Medicare Supplement

Medigap Standardized Letters Explained for Norfolk Readers

NORFOLK, Va. — If you have Original Medicare (Part A and Part B), you already know it doesn't cover everything. Deductibles, coinsurance, and hospital costs can add up fast. That's where Medicare Supplement insurance — usually called Medigap — comes in.

Medicare Supplement insurance, explained

Medigap is private insurance you buy to help pay some of the out-of-pocket costs Original Medicare leaves behind. It doesn't replace Medicare. It works alongside it. And because it's standardized by the federal government, a plan with the letter "G" from one company covers the same things as a plan "G" from another. What can differ is the monthly premium and the customer service.

Here in Norfolk, which sits in Norfolk city (Virginia's independent city that functions as its own county for Medicare purposes), Medigap plan availability follows federal and state rules — not city lines. So while we can talk about what's sold in your area, availability is set at the county/state level.

What Medigap actually does

Medigap helps pay the "leftover" costs of Original Medicare. Depending on the letter plan you choose, it may help with:

• Part A hospital coinsurance and hospital costs after Medicare benefits run out
• Part B coinsurance or copays (usually the 20% Medicare doesn't pay)
• The first three pints of blood each year
• Part A hospice care coinsurance
• Skilled nursing facility coinsurance
• Part A deductible
• Some plans still cover the Part B deductible, but only if you were eligible for Medicare before Jan. 1, 2020
• Foreign travel emergency care (up to plan limits) on certain letters

That's it. Medigap does not cover prescription drugs, dental, vision, hearing aids, long-term care, or private-duty nursing. For drugs, you'd add a separate Part D plan.

How the standardized letters work

In most states, including Virginia, Medigap plans are sold using letters: A, B, C, D, F, G, K, L, M, and N. (Plans C and F are only available if you became eligible for Medicare before Jan. 1, 2020.)

Each letter is a fixed package of benefits set by the federal government. So the coverage inside Plan G is identical from insurer to insurer. What isn't identical:

• The monthly premium
• How the company prices its plans (some raise premiums with age, some don't)
• Extras like 24/7 nurse lines or gym memberships (these are perks, not core benefits)
• Customer service quality

Because the benefits are the same, comparing Medigap really comes down to price, pricing method, and the company's track record.

The one enrollment window that matters most

Here's the mistake we see most often in Norfolk: people assume they can buy Medigap anytime. They can't — at least not easily.

Your Medigap Open Enrollment Period is a one-time, six-month window that starts the month you're 65 and enrolled in Part B. During that window, insurers must sell you any Medigap plan they offer at their best available rate, no matter your health history.

Miss that window, and in most cases insurers can use medical underwriting. That means they can charge you more — or turn you down — based on your health. There are a few limited "guaranteed issue" situations after that, but they're narrow. If you're approaching 65, put this window on your calendar.

Medigap vs. Medicare Advantage — they don't mix

You cannot have both a Medigap policy and a Medicare Advantage plan. They're two different roads:

• Original Medicare + Medigap (+ a Part D drug plan) — see any provider that accepts Medicare nationwide; higher predictable premiums, fewer surprise costs.
• Medicare Advantage (Part C) — a private plan that replaces how you get your Medicare benefits, usually with a network and often with drug coverage built in.

Switching between the two is possible, but the timing matters. Medicare's Annual Enrollment Period runs Oct. 15 – Dec. 7, and the Medicare Advantage Open Enrollment Period runs Jan. 1 – March 31. Neither of those, on its own, guarantees you can get back into Medigap without underwriting. That's important to understand before you switch.

A quick note on 2026 drug costs

Medigap doesn't cover drugs, but most Norfolk readers pair it with a Part D plan. A few 2026 facts worth knowing:

• The Part D out-of-pocket cap is $2,100 in 2026. Once you hit it, you pay $0 for covered drugs the rest of the year.
• The maximum Part D deductible is $615.
• The old "donut hole" coverage gap is gone as of 2025 — Part D now has three phases.
• The Medicare Prescription Payment Plan lets you spread drug costs across the year in monthly installments instead of paying big amounts at the pharmacy counter.
• IRMAA surcharges (higher premiums for higher incomes) start above $109,000 for a single filer in 2026.