Understanding Medicare vs Medigap can feel confusing at first—but once you see how they work together (and differ), the decision becomes much clearer. This guide breaks down coverage, costs, and compatibility so you can choose with confidence.
What is Medicare? A Quick Overview of Parts A and B
Think of Original Medicare as the foundation of your health coverage. Part A helps with hospital stays, skilled nursing, hospice, and some home health. Part B covers doctor visits, outpatient care, tests, durable medical equipment, preventive screenings, and mental health. You can see any doctor who accepts Medicare nationwide—no referrals, no networks.
Here’s the key: for most Medicare-approved Part B services, Medicare pays about 80% of the allowed amount—you’re responsible for the other ~20%, and there’s no annual out-of-pocket maximum under Original Medicare. That uncovered portion (plus deductibles/coinsurance) is exactly where Medigap steps in to steady your bills. (Source: Medicare.gov)
👉 Turning 65 soon? Start smart with our step-by-step Medicare playbook. Open the Complete Medicare Guide for Turning 65.
What is Medigap? How It Complements Original Medicare
Medigap is the safety net for the ~20% that Original Medicare leaves on you—those coinsurance amounts (and some deductibles) that turn into surprise bills. It’s purchased from private insurance companies, and plans come by letters (G, N, High-Deductible G, etc.). By law, the same letter = the same benefits no matter the company. What changes is the price, discounts, and little perks.
Billing is simple: Medicare pays first, and then your Medigap plan typically pays its share automatically. Fewer papers, fewer surprises—more peace of mind.
👉 Want to explore Medigap options? Get a Medigap Quote here and compare plans from different insurance companies to find the one that best fits your needs and budget.
☎️ Two minutes of clarity: call 800-930-7956 and we’ll translate the alphabet soup into plain English.
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Medicare vs Medigap (Medicare Supplement): Key Differences in Coverage and Cost
Now that we’ve defined both, let’s break down the key differences between Medicare vs Medigap—because understanding what each one covers (and doesn’t) is essential for making the right choice:
| Medicare | Medigap (Medicare Supplement) | |
|---|---|---|
| What it is | Federal health insurance (Parts A & B) | Optional private policy that helps pay Medicare’s leftover costs that are passed on to patient |
| Coverage | Approved services under Parts A & B | Helps pay Medicare cost-sharing (deductibles/coinsurance/copays) depending on plan letter |
| Doctors & hospitals | Any provider that accepts Medicare | If a provider accepts Medicare, they accept your Medigap (any company) |
| Monthly premium | Part B premium (and Part A for some) | Additional premium that varies by plan letter, ZIP, age, company, and discounts |
| Out-of-pocket protection | No annual out-of-pocket maximum | Reduces and steadies costs; extent depends on the plan letter (e.g., G, N, HD-G) |
| Prescription drugs at pharmacy | Not included (use a separate Part D plan) | Not included (still use Part D) |
| Travel note | Very limited coverage outside the U.S. | Some letters include $50K in foreign travel emergency benefits |
💡 In short: Medicare is your primary coverage, and Medigap is your backup plan to reduce out-of-pocket costs.
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How Do Medicare and Medigap Work Together?
The coordination of benefits is the most beautiful part of the Medicare vs Medigap relationship. It’s incredibly straightforward:
- You receive a service. You visit the doctor, go to the hospital, or get a lab test.
- Medicare pays first. Medicare processes the bill and pays its share (usually 80% of the approved costs).
- Medigap pays second. Your Medigap company receives the remaining bill and automatically pays the deductible, coinsurance, or copay you owe, depending on your plan letter.
- The Result: Your out-of-pocket cost is minimal, or, in many cases (like with Plan G) it would be the Part B deductible of $257.
👉 Want to compare Medigap plans side by side? Use our MedSup Quote Tool to check your estimated monthly premium instantly.
Do I Need Medigap if I have Medicare?
You don’t have to buy Medigap if you have Medicare—but if you’re staying on Original Medicare (Parts A & B), it’s the difference between doing mental math in the waiting room and just focusing on feeling better. Without Medigap, you’re on the hook for 20% of Part B costs with no annual cap. That “just 20%” can snowball fast during a serious illness, turning a tough moment into a tough bill.
Medigap smooths out the surprises so your costs feel steady and predictable—no guesswork before appointments, no calculator on your lap. It’s the calm, practical add-on that lets you keep the doctors you want and skip the financial whiplash.
👉 Wondering if Medigap is really worth the cost? You’re not alone. Take a look at this article revealing that 93% of Medigap users are happy with their coverage (and why!). It’s a quick read that could save you money—and stress.
What Does Medigap Cover That Medicare Doesn’t?
When comparing Medicare vs Medigap, one of the biggest differences is what each actually covers. Original Medicare (Parts A and B) pays for many medical services—but it leaves behind some significant out-of-pocket costs. That’s where Medigap steps in.
Here’s what Medigap can cover that Medicare doesn’t:
- Part A and B coinsurance and copayments.
- The Part A deductible (hospitalization). Most Medigap plans cover this entirely.
- Blood (the first three pints).
- Skilled nursing facility coinsurance.
- Up to an extra year of hospital days after Medicare benefits are used up.
- Foreign Travel Emergencies: Many top plans (like G and N) cover 80% of emergency medical costs when you travel outside the U.S. (subject to limits).
👉 Want to see which Medigap plans cover the benefits you care about most? Use our Plan Finder Wizard for a personalized recommendation.
📞 Prefer to talk it through? Call us today at 800-930-7956 or leave us a message—we’ll help you compare plans and find the right fit.
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Next Steps with Medicare and Medigap
Now that you know the difference between Medicare and Medigap, it’s time to consider enrolling in both. Don’t wait until a health issue arises to realize that the 20% gap could wipe out your savings.
Ready to secure your future?:
- Read our article: Is Medigap Worth It? New report says 93% happy to see why so many seniors choose supplemental coverage
- Use our Medigap Quote Tool to check your estimated cost instantly.
- Ready to talk? Call 800-930-7956 or leave a comment. We’ll help you find the perfect plan to give you true confidence with zero pressure and free.
FAQs — Medicare vs Medigap
Q: Does Medigap replace Medicare?
A: No. Medicare stays primary; Medigap just helps pay the leftover amounts.
Q: Can I keep my doctor with Medigap?
A: Yes. If a provider accepts Medicare, they accept your Medigap—no matter the company.
Q: Is Medigap the same as Medicare Advantage?
A: No. Medigap supplements Original Medicare (no networks). Medicare Advantage is an alternative with networks and different rules. You can’t combine both.
Q: Is Medigap the same as Supplemental Insurance?
A: Yes—Medigap is Medicare Supplement Insurance. It’s just another name for the same thing as MedSup too.
Q: Does Medigap cover my prescriptions?
A: No. Add a Part D plan for drug coverage.