments
- Part A deductible (estimated $1,632 for 2025)
- Skilled nursing facility care coinsurance
- Emergency healthcare coverage outside the U.S. (up to plan limits)
- First 3 pints of blood if needed in a medical procedure
You can view full plan comparisons on Medicare.gov.
What Medigap Does Not Cover
It’s also important to know what Medigap plans don’t include:
- Prescription drug coverage (you’ll need a separate Medicare Part D plan)
- Routine dental, vision, or hearing care
- Long-term care like nursing home stays
- Private-duty nursing or home care assistance
To get complete coverage, many people pair Medigap with a Part D drug plan and a dental or vision plan.
Why Seniors Choose Medigap
At Legacy Insurance, we hear the same concerns from seniors again and again. Medigap solves many of those concerns by offering:
- Lower out-of-pocket costs
- Freedom to see any doctor that accepts Medicare
- Emergency medical coverage when traveling abroad
- Guaranteed renewability as long as you pay your premium
- Predictable monthly medical costs for easier budgeting
More than 14 million Americans currently rely on Medigap to make their healthcare more affordable and stress-free.
How to Choose the Right Medicare Supplement Plan
Not all plans are the same. When choosing a Medigap policy, ask yourself:
- Do you want full coverage with minimal out-of-pocket costs?
- Are you okay with a lower premium and some shared costs?
- Do you travel internationally and need emergency coverage abroad?
- Will you need skilled nursing care as you age?
Our team at Legacy Insurance can help you answer these questions. We'll explain each plan option clearly and match you with a provider that meets your needs.
Ready to Explore Your Options?
Choosing the right Medigap plan can make a big difference in your finances and peace of mind. Don’t wait until you’re facing a big medical bill. Contact Legacy Insurance today for a free, no-obligation consultation. We'll help you compare Medicare Supplement Insurance plans and find one that fits both your health and your budget.
Top 10 FAQs
- What is the difference between Medigap and Medicare Advantage?
Medigap works with Original Medicare to cover out-of-pocket costs, while Medicare Advantage replaces Original Medicare entirely. Medigap offers broader provider access but no extras like dental or vision.
- When is the best time to enroll in Medigap?
The ideal time is during your Medigap Open Enrollment Period, which begins when you’re 65 and enrolled in Medicare Part B. During this time, you can’t be denied coverage based on health.
- Can I be denied a Medigap plan?
Yes, if you apply outside your Open Enrollment window, insurers may deny you or charge more based on your health. That’s why it’s best to enroll early.
- Does Medigap cover prescriptions?
No, Medigap doesn’t cover prescription drugs. You’ll need to enroll in a separate Medicare Part D plan for drug coverage.
- Can I switch Medigap plans later?
Yes, but you may have to go through medical underwriting unless you have guaranteed issue rights. It’s important to compare costs and benefits before switching.
- Is Medigap accepted by all doctors?
Yes, as long as the doctor accepts Medicare patients, they will accept your Medigap plan. That gives you flexibility to choose providers.
- How much does a Medigap plan cost?
Monthly premiums vary by plan type, provider, location, and age. In 2025, premiums for Plan G average between $100 and $200 per month.
- Do Medigap plans cover emergency care abroad?
Some plans do. Plans C, D, F, G, M, and N offer emergency medical coverage while traveling outside the U.S., up to plan limits.
- What if I have pre-existing conditions?
If you apply during your Medigap Open Enrollment Period, you can’t be denied coverage for pre-existing conditions. Outside that window, it depends on the insurer.
- Can my Medigap plan be canceled?
No. As long as you pay your premiums on time, your plan is guaranteed renewable. The insurer cannot cancel your policy based on your health.
