What a Medicare Supplement plan does
Original Medicare pays a large share of your hospital and medical bills, but not all of them. You’re left with a Part A deductible for each benefit period, a Part B deductible each year, coinsurance on most doctor and outpatient services, and a daily coinsurance for skilled nursing days 21 through 100. There’s no yearly cap on what those gaps can add up to.
A Medicare Supplement policy, also called Medigap, fills in those gaps. Medicare pays its share first, then your Medigap plan pays its share, often with little or nothing left for you depending on the plan letter. Because Medigap follows Original Medicare, you can see any doctor or hospital in the country that accepts Medicare. There are no networks and no referrals.
Medigap plans are standardized by letter. A Plan G from one company offers the same core benefits as a Plan G from another. What differs is the monthly premium, how the company sets and raises rates, and its customer service. Medigap doesn’t include prescription coverage, so most people pair it with a standalone Part D drug plan.
- Part A hospital deductible and coinsurance
- Part B coinsurance on doctor visits, tests and outpatient care
- Skilled nursing facility coinsurance for days 21–100
- Part B excess charges, on plans that cover them
- Emergency care during foreign travel, up to plan limits
Plan G vs. Plan N vs. high-deductible Plan G
If you became eligible for Medicare on or after January 1, 2020, Plans C and F aren’t available to you. That’s why Plan G and Plan N have become the most common choices for people new to Medicare. Plan G covers everything Original Medicare leaves behind except the yearly Part B deductible. Once you pay that deductible, covered care typically costs you nothing more.
Plan N usually has a lower premium than Plan G. In exchange, you pay small copays for some office visits and emergency room visits, and it doesn’t cover Part B excess charges. Excess charges happen when a doctor who doesn’t accept Medicare’s approved amount as full payment bills you a bit more. For people who visit the doctor only occasionally, Plan N can work well.
High-deductible Plan G offers the same benefits as Plan G, but only after you meet a yearly deductible that Medicare sets. Premiums are typically much lower. It can suit healthy people who want catastrophic protection and are comfortable paying more out of pocket in a bad year.
| Feature | Plan G | Plan N | High-deductible G |
|---|---|---|---|
| Part A deductible | Covered | Covered | Covered after plan deductible |
| Part B deductible | You pay it | You pay it | Counts toward plan deductible |
| Part B coinsurance | Covered | Covered, minus some office and ER copays | Covered after plan deductible |
| Part B excess charges | Covered | Not covered | Covered after plan deductible |
| Typical premium | Higher | Moderate | Lower |
Your Medigap Open Enrollment Period and guaranteed issue
Timing matters more with Medigap than with almost any other Medicare choice. Your Medigap Open Enrollment Period lasts six months, starting the month you’re 65 or older and enrolled in Part B. During those six months, a company can’t turn you down or charge you more because of your health. This is your federal guaranteed-issue window.
After that window closes, carriers can generally ask health questions and use medical underwriting. That means they may decline your application or charge a higher rate based on conditions like heart disease, diabetes or a recent surgery. Some situations, such as losing certain other coverage or a plan leaving your area, can create guaranteed-issue rights later, but they’re specific and time-limited.
If you’re still working and covered by an employer plan with 20 or more employees, you can usually delay Part B without penalty, and your Medigap window won’t start until you enroll. When that coverage ends, you have eight months to sign up for Part B, and your six-month Medigap window begins with it. Use the Medicare enrollment window tool to map out your dates.
Once your Medigap Open Enrollment Period ends, getting the plan you want can depend on your health. If you’re within six months of starting Part B, talk with Kris now, even if you’re still deciding between Medigap and Medicare Advantage.
Medigap vs. Medicare Advantage
Most people choose between two paths. With Original Medicare plus Medigap and Part D, you typically pay a higher monthly premium but have very predictable costs and the freedom to see any provider that accepts Medicare. With Medicare Advantage, you often pay a lower premium but accept a network and copays as you use care, up to the plan’s yearly cap.
Neither path is right for everyone. People who travel, see specialists at major medical centers, or simply want to avoid surprise bills often lean toward Medigap. People who are comfortable with a local network and want extras bundled in often lean toward Medicare Advantage. Switching from Advantage back to Medigap later can be harder because of underwriting, so it helps to decide carefully up front.
One helpful way to decide is to picture a hard year: a hospital stay, a surgery and months of follow-up visits. With Plan G, your costs for covered care would be close to the Part B deductible. With Medicare Advantage, you’d pay copays along the way up to the plan’s out-of-pocket maximum. Then picture a healthy year and compare total premiums. The right answer is the one you’re comfortable with in both years.
| Medigap + Part D | Medicare Advantage | |
|---|---|---|
| Provider choice | Any provider nationwide that accepts Medicare | Plan network; PPOs allow out-of-network at higher cost |
| Monthly premium | Generally higher | Often lower, depending on the plan |
| Costs when you get care | Low and predictable | Copays and coinsurance up to a yearly cap |
| Drug coverage | Separate Part D plan | Usually included (MAPD) |
| Extras like dental | Not included | May be included, depending on the plan |
Medigap carriers and pricing in northwest Ohio
Medigap premiums in Ohio depend on the carrier, your age, your ZIP code, your gender and whether you use tobacco. Two companies can charge noticeably different premiums for the exact same Plan G benefits in Perrysburg or Toledo. That’s why quoting several carriers is worth the time.
Medigap carriers named on Kris’s site include Aetna, Anthem, ACE (Chubb), Heartland, Humana, Lumico, Manhattan Life, Medical Mutual, Mutual of Omaha, Physicians Mutual and UnitedHealthcare. Beyond today’s price, she looks at how each company sets rates over time, whether household discounts may apply, and how the company handles service. See the full list on the carriers page.
Because Medigap works anywhere Medicare is accepted, it’s a natural fit for northwest Ohio retirees who winter in Florida or visit family out of state. And if you move, Kris is licensed in Ohio, Michigan, Indiana and Florida, so she can keep helping.
How Kris helps you choose a Medigap plan
Kris begins with a no-cost, no-pressure conversation at her Perrysburg office, by phone or by video. She’ll confirm your Part B start date to see whether you’re inside your guaranteed-issue window, then talk through how you use health care and how much monthly premium versus out-of-pocket risk feels comfortable.
From there she quotes Plan G, Plan N and high-deductible G across the carriers she represents, explains the differences in plain English and helps you choose a Part D plan that covers your prescriptions. She handles the applications with you, and she stays your contact year-round for questions, billing issues and future rate reviews. Ready to see numbers? Request a quote.
- Confirm your Medigap Open Enrollment dates
- Quote Plans G, N and high-deductible G from multiple carriers
- Pair your plan with a Part D plan that fits your prescriptions
- Submit applications and confirm coverage start dates
- Review rate increases and options with you over time
Who Medicare Supplement (Medigap) may be right for
- People turning 65 who want to see any provider that accepts Medicare
- Retirees who split time between Ohio and Florida or travel often
- Anyone who prefers predictable costs over copays at each visit
- People still within their six-month Medigap Open Enrollment Period
- Current Medigap members wondering whether their premium is still competitive
Medicare Supplement Insurance Carriers Kris represents
Availability varies by county and changes every year. Kris will show you which of these carriers offer plans where you live.
- Aetna
- Anthem
- ACE
- Heartland
- Humana
- Lumico
- Manhattan Life
- Medical Mutual
- Mutual of Omaha
- Physicians Mutual
- UnitedHealthcare®
We do not offer every plan available in your area. Currently, we represent 14 organizations which offer 119 products in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. This is a proprietary website and is not associated, endorsed or authorized by the Social Security Administration, the Department of Health and Human Services or the Center for Medicare and Medicaid Services. This site contains decision-support content and information about Medicare, services related to Medicare and services for people with Medicare. If you would like to find more information about the Medicare program please visit the Official U.S. Government Site for People with Medicare located at www.medicare.gov.