Health care can sometimes feel like a maze of benefits, deductibles, and out-of-pocket costs. If you have Medicare Parts A and B, you might already know that gaps in coverage can leave you footing the bill for certain expenses—like coinsurance, copays, and deductibles. That’s where Medigap (also known as Medicare Supplement Insurance) can be a huge help. These private insurance policies aim to fill the “gaps” in Original Medicare coverage, ensuring you’re not caught off-guard by high medical costs.
In this comprehensive guide, we’ll tackle the question: “What Are the Top 5 Medigap Plans?” We’ll look at which plans consistently stand out among beneficiaries, discuss how they differ in benefits, and explore how to decide the right fit for your health and financial needs. By the end, you’ll have a clearer picture of how Medigap can bring you greater peace of mind—and which plan might be your best match.
A Quick Overview: Why You Need Medigap
Original Medicare (Part A and Part B) is designed to cover a significant portion of your hospital and medical expenses. However, it doesn’t pay for everything. You could be responsible for deductibles, coinsurance, and other out-of-pocket costs. Over time, especially if you develop chronic conditions or require hospitalization, these costs can add up fast.
Medigap—also referred to as Medicare Supplement Insurance—steps in to help cover these “gaps.” Depending on the plan you choose, Medigap may pay for:
- Part A and Part B deductibles
- Coinsurance for hospital stays and skilled nursing facility care
- Part B copays (e.g., doctor’s office visits)
- Foreign travel emergency coverage (up to plan limits)
This extra coverage can provide:
- Financial Predictability: Know in advance what your share of costs will be for hospital stays or medical services.
- Peace of Mind: Avoid large surprise bills, allowing you to focus on recovery or preventive care.
- Freedom to Choose Providers: Most Medigap plans let you see any doctor who accepts Medicare—no HMO or PPO network restrictions.
How Medigap Plans Are Standardized
One of the key points about Medigap is that plans are standardized at the federal level. That means if you buy a Plan G from one company, it should offer the same basic benefits as a Plan G from another. Premiums may vary depending on your state, age, tobacco use, and the insurer’s underwriting, but the core coverage remains the same.
Here’s what “standardization” means in practice:
- Each Medigap plan is labeled by a letter: A, B, C, D, F, G, K, L, M, or N.
- Plans with the same letter must offer the same set of benefits (regardless of the company selling it).
- In most states, insurers can only sell these standardized policies. (Minnesota, Massachusetts, and Wisconsin have variations in how they structure Medigap.)
Important Note on Availability: Plans F and C are not available to those who became eligible for Medicare on or after January 1, 2020. However, if you were eligible for Medicare before January 1, 2020, you may still be able to enroll in one of these plans.
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The Top 5 Medigap Plans
The “top” Medigap plans can vary depending on individual preferences and overall popularity, but Plans F, G, N, K, and L often get a lot of attention. Each offers a different mix of cost-sharing and coverage, and your choice may boil down to how much you’re willing to pay in premiums for more comprehensive benefits—or how comfortable you are with cost-sharing for lower monthly premiums.
Plan F
Key Features:
- Most Comprehensive: Covers Part A and Part B deductibles, coinsurance, foreign travel emergency, skilled nursing facility coinsurance, and more.
- No Part B Excess Charges: Pays for the extra 15% you might face if a doctor doesn’t accept Medicare assignment.
- Availability: Limited to those who were eligible for Medicare before January 1, 2020. If you qualify, you can still purchase a Plan F, assuming insurers in your area continue offering it.
Why People Like It:
Plan F leaves you with almost no out-of-pocket costs for Medicare-approved services. This makes it extremely predictable—you pay your monthly premium, and nearly all other expenses are covered. People who value financial certainty and simplicity generally love Plan F.
Potential Drawbacks:
- Typically has higher premiums than other Medigap plans, since it provides the most coverage.
- Not available to new Medicare beneficiaries post-2020.
Plan G
Key Features:
- Second-Most Comprehensive: Very similar to Plan F, but does not pay the Part B deductible.
- No Part B Excess Charges: Covers that extra 15% charge if your doctor doesn’t accept Medicare assignment.
- Availability: Open to all Medicare beneficiaries, including those who became eligible on or after January 1, 2020.
Why People Like It:
Plan G has surged in popularity since Plan F closed to new enrollees. It offers a high level of coverage, leaving beneficiaries responsible only for the Part B deductible (which is $226 in 2023, but this amount can change annually). After you meet that deductible, Plan G generally picks up all remaining Medicare-covered costs.
Potential Drawbacks:
- Premiums can still be on the higher side compared to options like K, L, or N.
- You must pay the Part B deductible, which some people find inconvenient—though you often save on monthly premiums compared to Plan F.
Plan N
Key Features:
- Covers Part A deductible, Part A coinsurance, and skilled nursing facility coinsurance.
- Does not cover Part B deductible or Part B excess charges.
- You may have small copays for doctor’s office visits (up to $20) and emergency room visits (up to $50) if you aren’t admitted.
Why People Like It:
For those willing to handle modest copays in exchange for lower monthly premiums, Plan N is a great middle ground. It still provides robust coverage—particularly for hospital stays—while also minimizing premiums.
Potential Drawbacks:
- Part B Excess Charges: If your doctor charges more than the Medicare-approved amount, you’ll be responsible for those excess charges.
- Copays can add up if you see doctors frequently or visit the ER often.
Plan K
Key Features:
- Cost-Sharing Plan: Covers 50% of many Medicare-approved costs, including Part B coinsurance, Part A deductible, and hospice coinsurance.
- After meeting your out-of-pocket limit (which can vary each year—$6,940 in 2023), Plan K covers 100% of Medicare-covered services for the remainder of the year.
- Lower monthly premiums than more comprehensive plans (like F, G, or N).
Why People Like It:
Plan K appeals to budget-conscious beneficiaries. The premiums are often significantly lower because you share a higher portion of the costs. Plus, there’s a built-in safety net in the form of an annual out-of-pocket maximum (a feature that’s not found in Plans F or G).
Potential Drawbacks:
- Cost-sharing can be confusing. You’ll need to be prepared to pay 50% of many Part B coinsurances until you reach the maximum limit.
- You may need to keep close track of your medical expenses to ensure you don’t exceed your budget.
Plan L
Key Features:
- Similar to Plan K but with a 75% coverage level (instead of 50%) for many services.
- Annual out-of-pocket limit ($3,470 in 2023)—once you hit that limit, Plan L pays 100% for covered services for the rest of the year.
- Lower premiums than Plans F, G, or N, but usually a bit higher than Plan K (because it covers a greater share of costs).
Why People Like It:
Plan L strikes a balance: you pay a portion of your costs but not as much as Plan K. The out-of-pocket limit is also lower than Plan K, offering a greater safety net for those who frequently access healthcare services.
Potential Drawbacks:
- You will still share costs (25% of many medical expenses) until you hit your plan’s limit.
- You might find a Plan N or G more straightforward if you prefer less cost-sharing, though premiums will likely be higher.
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How to Choose the Right Plan
Selecting the “best” Medigap plan boils down to your personal priorities: budget constraints, frequency of doctor visits, travel habits, and overall health condition. Here are key factors to consider when deciding between these top 5 plans:
- Coverage vs. Premium
- If you want near-total coverage and minimal out-of-pocket expenses, you might lean toward Plan F (if eligible) or Plan G.
- If your main goal is a low monthly premium, consider Plan K or Plan L, but remember you’ll pay a share of costs.
- Doctor Choice
- Most Medigap plans allow you to see any doctor who accepts Medicare, so you won’t need referrals or deal with restrictive networks.
- However, watch out for Part B excess charges (not covered by Plan N, K, or L). If your doctor doesn’t accept Medicare assignment, you could face higher bills.
- Financial Predictability
- Plans F, G, and N have straightforward cost structures (beyond copays or the Part B deductible).
- Plans K and L have more moving parts because of the cost-sharing setup.
- Medigap Enrollment Timing
- Your Medigap Open Enrollment Period starts when you’re both 65 and enrolled in Part B.
- During this window, insurers can’t deny you coverage or charge higher premiums due to health conditions.
- If you apply outside this window, you may be subject to medical underwriting, potentially raising premiums or being denied coverage.
Ultimately, weigh how much you value peace of mind against the higher monthly premiums. One beneficiary might appreciate paying a higher premium to avoid any out-of-pocket surprises, while another might be comfortable paying cost-sharing as services occur, in exchange for a much lower premium.
Reviews and Testimonials
To get a better feel for real-life experiences, here are a few anecdotal reviews people have shared about their Medigap policies. Note that experiences can vary based on provider, state regulations, and personal health circumstances.
- Bob, 72, Plan F
- Location: Illinois
- Experience: “After two hospital stays in the past year, I’m so thankful I chose Plan F years ago. I haven’t had a single unexpected bill, aside from my monthly premium. It’s pricey, but it’s worth every penny for me.”
- Mary, 67, Plan G
- Location: Texas
- Experience: “I was eligible for Medicare after 2020, so Plan F wasn’t an option. I went with G, and it’s been smooth. I pay the Part B deductible, but the premium is lower than some Plan F quotes I’ve seen. No regrets so far!”
- Alan, 69, Plan N
- Location: Florida
- Experience: “Plan N works for me because I’m healthy overall. The occasional $20 copay for doctor visits doesn’t bother me, and my premium is very reasonable. I do keep an eye on my providers to ensure I’m not getting hit with excess charges.”
- Linda, 70, Plan K
- Location: Ohio
- Experience: “I live on a fixed income, so Plan K’s premium is a big money-saver. I pay some of my bills out-of-pocket if I go to the doctor, but it all evens out, especially because I don’t go that often. The out-of-pocket limit is nice for peace of mind if something catastrophic happens.”
- John, 71, Plan L
- Location: Georgia
- Experience: “I considered Plan K but decided on Plan L for the higher coverage. I do pay some out-of-pocket for hospital stays, but the limit is fairly low, so I feel protected. The monthly premium is also lower than G or N in my area.”
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Frequently Asked Questions (FAQ)
Q1: Who is eligible for Medigap coverage?
A: If you’re enrolled in Medicare Part A and Part B, you can apply for Medigap coverage. Your Medigap Open Enrollment Period begins the month you turn 65 (and have enrolled in Part B). If you don’t sign up during this window, you may undergo medical underwriting later.
Q2: Are Medigap Plans F and C really going away?
A: Plans F and C are no longer available for new Medicare beneficiaries who became eligible on or after January 1, 2020. If you were eligible for Medicare before 2020, you can still buy or keep these plans.
Q3: What about High-Deductible Plans F or G?
A: Some insurers offer High-Deductible Plan F or High-Deductible Plan G, which require you to pay a higher annual deductible before your coverage kicks in. These plans have lower premiums, making them an option for those comfortable with potentially larger out-of-pocket costs during the year.
Q4: How do I compare premium costs for the same plan (e.g., Plan G) across different insurers?
A: Each insurer sets its own pricing. Variables like community-rated, issue-age-rated, or attained-age-rated premium structures can affect your costs over time. It’s wise to shop around, compare quotes, and read plan details carefully.
Q5: Can I switch Medigap plans later if my health needs change?
A: You can try to switch, but outside of certain guaranteed-issue rights or trial rights, you could face medical underwriting—meaning your application can be denied or you could pay a higher premium due to pre-existing conditions. Always check your state’s rules and possible special enrollment scenarios.
References
- Medicare.gov
Medigap Policy Information
The official U.S. Government website provides extensive details on each Medigap plan’s coverage. - Centers for Medicare & Medicaid Services (CMS)
www.cms.gov
Offers regulatory updates, official Medicare guidelines, and annual changes to deductibles and coverage limits. - State Health Insurance Assistance Program (SHIP)
www.shiphelp.org
Provides local, personalized counseling to help you compare Medigap plans and costs in your state.
Final Thoughts
Choosing among the top 5 Medigap plans—Plan F, Plan G, Plan N, Plan K, and Plan L—can be both exciting and daunting. Each plan has its own balance of cost-sharing, coverage, and premiums. The right one for you will depend on how often you visit the doctor, whether you’re comfortable with copays or deductibles, and how much you can afford to pay in monthly premiums.
- Plan F (if you qualify) or Plan G: Ideal if you want top-tier coverage and don’t mind higher premiums.
- Plan N: A solid middle ground—lower premiums, modest copays, and coverage for many key benefits.
- Plan K and Plan L: Great for those who want a lower monthly premium but are comfortable paying a portion of costs until they hit an out-of-pocket limit.
No matter which plan you lean toward, do your homework: compare premiums from multiple insurers, confirm you’re shopping during a period that guarantees issue (if possible), and read each plan’s benefits carefully. A bit of research now can translate into peace of mind—and potential financial savings—down the road.
