What Are Medicare Supplement Plans?
Comprehensive guide to Medicare Supplement insurance in NC. Understand why Medigap matters, compare all 10 plan types, learn 2026 costs, and find the right coverage to fill gaps in Original Medicare.
Comprehensive guide to Medicare Supplement insurance in NC. Understand why Medigap matters, compare all 10 plan types, learn 2026 costs, and find the right coverage to fill gaps in Original Medicare.
Many North Carolinians are surprised to learn that Original Medicare (Parts A and B) doesn't cover all healthcare costs. Medicare Part B only covers 80% of approved medical expenses, leaving you responsible for the remaining 20%—with no annual limit on what you could owe.
This gap can lead to significant out-of-pocket expenses, especially if you face a serious illness, surgery, or extended hospital stay. Medicare Supplement Plans (also called Medigap) are private insurance policies designed to fill these gaps, helping you manage and predict your healthcare costs.
Before exploring Medigap options, it's important to understand what costs Original Medicare leaves you to pay.
Medicare Part B (Medical Insurance) Costs You Pay:
• Monthly premium: $202.90 (2026 standard amount)
• Annual deductible: $283 (2026)
• 20% coinsurance on all Medicare-approved services after deductible
• Part B excess charges if the doctor doesn't accept the Medicare assignment
• No out-of-pocket maximum (your costs are unlimited)
Medicare Part A (Hospital Insurance) Costs You Pay:
• Hospital deductible: $1,736 per benefit period (2026)
• Days 1-60 in hospital: $0 after deductible
• Days 61-90 in hospital: $434/day coinsurance (2026)
• Lifetime reserve days (91+): $868/day coinsurance (2026)
• Skilled nursing facility: $217/day for days 21-100 (2026)
Example: If you have a $50,000 surgery covered by Part B, you would owe 20%—that's $10,000 out of your pocket. With a Medigap plan, much or all of that cost would be covered.
Medigap plans work alongside Original Medicare to cover your share of costs. Here's the process:
1. You visit a healthcare provider that accepts Medicare
2. The provider bills Medicare first
3. Medicare pays its portion (typically 80% of approved Part B costs)
4. The remaining balance is automatically sent to your Medigap insurer
5. Your Medigap plan pays according to your coverage (up to 100% of remaining costs)
Important: Medigap plans only work with Original Medicare (Parts A and B). If you have Medicare Advantage (Part C), you cannot use a Medigap plan. You must choose one or the other.
Freedom to Choose Any Provider:
Unlike Medicare Advantage plans with networks, Medigap works with any doctor, specialist, or hospital in the United States that accepts Medicare. No referrals needed—see any specialist directly.
Nationwide Coverage:
Your Medigap plan works anywhere in the country. If you travel frequently, split time between states, or snowbird to warmer climates, your coverage travels with you.
Predictable Costs:
With comprehensive Medigap plans like Plan G, you'll know exactly what your healthcare will cost. Once you pay the Part B deductible ($283 in 2026), Plan G covers everything else—no surprise bills.
No Network Restrictions:
There's no need to check if your doctor is "in network" because there is no network. Any Medicare-accepting provider works with your Medigap plan.
Simplified Claims:
In most cases, you don't need to file claims yourself. After Medicare processes your claim, it automatically forwards the information to your Medigap insurer for payment.
Guaranteed Renewable:
As long as you pay your premiums, your Medigap policy cannot be canceled regardless of health conditions you develop after enrollment.
Foreign Travel Emergency Coverage:
Most Medigap plans (C, D, F, G, M, and N) include coverage for medical emergencies during foreign travel—up to plan limits—which Original Medicare doesn't cover.
Medigap plans are standardized by the federal government, meaning that Plan G from one insurance company covers the same benefits as Plan G from another. The only differences are the premium prices and the company's service. Here's what each plan covers:
Plan G — Most Popular for New Enrollees
Plan G is the most comprehensive Medigap plan available to people who became eligible for Medicare on or after January 1, 2020. It covers:
• Part A hospital coinsurance and costs for 365 extra days after Medicare ends
• Part B coinsurance or copayment (the 20% you'd otherwise pay)
• Part A hospice care coinsurance or copayment
• Skilled nursing facility coinsurance
• Part A deductible ($1,736 in 2026)
• Part B excess charges
• Blood (first 3 pints)
• Foreign travel emergency coverage (80% up to plan limits)
You Pay: Only the annual Part B deductible ($283 in 2026). That's it.
Best For: People who want maximum coverage with predictable costs and are willing to pay the Part B deductible.
Plan N — Popular Lower-Premium Alternative
Plan N offers similar coverage to Plan G but with lower premiums in exchange for some cost-sharing. It covers:
• All benefits of Plan G EXCEPT:
- Does NOT cover Part B excess charges
- Requires copays for some office visits ($20) and ER visits ($50 if not admitted)
You Pay: Part B deductible ($283), up to $20 copay for office visits, up to $50 copay for ER visits (waived if admitted), and any Part B excess charges.
Best For: People who want good coverage at a lower premium and don't mind small copays. Works well if you only see doctors who accept Medicare assignment (avoiding excess charges).
Plan F — Most Comprehensive (Limited Availability)
Plan F covers 100% of all Medicare gaps—including the Part B deductible. However:
Important: Plan F is only available to people who were eligible for Medicare BEFORE January 1, 2020. If you turned 65 or became Medicare-eligible after that date, you cannot purchase Plan F.
You Pay: Nothing beyond your monthly premium—100% of Medicare gaps are covered.
Best For: Those who were Medicare-eligible before 2020 and want zero out-of-pocket costs. However, Plan F premiums are often higher than Plan G, so compare total costs.
Other Medicare Supplement Plans:
Plan A: Basic benefits only. Covers Part B coinsurance, Part A hospital coinsurance, hospice coinsurance, and blood. Does NOT cover deductibles, skilled nursing, excess charges, or foreign travel.
Plan B: Same as Plan A, plus covers the Part A hospital deductible ($1,736 in 2026). Does not cover Part B deductible.
Plan C: Comprehensive coverage including Part A and Part B deductibles. Like Plan F, it is only available to those who are Medicare-eligible before January 1, 2020.
Plan D: Similar to Plan G, but does NOT cover Part B excess charges. Covers Part A deductible, Part B coinsurance, and skilled nursing.
Plan K: Lower premium option that covers 50% of most costs. Has an annual out-of-pocket limit ($7,060 in 2025). Once you reach the limit, the plan pays 100%.
Plan L: Similar to Plan ,K but covers 75% of most costs. Has a lower out-of-pocket limit ($3,530 in 2025).
Plan M: Mid-range option that covers 50% of the Part A deductible. Lower premiums with some cost-sharing.
High-Deductible Plan G: Same coverage as Plan G, but you pay a $2,950 annual deductible (2026) before the plan pays—very low premiums.
For most North Carolinians enrolling in Medicare today, the choice typically comes down to Plan G or Plan N:
Choose Plan G If:
• You want maximum coverage and predictable costs
• You prefer paying one annual deductible ($283) and knowing everything else is covered
• You see multiple doctors or specialists
• You travel and want the security of full coverage anywhere
Choose Plan N If:
• You want lower monthly premiums
• You're comfortable with small copays for office visits
• You only see doctors who accept Medicare assignment (most do)
• You don't visit the doctor frequently
Medigap Open Enrollment Period (Most Important):
You have a 6-month Medigap Open Enrollment Period that begins the month you turn 65 AND are enrolled in Medicare Part B. During this window:
• Insurance companies MUST sell you any Medigap policy they offer
• They CANNOT deny you coverage for health conditions
• They CANNOT charge you more because of past or present health problems
This is critical: Once this 6-month window closes, insurance companies can use medical underwriting. They may deny coverage, exclude pre-existing conditions, or charge higher premiums based on your health.
Outside Open Enrollment:
If you apply outside your open enrollment period, you'll need to answer health questions and may be:
• Denied coverage entirely
• Charged higher premiums
• Subject to waiting periods for pre-existing conditions
Guaranteed Issue Rights:
In certain situations, you have guaranteed rights to buy a Medigap policy without medical underwriting:
• Losing employer group health coverage
• Medicare Advantage plan leaves your area or stops offering coverage
• Your Medigap company goes bankrupt or commits fraud
• Returning to Original Medicare from Medicare Advantage within 12 months of first joining
Medicare Supplement (Medigap):
• Works WITH Original Medicare
• See any doctor that accepts Medicare—nationwide
• Monthly premium (varies by plan and company)
• Predictable costs—know what you'll pay
• Need a separate Part D for prescription drugs
• No extra benefits (dental, vision, hearing, fitness)
Medicare Advantage (Part C):
• REPLACES Original Medicare
• Must use the plan's network (HMO or PPO)
• Often $0 premium (beyond Part B premium)
• Out-of-pocket maximum (2026: up to $9,250)
• Usually includes Part D drug coverage
• Often includes dental, vision, hearing, and fitness benefits
Note: You cannot have both a Medigap plan and a Medicare Advantage plan. You must choose one approach.
How much does Medicare Supplement insurance cost?
Premiums vary by plan type, insurance company, age, location, and health (if outside open enrollment). In North Carolina, Plan G premiums typically range from $100 to $250/month. Plan N premiums are usually 15-25% lower. Shop around—the same plan can cost very different amounts from different companies.
Do Medigap plans cover prescription drugs?
No. You'll need a separate Medicare Part D prescription drug plan for medications. The good news: you can combine any Medigap plan with any standalone Part D plan.
Do Medigap plans cover dental, vision, and hearing?
No. Original Medicare and Medigap do not cover routine dental, vision, or hearing care. You can purchase separate, standalone dental and vision plans, such as Blue Cross NC's Dental Blue and Blue 20/20 for Individuals.
Can I switch Medigap plans later?
Yes, but outside your open enrollment period, you'll need to pass medical underwriting. If you have health conditions, you may be denied. The exception: some states have guaranteed-issue periods for switching, and some companies offer "birthday rules" that allow annual switching.
Are all Plan G policies the same?
Yes—benefits are standardized by law. Plan G from Blue Cross NC covers the same things as Plan G from AARP/UnitedHealthcare or any other company. The difference is the premium price and customer service.
Choosing the right Medicare Supplement plan is one of the most important healthcare decisions you'll make. At Health Plans of NC, our licensed agents specialize in helping North Carolina residents compare Medigap options and find coverage that fits their needs and budget.
We Can Help You:
• Compare Medicare Supplement plans from top carriers
• Understand your enrollment options and timing
• Choose between Plan G, Plan N, and other options
• Find the lowest premiums for the coverage you need
• Coordinate Medigap with Part D prescription drug coverage
• Add standalone dental and vision coverage if needed
Our services are completely free. We're paid by insurance carriers, never by you. Contact Health Plans of NC today for a personalized Medicare Supplement comparison and find peace of mind with the right coverage.