How Do Medicare Supplement Plans (Medigap) Work?

Medigap plans, also known as Medicare Supplement plans, help cover the “gaps” in Original Medicare (Parts A and B), such as deductibles, coinsurance, and copayments. These out-of-pocket costs can add up quickly—Medigap helps fill them, so you pay less when you receive covered services.

With a Medigap plan, Medicare pays its approved amount first, and your Medigap policy covers its share. Depending on the plan you choose, you could have little to no out-of-pocket costs for Medicare-covered services.

Standardized Medigap Plans

There are 10 standardized Medigap plans (labeled A, B, D, G, K, L, M, N, and in some states high-deductible versions of F and G). Each plan offers the same benefits nationwide, no matter the insurer—the only difference is the monthly premium. The most popular plans in North Carolina are typically G, N, and high-deductible G.

Our local Health Plans of NC agents can help you compare premiums and find the best fit for your budget and health needs.

Key Benefits of Medigap Plans

• Choose any provider

  that accepts Medicare—no networks or referrals required.

• Predictable costs

  —no surprise bills for covered services.

• Guaranteed renewal

  —your policy renews annually regardless of health changes.

What Medigap Covers (and What It Doesn’t)

All Medigap plans cover:

• Part A coinsurance and hospital costs

  (e.g., after 60 days in hospital)

• Part B coinsurance

  (covers the 20% Medicare doesn’t pay)

• First 3 pints of blood

• Part A hospice care coinsurance

Higher-level plans (like G, F, and N) also cover:

• Part A deductible

  (inpatient hospital stay)

• Part B deductible

  (some plans only)

• Skilled nursing facility coinsurance

• Part B excess charges

  (up to 15% extra if provider doesn’t accept Medicare assignment)

• Foreign travel emergency

  (usually 80% up to a lifetime limit, after a deductible)

Medigap does not cover:

• Medicare Part D prescription drugs

• Vision, dental, or hearing care (unless added via a Medicare Advantage plan)

• Long-term care

Selecting the Right Medigap Plan

When comparing plans:

• Premiums

  — Vary by insurer, age, location, gender, and tobacco use.

• Rate history

  — Review the past 3–5 years of increases to predict future costs.

• Financial stability

  — Check AM Best or other ratings for the insurer’s reliability.

Our North Carolina Medicare agents can access this information and help you compare options across providers.

Need Help Choosing a Medigap Plan?

At Health Plans of NC, our experienced local agents specialize in Medicare supplements for North Carolina residents. We’ll explain each plan’s benefits, compare quotes, and find the one that fits your health and budget. Contact us today for personalized guidance or to compare plans online!