Medigap

What is Medigap?
Medigap (also called Medicare Supplement Insurance) is private insurance that helps cover “gaps” in Original Medicare (Parts A & B). It can help pay for deductibles, co-payments, and coinsurance that Medicare doesn’t fully cover.

What Medigap Covers

  • Part A coinsurance and hospital costs

  • Part B coinsurance or copayments

  • Blood (first 3 pints)

  • Part A hospice coinsurance or copayments

  • Skilled nursing facility coinsurance (with some plans)

  • Part A & Part B deductibles (with some plans)

  • Foreign travel emergency care (with some plans)

Coverage depends on the Medigap plan letter you choose (Plans A–N).

What Medigap Doesn’t Cover

  • Prescription drugs (you need Part D for this)

  • Routine vision, dental, hearing aids

  • Long-term care

  • Private-duty nursing

Costs

  • You pay a monthly premium for Medigap (varies by plan, age, health, and location).

  • You must also keep paying your Part B premium.

  • Premiums may rise over time.

Enrollment (New York State – 2026)

  • New York has continuous Medigap open enrollment.
    You can apply for a Medigap plan any time, not just during a 6-month window.

  • No medical underwriting is allowed in New York.
    Insurers cannot deny coverage or charge more based on your health, at any age.

  • You must be enrolled in Medicare Part B to purchase a Medigap plan.

  • Premiums may vary by age or company, but health status cannot be used to raise your rate or deny coverage.

Maria’s Story:
Maria, age 66, has Original Medicare (Parts A & B) and a Medigap Plan G. When she needed knee replacement surgery, Medicare paid most of the bill. Her Medigap policy covered her Part A deductible and most of her out-of-pocket costs. Maria had predictable, manageable costs for her care.

⚠️ Important: You cannot have both a Medicare Advantage plan and a Medigap policy at the same time.