Yes, for most people enrolling in Medicare for the first time, Medigap is worth enrolling in when you first sign up for Medicare Part B.
Original Medicare covers roughly 80% of your medical costs, leaving the other 20% as your responsibility. Medigap covers most or all of that 20%, plus deductibles and other cost-sharing. The best time to start Medigap (for the majority of Americans) is the same time to enroll in Medicare Part B. Senior65.com can help make sure your Medigap and Medicare Part B start on the same day.
Why Your First Six Months on Medicare Are So Important
When you turn 65 and enroll in Medicare Part B, a six-month clock starts. This is your initial Medigap Open Enrollment Period, and it’s the one time in your Medicare life when you have guaranteed issue rights: any insurance company offering Medigap must accept you, regardless of your health history. No medical questions. No underwriting. No waiting periods for pre-existing conditions.
Once those six months close, those protections are largely gone in most states. Applying for Medigap after your open enrollment window typically means going through medical underwriting — answering health questions, and potentially being declined or charged more based on your medical history.
Timing your Medigap to start when your Medicare Part B starts ensures you have no gap in coverage although technically you could have your Medigap start 6 months after your Medicare Part B and still be in your initial Medigap Open Enrollment period.
What Does Medigap Actually Cover?
Original Medicare has several cost-sharing requirements it passes on to you. A Medigap plan — particularly Plan G or Plan N, the two most popular choices for new enrollees — handles most or all of them:
- The 20% coinsurance Medicare doesn’t pay after your Part B deductible
- The Part A hospital deductible ($1,736 per benefit period)
- Hospital coinsurance for extended stays
- Skilled nursing facility coinsurance (days 21–100)
- Foreign travel emergency coverage (up to $50,000)
Plan G covers all of the above. Plan N covers the same major items with two small trade-offs: you pay up to $20 for some office visits and up to $50 for emergency room visits that don’t result in inpatient admission. In exchange, Plan N premiums run noticeably lower than Plan G.
One thing that surprises many new enrollees: any doctor or facility that accepts Medicare must also accept your Medigap plan. You don’t pick a separate network. You have access to every Medicare-accepting provider in the country, and you’ll never need a referral to see a specialist.
How Much Does Medigap Cost at 65?
Pricing depends on your age, zip code, the insurance company, and which plan you choose. At 65, you’re typically at or near the lowest premium you’ll see for Medigap — rates generally increase as you age.
Plan G premiums at 65 commonly run between $100 and $200 per month depending on your location. Plan N runs lower — often 20–30% less than Plan G in the same area. High-Deductible Plan G can run under $50 per month; the trade-off is that you’d pay the first $2,960 in covered costs each year before the plan begins covering anything.
The fastest way to see actual pricing for your zip code is to get a Medigap quote here — it takes about 30 seconds and doesn’t require a phone call.
Is There Anyone Who Should Wait on Medigap?
A few situations where waiting makes sense:
You have employer coverage. If you’re still covered by your employer’s health plan or a spouse’s plan, you may not need Medigap yet. When that coverage eventually ends, you’ll typically qualify for a Special Enrollment Period — another guaranteed-issue window — to pick up Medigap without underwriting.
The premium isn’t workable right now. Medigap’s value is real, but not if it puts you in a financial bind. If that’s your situation, a Medicare Advantage plan may be a better fit. Just know that switching from Medicare Advantage back to Medigap later often requires medical underwriting.
You have VA benefits that cover your gaps. Veterans with comprehensive VA coverage may find Original Medicare alone is sufficient for now. Worth confirming with your VA benefits coordinator before making a decision.
If none of those situations apply to you, waiting generally costs you. Older age means higher premiums, and any health conditions that develop in the meantime can make it harder — or impossible — to qualify later.
What Happens If You Miss the Open Enrollment Window?
In most states, applying for Medigap outside your open enrollment period means going through medical underwriting. Insurance companies can ask about your health history and can decline your application based on pre-existing conditions.
There are exceptions. Some states like New York and Connecticut have year round Medigap enrollment. See if your state has special rules here. There are also trial rights if you’re leaving a Medicare Advantage plan within your first year, and special enrollment triggers for certain life events.
But none of those options are as broad or reliable as the six-month window you get when you first enroll in Part B. If you’re approaching 65, the simplest move is to get Medigap when your Part B starts.
Frequently Asked Questions
Q: Can I be denied Medigap when I first sign up for Medicare?
A: No. During your six-month Medigap Open Enrollment Period — which starts when you’re 65 or older and enrolled in Medicare Part B — insurance companies must accept you regardless of your health history. You cannot be denied or charged more for pre-existing conditions.
Q: What is the Medigap Open Enrollment Period?
A: It’s a one-time, six-month window that begins the month your Medicare Part B coverage starts. During this period, you have guaranteed issue rights for any Medigap plan sold in your state. Once it closes, those rights are gone in most states.
Q: Is Medigap worth it if I’m healthy?
A: For most people, yes — especially because signing up while you’re healthy is when you’ll qualify most easily and pay the lowest premiums. Waiting until you have health issues typically means higher costs or an outright denial in states without special switching rules.
Q: What’s the difference between Medigap and Medicare Advantage?
A: Medigap works alongside Original Medicare to cover your cost-sharing. Medicare Advantage replaces Original Medicare with a private plan that typically includes more benefits but uses a network. See our full comparison here. Senior65 doesn’t sell Medicare Advantage — we explain how it works so you can make an informed choice.
Ready to Compare Plans?
If you’re enrolling in Medicare for the first time, your open enrollment window is the most protected and affordable entry point into Medigap. Our team at Senior65.com can help you compare plans from top national carriers and enroll at no cost to you. New to Medicare? Start here.
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Prefer to talk through your options? Call 800-930-7956 to speak with a licensed agent on our team. Our help is free.