Medicare Supplement

Medigap letters explained for Fairmont Medicare readers

FAIRMONT, W.Va. — If you're turning 65 in Marion County, or helping a parent sort through Medicare mail, you've probably run into the word "Medigap." It sounds like jargon, but the idea is simple: Medigap is private insurance that helps pay some of the costs Original Medicare leaves behind.

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

Here's a plain-English guide to how Medigap works, what those standardized letters mean, and how to think about whether it fits your situation.

What Medigap is — and what it isn't

Medigap, also called Medicare Supplement insurance, works alongside Original Medicare (Part A and Part B). After Medicare pays its share of a covered service, your Medigap policy picks up some or all of what's left — things like coinsurance, copays, and sometimes deductibles.

A few important boundaries:

• Medigap is not Medicare Advantage. You can't have both at the same time. Medicare Advantage (Part C) replaces the way Original Medicare pays your claims; Medigap adds to Original Medicare.
• Medigap generally doesn't include prescription drug coverage. For that, most people add a stand-alone Part D plan.
• Medigap doesn't cover long-term care, most dental, vision, or hearing aids, according to Medicare.gov.

If you see a doctor or hospital that accepts Medicare in Fairmont — or anywhere in the country — your Medigap policy travels with you. That national reach is one reason snowbirds and frequent travelers often like it.

How the standardized letters work

This is the part that trips people up. In most states, Medigap plans are sold by letter: A, B, C, D, F, G, K, L, M, and N.

Each letter is a standardized benefit package set by the federal government. That means a Plan G sold by one insurer covers the same core benefits as a Plan G sold by another insurer. What can differ is the price, the customer service, and sometimes small extras.

A few things worth knowing:

• Plans C and F are only available to people who became eligible for Medicare before January 1, 2020. If you're newly eligible today, those two are off the table.
• Plans K and L have lower premiums but ask you to share more of the cost up front, with an annual out-of-pocket limit.
• Plan N has some copays for office and ER visits, which keeps its premium lower than plans that cover nearly everything.

Because the benefits inside each letter are standardized, comparing Medigap plans is really about comparing price and the company behind the policy, not hunting for hidden features.

When you can buy Medigap matters a lot

This is the single most important thing to understand before shopping.

You get a one-time, six-month Medigap Open Enrollment Period 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, regardless of your health history.

Miss that window, and in most states — including West Virginia — insurers can use medical underwriting. That means they can ask about your health, charge you more, or decline to cover you based on pre-existing conditions. There are a few limited "guaranteed issue" situations, but they're narrower than most people expect.

If you're weighing Medicare Advantage versus Original Medicare plus Medigap, factor this in: switching back to Medigap later isn't always simple.

How Medigap fits with Part D and 2026 drug costs

Since Medigap usually doesn't cover prescriptions, most people with a Medigap policy also enroll in a stand-alone Part D drug plan.

A few 2026 figures worth keeping in mind, per CMS:

• The Part D out-of-pocket cap is $2,100 in 2026. Once your covered drug spending hits that amount, you pay $0 for covered drugs the rest of the year.
• The maximum Part D deductible is $615 in 2026.
• The old "donut hole" coverage gap was eliminated in 2025, so Part D now has three phases instead of four.
• The Medicare Prescription Payment Plan lets you spread your drug costs across the calendar year in monthly bills instead of paying big amounts at the pharmacy counter.
• IRMAA surcharges — extra amounts for Part B and Part D — start above $109,000 in income for a single filer in 2026.

Enrollment timing matters too. The Annual Enrollment Period runs October 15 – December 7 each year for Part D and Medicare Advantage changes. Medigap is separate and doesn't follow that calendar — you can apply anytime, but outside your initial window, underwriting usually applies.

What this looks like in Fairmont

Fairmont is in Marion County, where residents choose from the same standardized Medigap letters available across West Virginia. Availability of specific carriers and their pricing is regulated at the state level through the West Virginia Offices of the Insurance Commissioner.

For plan comparisons that are specific to you — your ZIP code, your doctors, your prescriptions — the official Medicare Plan Finder at medicare.gov/plan-compare is the place to start. For free, unbiased one-on-one help, West Virginia SHIP (State Health Insurance Assistance Program) counselors can walk you through Medigap, Part D, and Medicare Advantage without trying to sell you anything.