Medicare Supplement

How Medigap letter plans fill Original Medicare gaps in Winston Salem

WINSTON-SALEM, N.C. — If you have Original Medicare, you already know it doesn't pay for everything. There are deductibles, coinsurance, and costs that can add up quickly, especially after a hospital stay. That's the gap Medicare Supplement insurance — often called Medigap — is designed to fill.

Making sense of Medicare Supplement insurance in Winston-Salem

Medigap isn't Medicare Advantage, and it isn't a drug plan. It's a private policy that works alongside Original Medicare (Part A and Part B) to help pay some of the out-of-pocket costs Medicare leaves behind. Here's how it works, and how to think through your options.

What Medigap actually does

Medigap policies help cover costs like the Part A hospital deductible, Part B coinsurance, and the daily copays that kick in during long hospital stays. Some plans also help with skilled nursing coinsurance, the Part B deductible (for people who first became eligible before 2020), and limited emergency care during foreign travel.

A few important things Medigap does not do:

• It does not include prescription drug coverage. For that, you'd add a separate Part D plan.
• It does not cover dental, vision, hearing aids, or long-term custodial care.
• It does not work with Medicare Advantage. You have one or the other, not both.

Medigap simply pays after Medicare pays. If Medicare approves the service, your Medigap plan picks up its share of what's left.

How the standardized letters work

This is the part that trips people up. Medigap plans are sold by private insurance companies, but the benefits inside each lettered plan are standardized by federal law. That means Plan G from one carrier covers the same core benefits as Plan G from another carrier. The price and customer service can differ — the benefits cannot.

The plans available to most new enrollees today are labeled with letters: A, B, D, G, K, L, M, and N. (Plans C and F are still held by people who were eligible for Medicare before Jan. 1, 2020, but new enrollees generally can't buy them.)

Plans G and N tend to be the most popular for newer enrollees because they cover a wide share of out-of-pocket costs. Plans K and L cap your yearly out-of-pocket spending but ask you to share more of the cost along the way. There's no "best" plan — the right fit depends on how you use care and what you can budget monthly.

You can compare the standardized benefits side by side at medicare.gov.

Timing matters more than most people realize

The single most important thing to know about Medigap is your open enrollment window. It's a one-time, six-month period that starts the month you're 65 and enrolled in Part B. During that window, insurance companies must sell you any Medigap policy they offer at their best available rate, regardless of your health history.

Outside that window, in most states — including North Carolina — insurers can use medical underwriting. That means they can look at your health, charge more, or turn you down. There are limited "guaranteed issue" situations (like losing other coverage), but the safest time to shop is during that first six months.

Winston-Salem is in Forsyth County — here's how it fits in

Winston-Salem sits in Forsyth County, where residents have access to Original Medicare, Medicare Advantage plans, standalone Part D drug plans, and Medigap policies sold by carriers licensed in North Carolina. Medigap availability isn't tied to your county the way Medicare Advantage is — if a carrier sells a lettered plan in North Carolina, you can generally apply for it.

That's a real difference: with Medicare Advantage, your zip code drives what's offered. With Medigap, the menu is more consistent statewide, though pricing varies by carrier, age, and sometimes tobacco use.

How to think through the decision

A few questions worth sitting with:

• Do you travel often, or split time out of state? Medigap works anywhere Medicare is accepted, which many people find reassuring.
• Do you prefer predictable monthly costs over lower premiums with more cost-sharing? Higher-coverage letters like G tend to have higher premiums but fewer surprises.
• Are you comfortable managing a separate Part D drug plan? With Medigap, you'll need one. In 2026, Part D has a $2,100 out-of-pocket cap and a maximum deductible of $615, and the old "donut hole" is gone — there are now three coverage phases.
• Would the Medicare Prescription Payment Plan help you? It lets you spread drug costs over the year in monthly installments.

If your income is above $109,000 as a single filer in 2026, keep IRMAA surcharges in mind — those are extra amounts added to Part B and Part D premiums based on income.