Medigap plans A to N: what each one pays

What each plan pays

The chart reads in one direction: the further right, the more the plan leaves to you, except that Plans F and G cover the most. Plan F pays everything Original Medicare does not, Part B deductible included; since 2020 it can no longer be sold to people newly eligible for Medicare, which made Plan G, identical except for the Part B deductible, the most complete plan available to new enrollees. Plan N trades small copays and the Part B excess charge for a lower premium. Plans K and L pay only half or three quarters of most cost sharing, but stop your spending at a yearly limit.

Plan N in practice

Plan N pays the Part A deductible, the hospital and nursing coinsurance and the 20% of Part B, but you pay the Part B deductible, a copay of up to $20 for some office visits, up to $50 for an emergency room visit that does not end in an admission, and any excess charge from a doctor who does not accept Medicare's approved amount. For someone who sees a doctor a few times a year and uses doctors who accept assignment, those costs stay small, and the premium is usually well below Plan G's.

Plans K and L: a ceiling instead of full coverage

K and L suit people who want protection against a catastrophic year at a lower premium. In 2026, once your out-of-pocket spending on covered services reaches $8,000 with K or $4,000 with L, plus the Part B deductible, the plan pays 100% for the rest of the calendar year. Until then you pay half (K) or a quarter (L) of the cost sharing, which makes the first visits of the year noticeably more expensive than with G or N.

The six-month window that decides everything

For six months starting with the first month you are both 65 or older and enrolled in Part B, any insurer selling Medigap in your state must sell you any of its policies at its standard price, whatever your health (Social Security Act §1882(s)(2)). After that window, outside a few protected situations such as an Advantage plan leaving your area, most states let insurers ask health questions, charge more or refuse you. That is the main reason the first choice at 65 between Medigap and an Advantage plan matters: switching from Advantage to Medigap later is not guaranteed, while the reverse is always possible during the annual period.

Delaying Part B because you still have coverage from a current job also delays the window: it opens when Part B starts. Signing up for Part B too early, while you still have a job plan you intend to keep, starts the clock for nothing.

How prices are set

Federal law fixes the benefits, not the prices. Insurers price their policies in one of three ways: by your age when you buy, rising as you age ("attained age"), or the same for everyone whatever their age ("community rated"), and each state decides which methods it allows. Premiums also vary by ZIP code, sex and tobacco use, and two insurers can charge very different amounts for the same letter. No national price file exists, which is why the calculator above asks for the quotes you receive; your state's insurance department often publishes a comparison guide of Medigap premiums.

Medigap or a Medicare Advantage plan

With Medigap you keep Original Medicare: any doctor or hospital in the country that accepts Medicare, no referrals, no prior authorization from a plan, predictable bills. You pay for that with a monthly premium on top of Part B and a separate drug plan. An Advantage plan usually costs less each month and adds extras such as dental or vision, but works within a network and charges copays up to its cap. The whole-year calculator puts both routes on the same footing for your own level of care.