Medicare Supplement

Medigap coverage for Jacksonville on Original Medicare

JACKSONVILLE, Fla. — If you're new to Medicare, one of the most confusing choices is whether to add a Medicare Supplement policy, often called Medigap. These plans don't replace Medicare. They sit alongside Original Medicare and help pay some of the costs Medicare leaves behind — things like coinsurance, copays, and hospital deductibles. Here's a plain-language look at what Medigap does, how the lettered plans work, and what to think about before you sign up.

What Medigap actually does

Original Medicare (Part A and Part B) pays a big share of your hospital and doctor costs, but not all of it. You're still on the hook for deductibles and a 20% coinsurance on many Part B services — with no yearly limit on what you could owe out of pocket.

A Medigap policy, sold by private insurance companies, helps fill those gaps. Depending on the plan you pick, it may cover your Part A hospital coinsurance, Part B coinsurance, the first three pints of blood, skilled nursing facility coinsurance, and more. According to Medicare.gov, you pay a monthly premium to the insurance company for this coverage, in addition to your Part B premium.

One important note: Medigap works only with Original Medicare. You cannot use a Medigap policy to pay costs under a Medicare Advantage plan, and it's actually against federal law for someone to sell you a Medigap plan if you're enrolled in Advantage (unless you're switching back).

What Medigap does not cover

Medigap is narrower than many people think. It generally does not cover:

• Prescription drugs (you'd need a separate Part D plan)
• Routine dental, vision, or hearing
• Long-term care (like a nursing home stay for custodial reasons)
• Hearing aids or eyeglasses
• Private-duty nursing

If you want drug coverage alongside Original Medicare and Medigap, you'll need to enroll in a stand-alone Part D plan. For 2026, Part D has a $2,100 annual out-of-pocket cap and a maximum deductible of $615, and the old "donut hole" coverage gap is gone — replaced by three simpler phases.

How the standardized letters work

Here's the part that trips up almost everyone: Medigap plans are standardized by the federal government and labeled with letters — A, B, C, D, F, G, K, L, M, and N. (Plans C and F are no longer sold to people who became eligible for Medicare on or after January 1, 2020.)

Standardized means a Plan G from one company covers the exact same medical benefits as a Plan G from another company. The insurer's name on the card changes; the covered benefits do not. What can differ is:

• The monthly premium
• Customer service and billing
• Optional extras a few insurers bundle in

That's why comparing Medigap really comes down to two questions: which letter fits your needs, and which company offers a fair price and reliable service for that letter in your area.

Massachusetts, Minnesota, and Wisconsin standardize their plans a little differently, but Florida follows the standard letter system.

What to think about before you enroll

A few things worth weighing:

• Your Medigap Open Enrollment Period. This is the six-month window that starts the month you're 65 and enrolled in Part B. During this window, insurers must sell you any Medigap policy they offer at their best available rate, regardless of your health history. Miss it, and in most states — Florida included — you can be medically underwritten later, meaning you could be charged more or turned down.
• How the premium is priced. Insurers use community-rated, issue-age-rated, or attained-age-rated pricing. Attained-age premiums start lower but rise as you get older; community-rated premiums don't change based on your age.
• Your travel habits. Some letter plans include foreign travel emergency coverage; others don't.
• Whether you want predictability. Plans that cover more upfront tend to cost more in premium but less at the doctor's office.

How this fits with local coverage in Jacksonville

Jacksonville is in Duval County, where seniors typically have a mix of Original Medicare with Medigap, Medicare Advantage plans, and stand-alone Part D options to choose from. Medigap availability and pricing are set by the insurance companies licensed in Florida, not by county — but the decision of whether Medigap makes sense for you often comes down to how you'd rather receive care locally: through Original Medicare's nationwide any-provider network, or through an Advantage plan's local network.

If you want a neutral second opinion, Florida's State Health Insurance Assistance Program (SHINE, Florida's SHIP) offers free one-on-one counseling to Duval County residents.