Original Medicare covers a lot — but it leaves behind cost-sharing with no built-in cap on your share of most outpatient costs. Medigap plans are sold by private insurers to cover those gaps. The catch: timing matters enormously.
You keep Original Medicare (Parts A and B). Medigap pays after Medicare pays its share — covering most or all of what's left.
You have a 6-month open enrollment window starting the month you turn 65 and are enrolled in Part B. During this window, no insurer can deny you or charge you more due to health conditions.
Plan G is the most comprehensive. Plan N costs less per month but has small copays when you use care.
You want to see any doctor anywhere without network limits, prefer predictable monthly costs over surprise bills, have complex health needs, or travel frequently.
You're enrolling in Medicare Advantage (Medigap doesn't work with Advantage plans), or you're comfortable with the built-in cost cap that Advantage plans provide.
A PharmSurance advisor will compare Medigap options in your state and help you decide if it's the right fit — or if Medicare Advantage makes more sense. At no cost to you.
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