10 Things You Need to Know About Choosing a Medigap Plan

6. The best time to buy a Medigap plan is (generally) when you first enroll in Medicare

You can buy any Medigap plan available in your state — and insurers can’t turn you down or charge you more due to preexisting health conditions — during the six months after you initially sign up for Medicare Part B. After that, you could be denied or charged higher monthly premiums.

7. Some states set their own enrollment rules

Connecticut and New York let Medicare beneficiaries buy a Medigap plan at any time without being denied. Other states (including California, Idaho, Illinois, Louisiana, Maryland, Missouri, Nevada, Oregon and Washington) let you switch plans at designated times.

8. Different plans have very different prices

For example, a 65-year-old nonsmoking man in Fort Myers, Florida, could pay $64 a month for a Plan K policy or $263 for Plan D. A 65-year-old nonsmoking woman in Wichita, Kansas, might pay $32 a month for a high-deductible Plan G policy versus $455 for a regular Plan G.

9. But shop based on coverage needs, not price

It’s pretty simple: Pay less, get less coverage. For example, plans A and B don’t offer coverage for big-ticket, out-of-pocket costs for stays at skilled nursing facilities. Likewise, high-deductible plans require you to pay thousands up front (up to $2,700 in 2023) before coverage kicks in. Lower-cost policies can be fine if you are relatively healthy, but if something goes wrong, your personal costs can skyrocket. Think long-term.

10. You can get unbiased help in deciding

The best place for more information is your State Health Insurance Assistance Program (SHIP). You can find one in your state at shiphelp.org. SHIP counselors can give you personalized help choosing a plan. Start early, because these services become increasingly busy toward the end of Medicare open enrollment (Dec. 7 ).

What the Experts Say

AARP asked a group of experts to give Medicare enrollees some advice about Medigap plans. These experts included: Bonnie Burns, a consultant for California Health Advocates, a nonprofit organization focused on Medicare advocacy and education; Tricia Neuman, executive director for the Program on Medicare Policy at KFF, a not-for-profit organization focused on health policy research; and Ray Walker, director of the Medicare Assistance Program at the Oklahoma Insurance Department. Here’s their advice:

Plans that offer more comprehensive coverage: C, F (if eligible), G

These generally have higher premiums but cover the majority of Medicare cost-sharing. C and F even pay your annual Part B deductible ($226 in 2023); G does not.

Plans that provide good coverage for less money: D, N

D plans cover almost everything that C, F and G plans do, but not Part B “excess” charges by some doctors; nor do they cover the Part B annual deductible. Under Plan N, you pay $20 for most doctor visits and a $50 copay for some emergency room visits.

Plans that are sensible if you have chronic health conditions: C, D, F, G, N

These have good coverage for doctor visits and lab tests, as well as time in the hospital and extended stays at skilled nursing facilities.

Plans for saving a buck — but read the fine print: High-deductible F or G; K, L 

These plans tend to have the lowest monthly premiums because you must pay a deductible ($2,700 in 2023 for high-deductible F and G) or reach an out-of-pocket limit ($6,940 for Plan K) before full coverage kicks in.

Plans that make sense if you don’t expect to visit the hospital or need skilled nursing: A, B 

Plans A and B cover many routine costs but don’t cover skilled nursing facility coinsurance ($200/day after 20 days); Plan A doesn’t cover Medicare Part A hospital deductibles.

Worst plans for hospital coverage: A, K, L, M 

Medicare’s Part A hospital deductible is $1,600, and you pay it with each new hospital admission. Plan A doesn’t cover it; Plan M pays half; and Plans K and L cover a percentage (50 and 75 percent, respectively) until you reach your out-of-pocket limit.

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