How to Compare Medigap Policies
Comparing Medigap policies means weighing standardized letter plans against your personal health costs, preferred providers, and tolerance for out-of-pocket risk. Because every Medigap plan with the same letter offers identical core coverage, the real differences live in price, underwriting, and the small print around extras like foreign travel emergency care. The best comparison starts with what Medicare does not cover and builds from there.
- How to Compare Medigap Policies
- Start With What Original Medicare Leaves Uncovered
- Understand the Standardized Letter Plans
- Plan F and Plan G: The Common Benchmarks
- High-Deductible Plan F and Other Options
- Compare Premium Structures, Not Just the Monthly Number
- Check Provider Networks and Acceptance Rules
- Look at the Underwriting and Enrollment Timing
- Use the Comparison Table
- Read the Fine Print on Pre-Existing Condition Waiting Periods
- Consider the Insurer's Financial Stability and Service Record
- Finalize Your Comparison With a Personal Cost-Benefit Test
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Start With What Original Medicare Leaves Uncovered
Original Medicare Part A and Part B pay set amounts for covered services, leaving you responsible for deductibles, coinsurance, and copayments. Medigap policies fill many of those gaps, but they do not cover everything. Long-term care, vision, dental, hearing aids, and private-duty nursing are generally excluded. When comparing policies, list the services you actually expect to use so you can judge whether a lower premium or a broader coverage edge matters more to you.
Understand the Standardized Letter Plans
Medigap plans are labeled A through N, and benefits for each letter are the same regardless of insurer. The variation is in price and in whether the company offers extra perks beyond the standard set. If you are comparing policies, group them first by letter so you are comparing apples to apples on coverage, then look at cost and company-level factors.
Plan F and Plan G: The Common Benchmarks
Plan F covers the Part A deductible, all Part A coinsurance and hospital costs, Part B coinsurance, and the first three pints of blood. Plan G is the same except it does not cover the Part B deductible. Because Plan F is no longer sold to people new to Medicare, most current shoppers look at Plan G. When you compare these two, the question is whether the Part B deductible you would pay yourself is worth the lower monthly premium that Plan G usually carries.
High-Deductible Plan F and Other Options
A high-deductible Plan F requires you to meet a deductible before the plan pays anything, similar in concept to a Part B deductible but usually larger. It can make sense if you want catastrophic protection but rarely use doctors. Plan N, which requires small copays for office visits and emergency room trips without hospital admission, is another option worth comparing when you have a predictable usage pattern.
Compare Premium Structures, Not Just the Monthly Number
Insurers price Medigap policies in three ways, and the structure affects how your costs change over time. Community-rated plans charge the same premium to everyone regardless of age. Issue-age-rated plans base the premium on the age you were when you bought the policy, so younger buyers pay less. Attained-age-rated plans charge based on your current age, meaning premiums rise as you get older. When you compare policies, ask which rating method the company uses and model how the premium could look in five or ten years.
Check Provider Networks and Acceptance Rules
Medigap policies are not the same as Medicare Advantage plans with restricted networks, but some companies sell policies through preferred agent or broker channels. The critical point is that Medigap works with any provider who accepts Medicare assignment. Still, it is worth confirming that the insurer you choose has a straightforward claims process and does not require you to file paperwork yourself, because a smoother claims experience reduces the administrative burden of using coverage.
Look at the Underwriting and Enrollment Timing
Your ability to compare policies freely depends heavily on when you sign up. During the Medigap open enrollment period, which starts the first month you are 65 or older and enrolled in Part B, insurers cannot use medical underwriting. Outside that window, companies can reject your application or charge higher premiums based on health history. If you have a guaranteed-issue right because of a move or loss of employer coverage, use that window to compare without restriction.
Use the Comparison Table
The table below lays out the core attributes to compare across standardized Medigap plans, focusing on the most common choices for new Medicare enrollees.
| Plan | Part A Deductible | Part B Deductible | Part B Coinsurance | Foreign Travel Emergency | Typical Trade-Off |
|---|---|---|---|---|---|
| Plan F | Covered | Covered | Covered | Covered (80%) | Highest premium; no longer sold to new Medicare-eligible |
| Plan G | Covered | Not covered | Covered | Covered (80%) | Lower premium than Plan F; you pay the Part B deductible |
| High-Deductible Plan F | Not covered until deductible met | Not covered until deductible met | Covered after deductible | Covered (80%) | Lowest premium; higher first-year cost risk |
| Plan N | Covered | Not covered | Covered after small copay | Covered (80%) | Moderate premium; small out-of-pocket copays for office and ER visits |
Read the Fine Print on Pre-Existing Condition Waiting Periods
Even during open enrollment, some Medigap policies include a waiting period for coverage related to pre-existing conditions, typically six months. During that time, the plan may not pay for claims tied to those conditions. When comparing policies, ask specifically about pre-existing condition exclusions and how they interact with any prior insurance you had, because a shorter or no waiting period can save you significant out-of-pocket costs if you have ongoing treatment needs.
Consider the Insurer's Financial Stability and Service Record
A Medigap policy is a contract with a private insurance company, so the company's ability to pay claims matters. Check independent financial ratings from agencies such as AM Best, and look up complaint ratios through your state insurance department. A slightly lower premium from a company with frequent complaints or a weaker financial rating is a trade-off, not a pure saving.
Finalize Your Comparison With a Personal Cost-Benefit Test
Once you have narrowed the field, run the numbers against your own usage. Add the premiums you would pay over a year to the deductibles and copays you would likely incur. If a Plan G premium is only slightly higher than a Plan N premium but the copays on Plan N add up, Plan G may be the better value. The goal is not to find the cheapest premium but to find the policy that aligns coverage with your health costs and risk tolerance.