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Medicare Supplement (Medigap) in 2026: Costs, Coverage

Medicare Supplement (Medigap) plans help pay the costs Original Medicare doesn’t cover, and 2026 brings familiar rules with a few updates to watch.

If you’re turning 65, already on Medicare, or helping a parent compare options, this guide explains how Medigap works, what’s changing (and not) for 2026, and how to choose a plan with predictable costs.

What is a Medicare Supplement (Medigap) plan?

Medigap is private insurance that works alongside Original Medicare (Parts A and B). It helps pay Medicare’s “gaps,” such as Part A hospital deductibles, Part B coinsurance and copayments, and, in some plans, Part B excess charges and limited foreign travel emergency care.

Medigap plans are standardized by letter (A, B, D, G, K, L, M, N, and in some states high-deductible versions). A Plan G from one insurer has the same core benefits as Plan G from another; the main differences are price, service, and underwriting. You can see the standardized chart on Medicare.gov’s compare page.

Important: Medigap isn’t Medicare Advantage. You keep Parts A and B, can see any provider nationwide who accepts Medicare, and you’ll typically add a standalone Part D drug plan for prescriptions because Medigap doesn’t include drug coverage.

What’s staying the same—and what may change in 2026

What’s the same: The standardized benefits for each Medigap letter are not expected to change for 2026. Plans C and F remain closed to people first eligible for Medicare on or after January 1, 2020 (Plan G is the closest alternative). Medigap still doesn’t cover Part D drugs, routine dental, vision, or hearing aids, although some insurers bundle separate discount or ancillary benefits.

What may change: Medicare’s Part A and Part B deductibles and coinsurance amounts are set annually by the federal government, so expect updated figures for 2026 to be announced late in 2025. Premiums for Medigap plans also adjust annually by insurer and state based on claims experience, inflation, and rating method (community-rated, issue-age, or attained-age). The high-deductible Plan G deductible is indexed each year; check the official 2026 amount during your comparison.

State rules vary: Some states provide additional guaranteed-issue protections or birthday/change windows that allow switching without medical underwriting. Always confirm your state’s latest rules with your State Health Insurance Assistance Program (SHIP) or department of insurance.

Enrollment timing: when can you get Medigap?

Medigap Open Enrollment Period (OEP): Your six-month OEP starts the first month you’re 65 or older and enrolled in Part B. During this window, you can buy any Medigap plan available in your state with no health questions or underwriting. This is often your best chance to lock in coverage and potentially lower premiums.

Guaranteed-issue (GI) rights: Outside your OEP, you may qualify for GI in specific situations (for example, losing employer coverage that secondary-paid after Medicare, moving out of a Medicare Advantage service area, or using the “trial right” after trying Medicare Advantage for the first time). GI rules differ by state, and the specific plans available under GI can be limited—verify your eligibility before canceling current coverage.

Switching later: If you apply outside OEP or without a GI right, insurers usually use medical underwriting and can deny your application or charge more based on health. There is no annual, nationwide Medigap open enrollment like there is for Medicare Advantage; the fall Annual Enrollment Period mainly affects Part D and Medicare Advantage, not Medigap.

Travel and provider access: With Medigap plus Parts A and B, you can see any Medicare-participating provider nationwide—no networks, no referrals. Some letter plans include limited foreign travel emergency coverage.

Key Medigap plan options for 2026

Plan G: the comprehensive choice for most new enrollees

Plan G is the most popular option for people first eligible for Medicare in 2020 or later. It covers everything Plan F did except the Part B deductible. After you pay the Part B deductible each year, Plan G typically pays the rest of Part B coinsurance (including 100% of allowed excess charges where applicable) and most Part A costs, including the Part A hospital deductible and skilled nursing facility coinsurance.

Best for: Those who want robust, predictable protection and are okay paying the Part B deductible each year in exchange for strong coverage and wide provider choice.

Plan N: lower premiums with small copays

Plan N often has lower premiums than Plan G. In exchange, you’ll pay up to a $20 copay for some office visits and up to $50 for emergency room visits that don’t lead to admission, and Plan N doesn’t cover Part B excess charges. Like Plan G, it doesn’t cover the Part B deductible.

Best for: Budget-conscious beneficiaries in states where providers seldom bill excess charges (or who are comfortable confirming “no excess charge” providers) and who don’t mind occasional copays.

High-Deductible Plan G (HDG): pay less monthly, more if you use care

HDG has the same benefits as standard Plan G, but coverage kicks in only after you meet a high annual deductible that’s set by CMS each year. Premiums are typically much lower, but you’ll be responsible for Medicare cost-sharing until you reach the deductible; after that, the plan pays like a regular Plan G for the rest of the year.

Best for: People who want the freedom of Medigap’s nationwide access at a lower monthly cost and are comfortable with higher potential out-of-pocket exposure in a bad health year.

Other lettered options (K, L, M, A, B)

Less common choices like Plans K and L cover a percentage of Part A and B costs until you hit an annual out-of-pocket maximum; premiums are lower, but you’ll share more costs. Plans A and B are basic options with minimal extras. Plan M splits the Part A deductible 50/50. Consider these if local pricing for G or N is unusually high and you understand the cost-sharing.

Costs in 2026: premiums and out-of-pocket expectations

Premiums: Medigap premiums vary widely by state, age, tobacco status, household discounts, and rating method. A 65-year-old might see monthly premiums roughly in the $90–$250+ range for Plan N or G in many areas, while high-deductible G can be considerably less. Always compare several insurers offering the same letter—benefits match, but prices and rate histories differ.

Cost-sharing with Original Medicare: With Plan G, your main predictable expense after premiums is the annual Part B deductible, then Medicare-approved services are typically covered in full by Part B + Plan G. With Plan N, budget for small office and ER copays and consider the risk of excess charges if your providers bill them. With HDG, be prepared to cover Medicare cost-sharing until you reach the annual high deductible.

Annual updates: The Part A hospital deductible, Part B deductible, and skilled nursing coinsurance usually adjust each year. For 2026 amounts, check Medicare’s official cost pages when released. Also review your insurer’s renewal notice for any premium changes and potential household or EFT discounts.

How to compare Medigap plans for 2026

1) Confirm your doctors accept Medicare: With Medigap, any Medicare-participating provider is in-network, but it’s still wise to verify acceptance and ask about excess charges if considering Plan N.

2) Decide your risk tolerance: Prefer paying a bit more each month for near-total predictability? Consider Plan G. Want a lower premium and comfortable with small copays (and confirming no excess charges)? Consider Plan N. Want the lowest premium and can handle higher risk in a bad year? Explore High-Deductible G.

3) Compare prices for the same letter from multiple insurers: Because benefits are standardized, weigh monthly premium, rate stability (past increases), household discounts, and customer service. A slightly higher starting premium with gentle increases can beat a rock-bottom price that spikes later.

4) Check underwriting rules before switching: Outside OEP or GI rights, you may need medical underwriting. In states with special switching windows (e.g., birthday rules), you might swap plans of equal or lesser benefits without underwriting—verify details locally.

5) Use official tools: Medicare.gov’s Medigap policy search lets you see insurers offering each letter plan in your ZIP code and estimate premiums. SHIP counselors offer free, unbiased help comparing options and understanding state-specific protections.

Medigap vs. Medicare Advantage (quick contrast)

Medigap + Original Medicare: Nationwide freedom to use any Medicare provider, minimal referrals, generally higher premiums with lower out-of-pocket variability, separate Part D drug plan needed.

Medicare Advantage (Part C): Usually lower premiums, annual out-of-pocket maximums, but provider networks and prior authorization rules apply; benefits and costs can change each year. You generally can’t use Medigap with Medicare Advantage.

Practical checklist before you enroll for 2026

  • List your doctors, hospitals, and anticipated procedures; confirm Medicare acceptance and whether they bill excess charges.
  • Estimate prescriptions and choose a standalone Part D plan separately; Medigap doesn’t cover drugs.
  • Decide between Plan G, Plan N, or High-Deductible G based on budget and risk tolerance.
  • Get quotes from multiple insurers for the same letter; review household/tobacco discounts and payment options.
  • Ask about underwriting if switching; confirm any state GI or birthday-change opportunities.
  • Set a reminder to review 2026 cost updates (Part A/B deductibles, HDG deductible) when CMS publishes them.

Helpful tools and resources

Bottom line

For 2026, Medicare Supplement (Medigap) plans remain a steady way to turn unpredictable medical bills into more predictable monthly expenses. Start by deciding how much risk you want to carry (G, N, or HDG), compare prices across multiple insurers, and time your application to use OEP or any state guaranteed-issue window available to you. With a clear plan and the tools above, you can choose confidently and protect your retirement budget.

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