Medicare Supplement

Standardized Medigap letters: a Warren Medicare guide

If you live in Warren and you're sorting through Medicare choices, you've probably run into the word "Medigap." It sounds technical, but the idea is simple: Medigap is extra insurance that helps pay some of the costs Original Medicare leaves behind. This guide walks through what it does, what it doesn't do, and how the standardized letter plans work — so you can decide whether it fits your situation.

Medicare Supplement insurance, explained: what Medigap does and doesn't cover

What Medigap actually does

Medigap, also called Medicare Supplement Insurance, is sold by private insurance companies to work alongside Original Medicare (Part A and Part B). After Medicare pays its share of a covered service, your Medigap policy can pick up some or all of what's left — things like coinsurance, copayments, and deductibles.

A few key points to keep in mind:

• Medigap only works with Original Medicare. If you're enrolled in a Medicare Advantage plan (Part C), you can't use a Medigap policy at the same time.
• You pay a monthly premium for Medigap in addition to your Part B premium.
• Medigap policies generally do not include prescription drug coverage. For drugs, you'd typically add a stand-alone Part D plan.
• Medigap doesn't cover long-term care, most dental, vision, hearing aids, or private-duty nursing.

You can read the official rundown at medicare.gov.

How the standardized letter plans work

Here's the part that trips people up. In most states, including Michigan, Medigap plans are standardized and labeled with letters: A, B, C, D, F, G, K, L, M, and N. Every plan with the same letter offers the same core benefits, no matter which company sells it. A Plan G from one insurer covers the same Medicare-approved costs as a Plan G from another. What changes is the price and the customer service.

That standardization is meant to make comparing easier. If two companies both sell Plan N, you're really comparing premium, company reputation, and how they handle billing — not the benefits themselves.

A couple of important notes:

• Plans C and F are only available to people who became eligible for Medicare before January 1, 2020.
• Plans K and L have out-of-pocket limits and cover a smaller share of costs, which usually means lower premiums.
• Massachusetts, Minnesota, and Wisconsin standardize their plans differently.

When you can buy a Medigap policy

Timing matters more with Medigap than many people realize. Your Medigap Open Enrollment Period is a one-time, six-month window that starts the month you're 65 or older and enrolled in Part B. During that window, insurance companies must sell you any Medigap policy they offer at their best available rate, and they can't turn you down or charge you more because of health problems.

Outside that window, in most states, insurers can use medical underwriting. That means they can ask health questions and may deny coverage or charge more. Michigan follows the federal rules here, so if you're in Warren and thinking about Medigap, that first six-month window is the friendliest time to shop.

Medigap vs. Medicare Advantage — a quick reality check

Warren is in Macomb County, where residents have access to both Medicare Advantage plans and Medigap policies. But you can only be in one system at a time:

• Original Medicare + Medigap + Part D — You keep the freedom to see any provider that accepts Medicare, and Medigap helps with cost-sharing. You pay separate premiums.
• Medicare Advantage — A private plan bundles your Part A, Part B, and usually Part D. Networks and rules vary by plan. You cannot use Medigap alongside it.

Neither path is automatically better. The right fit depends on your doctors, your prescriptions, how you travel, and your budget.

A few 2026 numbers worth knowing

Even though these aren't Medigap rules, they shape the bigger picture:

• The Part D out-of-pocket cap is $2,100 in 2026.
• The maximum Part D deductible is $615.
• The coverage gap (the old "donut hole") has been eliminated as of 2025; Part D now has three phases.
• The Medicare Prescription Payment Plan lets you spread drug costs across the year instead of paying big bills at the pharmacy.
• IRMAA surcharges (higher Part B and Part D premiums) begin above $109,000 in income for a single filer in 2026.
• Annual Enrollment: October 15 – December 7. Medicare Advantage Open Enrollment: January 1 – March 31. Note: neither of these is a guaranteed-issue window for Medigap.

How to decide if Medigap fits you

There's no formula, but these questions help:

1. Do you want the ability to see any provider nationwide who accepts Medicare, without referrals or networks? 2. Are you comfortable paying a monthly premium in exchange for more predictable out-of-pocket costs? 3. Are you inside your six-month Medigap Open Enrollment window, or do you qualify for a guaranteed-issue right? 4. Do you also need drug coverage? (If yes, plan to add a Part D policy.)

If you answered yes to most of these, Medigap is worth a serious look. If you'd rather have a bundled plan with extras and don't mind a network, Medicare Advantage may feel like a better fit.