Full Definition

Medigap policies are standardized by CMS and labeled by letter (Plan A, B, D, G, K, L, M, N in Texas). Each plan type has defined benefits regardless of which insurer sells it. Plan G and Plan N are currently the most popular options. Premiums vary by insurer, beneficiary age, and location.

Medigap is not compatible with Medicare Advantage — beneficiaries must choose one or the other. With Medigap and Original Medicare, beneficiaries can use any provider that accepts Medicare, without network restrictions. For high-utilizing seniors, Medigap provides cost predictability that Medicare Advantage may not.

During a SNF stay, Medigap can cover the daily copayment for days 21-100 (~$194.50/day in 2024 under most plans), which can represent thousands of dollars in savings. For seniors who expect to use significant post-acute care, comparing the premium cost of Medigap against potential SNF copayments is an important financial calculation.