What to Ask When Choosing a Medicare Supplement Insurance Plan
What to Ask When Choosing a Medicare Supplement Insurance Plan. Preparing Questions for Medicare Supplement Coverage
Picking a Medicare Supplement Insurance plan can feel like a big test. There are letters, prices, and rules, and it is easy to get lost. I have found that the best way to stay calm is to ask good questions before I sign anything.
A Medicare Supplement Insurance plan is also called Medigap. It helps pay the bills that Original Medicare leaves behind. The right plan can save me a lot of money. The wrong one can cost me for years.
In this guide, I share the 18 questions I would ask before choosing a plan. I explain each one in plain words. I also added a checklist near the end that you can take along when you shop.
The short list: what to ask about a Medicare Supplement Insurance plan
If you only have a minute, here are the big ones:
- Am I in my Medigap Open Enrollment Period?
- Which plan letter fits my health and my budget?
- What will I still pay out of my own pocket?
- How does this company set its prices, and how will those prices go up?
- Can I switch plans later if I need to?
- Is the company steady and easy to work with?
Keep reading, and I will walk through each one.
What is a Medicare Supplement Insurance plan?
A Medicare Supplement Insurance plan is extra insurance I can buy from a private company. It works with Original Medicare: Part A (hospital care) and Part B (doctor visits).
Original Medicare pays a big share of my bills, but not all of them. I still owe things like:
- Deductibles. This is what I pay first, before Medicare starts to pay.
- Coinsurance. This is my share of the bill, often 20% for doctor care.
- Copays. These are set dollar amounts for some kinds of care.
Those leftover costs are the “gaps.” Medigap helps fill them. That is where the nickname comes from.
Here are a few facts I think everyone should know first:
- Plans have letter names. In most states, there are 10 plan types: A, B, C, D, F, G, K, L, M, and N.
- Each letter is the same at every company. A Plan G from one company covers the same things as a Plan G from another. Only the price and the service change.
- Three states do it differently. Massachusetts, Minnesota, and Wisconsin have their own plan designs.
- One plan covers one person. My spouse would need a separate policy.
- I must have Part A and Part B. I still pay my Part B premium.
- Medigap is not Medicare Advantage. They are two different paths. I cannot use both at once.
Now, on to the questions.
Questions to ask about timing
When I buy matters almost as much as what I buy. So I start here.
1. Am I in my Medigap Open Enrollment Period?
This is the most important question on my list.
My Medigap Open Enrollment Period lasts six months. It starts the first month I have Part B and am 65 or older. During this time:
- A company cannot turn me down for any plan it sells.
- A company cannot charge me more because of my health.
- My coverage can start right away in most cases.
This window comes one time. It does not come back each fall as the Medicare Open Enrollment Period does. If I miss it, I may pay more, have fewer choices, or get turned down. (Medicare.gov)
2. If I missed that window, will I have to answer health questions?
Outside of my six-month window, a company can use medical underwriting. That is a fancy term for checking my health history. The company may ask about my past illnesses, medications, and hospital stays. Then it decides if it will cover me and what to charge.
So I ask each company:
- Will I need to answer health questions?
- Which health problems would get me turned down?
- Is there a waiting period before the plan pays for a health problem I already have?
That last one matters. In some cases, a plan can make me wait up to six months before it covers a health problem I had before I signed up.
3. Do I have a special right to buy a plan?
Sometimes the law protects me even after my window ends. These are called guaranteed issue rights. They mean a company must sell me a plan. I may have this right if:
- My Medicare Advantage plan leaves my area or shuts down.
- I move out of my plan’s service area.
- My job or retiree coverage ends.
- I tried Medicare Advantage for the first time and want to go back within 12 months.
Some states add more rights. A few, like New York and Connecticut, let people buy a plan any time of year. Others have a “birthday rule.” It gives me a short window around my birthday each year to switch plans with no health questions. About 16 states had some form of this rule in 2026, and the details differ in each one. (state list)
If I am under 65: Federal law does not make companies sell Medigap to people under 65 who have Medicare because of a disability. Some states do require it. I would call my State Insurance Department to check.
Questions to ask about coverage
4. Which plan letter fits me best?
Since each letter is the same at every company, I pick my letter first. Then I shop for price. Here is a quick look at the plans people ask about most. The dollar amounts are for 2026.
| Plan | What it does | What I still pay |
|---|---|---|
| Plan G | Covers almost all the gaps | The Part B deductible ($283) |
| High-deductible Plan G | Same as Plan G, with a lower monthly price | The first $2,950 of my costs each year |
| Plan N | Covers most gaps for a lower price than Plan G | The Part B deductible, up to $20 for some office visits, up to $50 for some ER visits, and any excess charges |
| Plan K | Pays 50% of most gaps | The other 50%, until I reach $8,000 in a year |
| Plan L | Pays 75% of most gaps | The other 25%, until I reach $4,000 in a year |
Source: Medicare.gov, Compare Medigap Plan Benefits
What about Plan F and Plan C? I can only buy these if I could get Medicare before January 1, 2020. If I became eligible on or after that date, they are off the table.
5. What will I still pay out of my own pocket?
No Medigap plan sold to new Medicare members pays for everything. So I ask, “What is left for me to pay?” My list looks like this:
- The monthly premium for the Medigap plan
- My Part B premium
- The Part B deductible
- Any copays, like with Plan N
- My share of costs with Plan K or Plan L
I add these up for a full year. That gives me a real number to compare.
6. Does this plan cover Part B excess charges?
Some doctors can bill more than Medicare’s set price. The extra amount is called an excess charge. It can be up to 15% more.
Only Plan F and Plan G cover it. Some states do not allow excess charges at all. I ask my doctors if they “accept assignment.” That means they take Medicare’s price as full payment. If they all do, this is less of a worry for me.
7. What does this plan not cover?
This one surprises a lot of people. Medigap plans do not cover:
- Prescription drugs (I need a separate Part D plan for those)
- Dental care
- Eye exams and glasses
- Hearing aids
- Long-term care, like a nursing home stay
- Private nurses
If I need these, I plan for them separately.
8. Will this plan work with my doctors and when I travel?
One of my favorite things about Medigap is the freedom. In most cases, I can see any doctor in the country who takes Medicare. I do not need a referral.
Still, I ask two things:
- Is this a Medicare SELECT plan? These cost less, but I may have to use certain hospitals and doctors.
- Does it cover emergencies in other countries? Plans C, D, F, G, M, and N pay 80% of emergency care abroad, up to plan limits.
Questions to ask about cost
9. What is the monthly premium for this plan?
The premium is what I pay each month to keep the plan. Prices for the same letter can vary widely from one company to the next. Since the coverage is the same, a higher price does not buy me better benefits.
So I get quotes from at least three companies for the same letter. Medicare.gov has a free tool that shows plans and price ranges in my area.
10. How does this company set its price?
This question can save me money for many years. Companies use one of three ways to set prices:
- Community-rated. Everyone pays the same price, no matter how old they are.
- Issue-age-rated. My price is based on my age when I buy. It does not go up just because I get older.
- Attained-age-rated. My price is based on my age right now. It starts low and goes up as I get older.
A plan that looks cheap at 65 may cost a lot more at 80. I ask how the company uses the money before I compare prices. With all three, prices can still go up because of inflation and rising health costs.
11. How much has the price gone up in the past?
A low price today is nice. A steady price is better. I ask each company:
- How much did this plan’s price go up in each of the last three to five years?
- How often do you raise rates?
- When would my first increase happen?
If a company will not answer, I take that as a sign. My State Insurance Department may also have rate records I can look at.
12. Are there discounts I can get?
Many companies offer ways to pay less. I always ask about:
- A household discount if my spouse or someone I live with also has a plan
- A discount for people who do not smoke
- A discount for paying once a year instead of each month
- A discount for automatic bank payments
I also ask if a discount ever goes away. Some “new customer” discounts shrink each year. That can make my price jump even with no rate increase.
Should I think about a high-deductible plan? It depends on my savings. In 2026, high-deductible Plan G has me pay the first $2,950 of my costs. In return, my monthly price is much lower. This can work well if I am healthy and could cover that bill in a bad year. If a surprise bill of that size would hurt, I would lean toward a regular plan.
Questions to ask about the insurance company
Since the benefits are the same, the company itself matters a lot.
13. Is this company strong and steady?
I want a company that will still be around in 20 years. I look for:
- Financial ratings. Groups like AM Best grade how strong an insurance company is.
- Years in business. I ask how long the company has sold Medigap in my state.
- Complaints. My State Insurance Department tracks complaints against companies.
14. How are claims paid?
With most Medigap plans, the doctor bills Medicare first. Then Medicare sends the rest to my Medigap company. I should not have to fill out forms. I ask the company to confirm this happens automatically.
I also call the customer service line before I buy. If I sit on hold for 40 minutes as a shopper, I can guess what it will be like as a member.
15. Is this agent showing me more than one company?
Some agents work for only one company. Others, called brokers, can show me many. Neither is bad, but I want to know which one I am talking to. I ask:
- How many companies do you work with?
- Do you get paid more for some plans than others?
- Will you help me after I sign up, like when my rate goes up?
A good agent answers these with no fuss. Agents are usually paid by the insurance company, not by me. And no one should rush me to sign.
Questions to ask about the future
16. Can I switch plans later?
Yes, I can apply to switch at any time of year. But here is the catch. In most states, the new company can ask health questions and turn me down. So the plan I pick now may be the plan I keep for a long time.
That is why I ask myself, “Would I be happy with this plan at 75 or 85?” I try to choose for my future health, not just my health today.
17. What happens if I move?
Medigap goes where I go inside the United States. If I move to another state, I can usually keep my plan. My price may change based on my new address. If I have a Medicare SELECT plan, I may need to switch, since those use local networks.
18. Can the company ever drop me?
All standard Medigap plans sold today are guaranteed renewable. That means the company cannot cancel my plan because I get sick. As long as I pay my premium and am honest on my application, I keep my coverage.
I also asked about the “free look” period. I get 30 days to try a new Medigap plan. If I do not like it, I can go back to my old one. I have to pay for both plans during that month, so I don’t cancel my old one too soon.
What if I want to try Medicare Advantage? I think hard about this one. If I drop Medigap for Medicare Advantage, I may not be able to get my Medigap plan back later. I do have a one-time “trial right.” If it is my first time in Medicare Advantage, I can go back to my old Medigap plan within 12 months, as long as the company still sells it.
Mistakes I would avoid
- Waiting too long. Missing my six-month window can cost me the most.
- Paying more for the same letter. A pricey Plan G covers the same things as a cheaper Plan G.
- Looking only at this year’s price. How a price grows matters as much as where it starts.
- Forgetting about drugs. Medigap does not cover prescriptions, so I need Part D too.
- Buying under pressure. If someone pushes me to sign today, I walk away.
- Dropping my old plan too early. I wait until the new one is approved and in place.
My Medigap checklist
Here is the list I take with me. I ask every company the same things so I can compare them fairly.
- Am I in my six-month Medigap Open Enrollment Period?
- Will I need to answer health questions?
- Is there a waiting period for health problems I already have?
- Which plan letters do you sell in my state?
- What is the monthly price for my letter?
- Is the price community-rated, issue-age-rated, or attained-age-rated?
- How much did the price go up in each of the last five years?
- What discounts can I get, and do they ever end?
- Is this a Medicare SELECT plan with a network?
- How long have you sold Medigap in my state?
- Will my claims be paid without forms?
- Who do I call if I have a problem?
Frequently asked questions
What is the best Medicare Supplement Insurance plan?
There is no one best plan for everyone. Plan G covers the most for people new to Medicare. Plan N often costs less each month if I am okay with small copays. The best plan for me fits my health, my budget, and my comfort with surprise bills.
Is Medigap the same as Medicare Advantage?
No. Medigap works with Original Medicare and helps pay my share of the bills. Medicare Advantage replaces Original Medicare with a private plan, often with a network of doctors. I can have one or the other, not both.
When is the best time to buy a Medigap plan?
The best time is during my six-month Medigap Open Enrollment Period. It starts the month I am 65 or older and have Part B. During that time, I cannot be turned down or charged more for my health.
Do Medigap plans cover prescription drugs?
No. Plans sold today do not cover prescription drugs. I would buy a separate Medicare Part D plan for my medicines.
Can I be turned down for a Medigap plan?
Yes, in many cases. Outside of my open enrollment window, a company can turn me down for health reasons unless I have a guaranteed issue right. Some states have extra rules that protect me.
Do my spouse and I each need our own plan?
Yes. Each Medigap policy covers only one person. Many companies give a household discount when two people sign up.
Does the price of a Medigap plan go up each year?
Most of the time, yes. Prices can rise with age, inflation, and health care costs. That is why I ask how the plan is priced and how much it has gone up before.
Do the dollar amounts in this guide change?
Yes. The numbers here are for 2026. Medicare sets new amounts each year, so I check Medicare.gov for the latest ones.
The bottom line
Choosing a Medicare Supplement Insurance plan gets much easier when I know what to ask. I start with timing, because my six-month window is my best chance to buy. Next, I pick the plan letter that fits my health and budget. Then I compare prices for that same letter and ask how those prices will grow. Last, I check out the company and think about my future.
I do not have to do this alone. My State Health Insurance Assistance Program, called SHIP, gives free help with no sales pitch. I can also call 1-800-MEDICARE or use the plan finder on Medicare.gov.
Take your time, ask every question on the list, and write down the answers. A little homework now can bring years of peace of mind.
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