Key Takeaways

• Medigap plans in 2025 offer standardized supplemental coverage to help reduce your out-of-pocket costs under Original Medicare, but they come with monthly premiums that vary based on multiple factors.

• While these plans provide peace of mind and predictable expenses, they also have restrictions you should be aware of, especially regarding when and how you can enroll.

What Medigap Actually Covers in 2025

Medigap, also known as Medicare Supplement Insurance, helps you cover the gaps left by Original Medicare. In 2025, these gaps include deductibles, copayments, and coinsurance associated with Part A and Part B. Depending on the plan letter you choose, Medigap can cover:

• Part A coinsurance and hospital costs for up to 365 extra days after Medicare benefits are used up

• Part B coinsurance or copayments

• The first three pints of blood

• Part A hospice care coinsurance or copayment

• Skilled nursing facility care coinsurance

• Part A deductible

• Part B deductible (only for those who qualified for Plans C or F before 2020)

• Part B excess charges

• Emergency care while traveling abroad

In 2025, all Medigap plans are standardized. This means the benefits for each plan letter remain the same across all insurers. However, premiums may still vary.

What Medigap Does Not Cover

Although Medigap fills several gaps, it does not act as comprehensive insurance. In 2025, Medigap plans do not cover:

• Prescription drugs (you need a standalone Part D plan)

• Long-term care

• Vision or dental services

• Hearing aids

• Private-duty nursing

These exclusions are important to keep in mind if you’re looking for more complete coverage beyond what Medigap offers.

Who Should Consider a Medigap Plan

You might want to consider Medigap in 2025 if you:

• Prefer to keep Original Medicare and want predictable out-of-pocket costs

• Travel frequently within the U.S. and need nationwide provider access

• Value flexibility in choosing healthcare providers without referrals

• Want to avoid high coinsurance costs for hospital stays or skilled nursing facility care

However, if you’re already enrolled in a Medicare Advantage plan, you cannot purchase a Medigap policy. You’ll have to disenroll from Medicare Advantage and return to Original Medicare before considering a Medigap plan.

Enrollment Timing Matters More Than You Think

The best time to enroll in a Medigap plan is during your Medigap Open Enrollment Period. This six-month window starts the month you’re both 65 or older and enrolled in Medicare Part B. During this time:

• You can buy any Medigap policy sold in your state

• You cannot be denied coverage based on health conditions

• You get the best pricing without medical underwriting

If you miss this window, you may have to go through underwriting, and your application can be denied or priced higher based on pre-existing conditions.

Cost Considerations in 2025

While Medigap helps you manage your medical expenses, it comes with a monthly premium. The exact cost depends on several factors:

• Age: Some insurers use attained-age pricing, where premiums increase as you age

• Location: Rates vary significantly by state and even zip code

• Tobacco use: Smokers often face higher premiums

• Gender: Some policies offer different rates for men and women

• Plan type: More comprehensive coverage typically means higher premiums

Even though the benefits are standardized, the method insurers use to price these plans can lead to long-term cost differences. That’s why comparing more than just the monthly premium is essential.

How Medigap Coordinates with Other Medicare Coverage

Medigap only works with Original Medicare. Here’s how the coordination plays out:

• Medicare pays its share of the approved amount for covered healthcare services

• Medigap pays its share based on your plan letter

You don’t need prior authorizations, and there’s no network—you can see any provider nationwide that accepts Medicare.

However, Medigap does not coordinate with:

• Medicare Advantage (Part C)

• Standalone dental, vision, or hearing plans

• Medicaid or employer retiree plans (in some cases)

It’s important to understand that Medigap won’t help if your primary coverage isn’t Original Medicare.

Changes You Should Know About in 2025

The year 2025 brings some important considerations:

• New Part B deductible: $257, which affects Medigap Plans C and F (no longer available to new enrollees)

• No change in standardization: The lettered plans remain consistent in terms of benefits

• Continued ban on Medigap drug coverage: Prescription drugs must still be covered through Part D

• Enrollment rights for those losing employer coverage: You may qualify for a Special Enrollment Period if you lose employer-sponsored insurance

Keeping an eye on policy changes ensures you make the most informed decision when reviewing or switching plans.

Is Medigap Worth the Premium in 2025?

That depends on your health needs, lifestyle, and financial situation. Ask yourself the following:

• Do you visit the doctor frequently or need ongoing specialist care?

• Would you rather pay higher monthly premiums and lower out-of-pocket costs when receiving care?

• Are you likely to need care while traveling in the U.S. or abroad?

• Are you concerned about budgeting for medical expenses over time?

If the answer is yes to most of these, Medigap can help you reduce financial risk in the long run.

On the other hand, if you’re healthy and rarely visit a doctor, a different Medicare path may be more cost-effective—though you’ll also carry more risk for unpredictable costs.

Enrollment Rights and Protections

Medigap enrollment rights are strongest during your one-time Open Enrollment Period. After that, you have limited protections:

• Guaranteed issue rights apply in specific situations, like losing coverage from a group health plan or a Medicare Advantage plan exiting your area.

• Trial rights let you try a Medicare Advantage plan and return to Medigap within 12 months if it’s your first time joining a Medicare Advantage plan.

These rights are time-sensitive, and in many cases, you only have 63 days to act after losing other coverage.

Reviewing Your Plan Annually Still Matters

Even though Medigap plans don’t change their benefits year to year, premiums can increase. It’s a good idea to:

• Reassess your healthcare usage

• Check if your plan still offers good value for your needs

• Explore other insurers for better pricing (if you qualify to switch)

You don’t need to wait for Medicare’s Annual Enrollment Period to switch Medigap plans, but you might undergo underwriting if outside your Open Enrollment Period.

Medigap in the Bigger Picture of Medicare Planning

Medigap isn’t a one-size-fits-all solution. It works best as part of a broader Medicare strategy:

• Combine it with a Part D plan for prescription drugs

• Consider separate dental, vision, or hearing plans if needed

• Evaluate how Medigap compares with Medicare Advantage based on your personal preferences

Looking at the full picture helps you avoid coverage gaps and ensures your plan meets both your medical and financial needs.

Understand Your Options Before You Decide

Choosing Medigap in 2025 involves more than just comparing letters or premiums. It’s about weighing consistent coverage, predictable costs, and flexible access against the price tag and what’s not covered.

If you’re considering Medigap or reviewing your existing plan, now’s the time to get a full understanding of how it fits into your healthcare goals. Talk to a licensed agent listed on this website for professional guidance and tailored support.