Medicare Supplement

Medigap in Irving: how the lettered plans are built

IRVING, Texas — If you're new to Medicare, or helping a parent sort through the mail piling up on the kitchen table, you've probably seen the phrase "Medicare Supplement" or "Medigap." It sounds like an add-on you might not need. In reality, it's one of the oldest and most straightforward pieces of the Medicare system — and once you understand how the lettered plans work, the choices get a lot less confusing.

Here's a plain-language guide to what Medigap does, what it doesn't, and how to think through whether it fits your situation.

What Medigap actually is

Medigap is private insurance that works alongside Original Medicare (Part A and Part B). It doesn't replace Medicare. Instead, it helps pay some of the out-of-pocket costs Original Medicare leaves behind — things like coinsurance, copayments, and, depending on the plan, the Part A hospital deductible.

So the order goes: Medicare pays its share first, then your Medigap policy picks up some or all of what's left, based on the letter of the plan you chose.

One important note: Medigap only works with Original Medicare. If you're enrolled in a Medicare Advantage plan (Part C), you cannot also use a Medigap policy — the two systems aren't designed to work together.

The lettered plans, and why they exist

Medigap plans are standardized by the federal government. That means a Plan G sold by one company covers the exact same Medicare-related costs as a Plan G sold by another company. The benefits are set; only the price and the customer service differ.

In most states, including Texas, the plans available today are labeled with letters: A, B, C, D, F, G, K, L, M, and N. (Plans C and F are only available to people who became eligible for Medicare before January 1, 2020.)

Each letter covers a different combination of gaps. For example:

• Plan G is one of the most comprehensive plans still open to new enrollees. It covers most out-of-pocket costs except the Part B deductible.
• Plan N generally has lower premiums but asks you to pay small copays for some office and emergency visits.
• Plans K and L are cost-sharing plans with lower premiums and an out-of-pocket limit.

Medicare.gov keeps a side-by-side chart of exactly what each letter covers. It's worth pulling up before you talk to any agent.

What Medigap does not cover

This trips a lot of people up. Medigap is designed for the gaps in Original Medicare — not for benefits Medicare never covered in the first place. That means a Medigap policy typically will not pay for:

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

If prescription coverage matters to you — and for most people it does — Medigap alone won't be enough. You'd pair it with a stand-alone Part D drug plan.

How this fits with 2026 Medicare rules

A few program-level facts worth knowing as you plan for 2026:

• Part D prescription drug costs are capped at $2,100 out of pocket per year.
• The maximum Part D deductible is $615.
• The old "donut hole" coverage gap is gone; drug coverage now moves through three simpler phases.
• The Medicare Prescription Payment Plan lets you spread your yearly drug costs into monthly payments, if that helps your budget.
• Higher-income enrollees pay IRMAA surcharges on Part B and Part D — these begin above $109,000 in income for a single filer in 2026.

None of those figures are set by your Medigap plan, but they affect the total picture of what you'll pay each year.

Timing matters more than most people realize

The best time to buy a Medigap policy is during your Medigap Open Enrollment Period — a six-month window that starts the month you're 65 and enrolled in Part B. During that window, insurers cannot deny you coverage or charge you more because of health conditions.

Outside that window, in most states, insurers can use medical underwriting. That means someone with a chronic condition might be turned down or pay more. Texas follows the federal rules here, so this timing decision is a big one.

Also remember the calendar for other Medicare changes:

• Annual Enrollment Period: October 15 – December 7 (for Part D and Medicare Advantage changes)
• Medicare Advantage Open Enrollment: January 1 – March 31

Medigap doesn't have those same annual windows — you can apply any time — but underwriting rules may apply after your initial period.

How to decide if Medigap fits you

Irving is in Dallas County, where there are many Medicare Advantage plans and multiple Medigap carriers competing for business. That's a lot of mail and a lot of phone calls. A few honest questions can cut through it:

• Do you want the freedom to see any doctor or hospital in the U.S. that accepts Medicare, without network restrictions? Medigap paired with Original Medicare is built for that.
• Do you travel often, or split time between states? Medigap follows you anywhere Medicare is accepted.
• Are predictable monthly costs more important to you than lower premiums with variable out-of-pocket bills? Comprehensive Medigap plans favor predictability.
• Are you comfortable managing a separate Part D drug plan? You'll need one.

If the answers lean toward flexibility and predictability, Medigap deserves a serious look. If you prefer bundled coverage that may include extras like dental or vision, Medicare Advantage may be the direction — just know you can't have both.