Medicare Supplement

Medigap Explained for University Place, Washington Residents

UNIVERSITY PLACE, Wash. — If you've spent an afternoon trying to figure out Medicare, you've probably run into a wall of letters: Plan A, Plan G, Plan N, and a few in between. Those letters aren't grades or rankings. They're standardized Medicare Supplement plans — better known as Medigap — and understanding how they work can spare you a lot of confusion (and some costly guesswork) later on.

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

Here's a plain-English guide to what Medigap does, what it doesn't do, and how those letter plans fit into the bigger Medicare picture.

What Medigap actually is

Medigap is private insurance you can buy to help pay some of the costs Original Medicare (Part A and Part B) leaves behind — things like deductibles, coinsurance, and copayments. It works alongside Original Medicare, not instead of it. Medicare pays its share of a covered service first, and your Medigap policy picks up some or all of what's left.

A few key ground rules, straight from Medicare:

• You must be enrolled in both Part A and Part B to buy a Medigap policy.
• Medigap only works with Original Medicare. It does not work with Medicare Advantage.
• Each Medigap policy covers one person. Spouses need their own policies.
• You pay a monthly premium to the private insurer, on top of your Part B premium.

How the standardized letters work

In most states, Medigap plans are standardized by the federal government and labeled with letters: A, B, C, D, F, G, K, L, M, and N. (Massachusetts, Minnesota, and Wisconsin standardize their plans a little differently.)

"Standardized" is the important word. It means Plan G from one insurance company must offer the exact same core benefits as Plan G from another company. The price and customer service can differ. The covered benefits cannot.

A quick tour of what the letters generally cover:

• Plans A and B: The most basic options, covering things like Part A coinsurance and hospital costs.
• Plans G and N: The most popular choices for people newly eligible today. They cover a broad set of gaps, though Plan N has some copays and Part B excess charges to be aware of.
• Plans K, L, and M: Cost-sharing plans that typically have lower premiums but ask you to pay a percentage of certain costs.
• Plans C and F: These cover the Part B deductible, but they are only available to people who became eligible for Medicare before January 1, 2020. If you became eligible after that date, these two are off the table.

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

What Medigap does not cover

This is where a lot of people get tripped up. Medigap is not a catch-all. It generally does not cover:

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

If prescription coverage matters to you — and for most people, it does — you'll want to look at a stand-alone Part D plan. In 2026, Part D has a $2,100 out-of-pocket cap on covered drugs, a maximum deductible of $615, and the old "donut hole" coverage gap is gone. There's also an optional Medicare Prescription Payment Plan that lets you spread your drug costs across the year in monthly amounts.

The best time to buy — and why timing matters

The single most important thing to know about Medigap is your Medigap Open Enrollment Period. It's a one-time, six-month window that starts the month you're 65 or older and enrolled in Part B.

During this window, you have what's called a "guaranteed issue" right. Insurers can't turn you down or charge you more because of health problems. Outside of it, in most states, they can — and often do — use medical underwriting. That means someone with a health condition might pay more, or be denied altogether.

This is one of the most common — and most expensive — mistakes people make with Medicare: assuming they can switch into a Medigap plan later, only to find out the door has partly closed.

How this fits with Medicare in Pierce County

University Place is in Pierce County, where residents choose between two main paths: Original Medicare (often paired with a Medigap policy and a stand-alone Part D plan) or a Medicare Advantage plan, which bundles coverage through a private insurer. Pierce County has a competitive Advantage market with plans from multiple carriers, but remember — Medigap only works with Original Medicare. You can't have both a Medigap policy and a Medicare Advantage plan at the same time.

If you're weighing the two paths, Washington's SHIBA program (the state's SHIP, or State Health Insurance Assistance Program) offers free, unbiased counseling. That's a good stop before you sign anything.

A few key dates to keep in mind

• October 15 – December 7: Medicare Annual Enrollment Period (for Part D and Medicare Advantage changes).
• January 1 – March 31: Medicare Advantage Open Enrollment Period.
• Your Medigap Open Enrollment Period: The six months starting when you're 65 and enrolled in Part B.

Also worth noting: if your income is above $109,000 as a single filer in 2026, you may pay an IRMAA surcharge on Part B and Part D premiums.