Medigap can make Original Medicare more predictable.
Medicare Supplement Insurance—better known as Medigap—is private coverage designed to help pay some of the deductibles, copayments and coinsurance left by Original Medicare.
Understand How Medigap Works ↓Supplementing Original Medicare.
What exactly does Medicare Supplement insurance do?
Original Medicare pays much of the cost of covered medical care, but beneficiaries remain responsible for certain deductibles, coinsurance and copayments.
A Medicare Supplement policy can help pay some of those remaining costs.
Medigap policies are sold by private insurance companies, but the coverage is designed to work alongside Original Medicare.
Generally, you must have both Medicare Part A and Medicare Part B to purchase a Medigap policy.
When you receive a Medicare-covered service, Medicare generally pays its share first. Your Medigap policy then pays according to the benefits included in your specific Medigap plan.
Medigap policies generally do not include prescription drug coverage, so beneficiaries who want outpatient prescription coverage commonly pair Original Medicare and Medigap with a separate Medicare Part D plan.
The Original Medicare + Medigap pathway
Think of Medigap as one component of a broader Original Medicare coverage strategy.
Original Medicare
Medicare Part A and Part B provide your primary hospital and medical coverage.
Medigap
Private supplemental insurance helps cover certain Original Medicare out-of-pocket costs.
Part D
A separate prescription drug plan may provide outpatient medication coverage.
Your federal Medigap Open Enrollment Period lasts six months.
For someone newly eligible for Medicare at 65, this period can be one of the most important insurance windows to understand.
months beginning the first month you are age 65 or older and enrolled in Medicare Part B.
Why this six-month period matters
During your federal Medigap Open Enrollment Period, you generally have strong protections when purchasing a Medigap policy.
An insurance company generally can't use medical underwriting to deny you a Medigap policy it sells or charge you more because of health problems during this window.
After this one-time period ends, federal law generally does not guarantee that you'll be able to purchase or switch Medigap coverage, unless another guaranteed-issue right or state protection applies.
A Plan G is a Plan G—but premiums can still be different.
Medigap policies are standardized by letter. That makes comparing them different from comparing Medicare Advantage plans.
Benefits are standardized
The standardized basic benefits of a particular lettered Medigap plan are the same regardless of which company sells that plan.
Premiums are not standardized
Different insurance companies can charge different premiums for the same standardized Medigap plan.
Pricing over time matters
When comparing insurers, consider not only today's premium but also how the policy is priced and how rates may change over time.
Plan G vs. Plan N
Several standardized Medigap plans exist. Plan G and Plan N are two options consumers may encounter when researching supplemental coverage.
More comprehensive cost sharing
Plan G covers many of the cost-sharing gaps left by Original Medicare after the beneficiary pays the Medicare Part B deductible.
- Part A hospital coinsurance coverage
- Part A deductible coverage
- Skilled nursing facility coinsurance coverage
- Part B coinsurance coverage
- Part B excess charge coverage
- Limited foreign travel emergency benefit
Potentially lower premium with additional cost sharing
Plan N covers many of the same Original Medicare gaps, but beneficiaries may have certain office-visit and emergency-room copayments.
- Part A hospital coinsurance coverage
- Part A deductible coverage
- Skilled nursing facility coinsurance coverage
- Part B coinsurance with specified copayment exceptions
- Limited foreign travel emergency benefit
- Does not cover Medicare Part B excess charges
Plan letters describe standardized benefit packages—not insurance companies. Premiums for the same lettered plan may vary by insurer.
Nevada's Medigap “birthday rule”
Nevada provides an additional annual opportunity for certain people who already have Medicare Supplement coverage to change policies around their birthday without medical underwriting.
Already have Medigap? Your birthday may create a switching opportunity.
Under Nevada law, an existing Medicare Supplement policyholder receives an annual open-enrollment period beginning on the first day of the policyholder's birthday month and continuing for at least 60 days.
During this window, the beneficiary may have the ability to replace the existing Medigap policy with another policy offering the same or lesser benefits without being subject to medical underwriting.
This Nevada protection is different from the federal six-month Medigap Open Enrollment Period that applies when someone first becomes eligible.
If you already have Medigap, it can be worthwhile to review your premium and available alternatives around your birthday each year.
Medigap doesn't create a separate provider network.
Because Medigap supplements Original Medicare, your underlying provider access remains based on Original Medicare.
That means beneficiaries generally can use Medicare-participating providers nationwide that agree to treat them rather than selecting providers from a particular Medigap insurer's HMO or PPO network.
For someone who spends significant time outside Nevada, visits family in other states or simply values broader geographic provider access, the Original Medicare + Medigap structure can be appealing.
Certain standardized Medigap plans also include limited benefits for qualifying emergency medical care during foreign travel.
Medigap doesn't cover everything.
Medigap is designed primarily to supplement the cost sharing associated with Original Medicare. It is not a comprehensive standalone health plan.
Medigap policies generally do not cover:
- Routine dental care
- Routine vision services
- Hearing aids
- Long-term custodial care
- Private-duty nursing
- Outpatient prescription drugs
Prescription coverage is generally obtained separately through Medicare Part D when using Original Medicare and Medigap.
Don't compare premium alone.
Because standardized plans can offer the same basic benefits across companies, insurer pricing and long-term considerations become especially important.
Current premium
Compare today's monthly premium among companies offering the same standardized plan.
Pricing method
Understand how the insurer prices the policy and how age may affect future premiums.
Rate history
Current price is only one consideration. Rate increases can affect the long-term cost of coverage.
Switching flexibility
Understand both federal guaranteed-issue protections and Nevada's state-specific switching opportunities.
Six questions to ask yourself.
Do I want Original Medicare?
Medigap is designed to work with Original Medicare, not Medicare Advantage.
How important is broad provider access?
Consider whether nationwide Medicare provider access is important to you.
Do I travel frequently?
Travel patterns may make the Original Medicare structure more or less appealing for your situation.
How do I prefer to budget?
Some people prefer a higher predictable monthly premium in exchange for less medical cost sharing when they receive care.
Am I in my enrollment window?
Your ability to buy coverage without medical underwriting can depend heavily on timing and applicable guaranteed-issue protections.
Do I already have Medigap?
Existing Nevada Medigap policyholders should understand the state's annual birthday-based switching opportunity.
Have questions about Medigap in Nevada?
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Nevada Medigap FAQs
What is Medigap?
Medigap, or Medicare Supplement Insurance, is private insurance that helps pay certain out-of-pocket costs associated with Original Medicare, such as deductibles, coinsurance and copayments.
Can I have Medigap with Medicare Advantage?
No. Medigap is designed to supplement Original Medicare. It does not supplement Medicare Advantage plan deductibles, copayments or coinsurance.
When is my Medigap Open Enrollment Period?
Under federal law, your one-time six-month Medigap Open Enrollment Period begins the first month you are 65 or older and enrolled in Medicare Part B. During this period you have important protections when purchasing a Medigap policy.
What is Nevada's Medigap birthday rule?
Nevada provides certain existing Medicare Supplement policyholders an annual open-enrollment opportunity beginning on the first day of their birthday month and lasting at least 60 days. Eligible consumers may be able to switch to another policy with the same or lesser benefits without medical underwriting.
What's the difference between Plan G and Plan N?
Both are standardized Medigap plans. Plan G covers Medicare Part B coinsurance after the Part B deductible and also covers Part B excess charges. Plan N includes specified copayments for certain office and emergency-room visits and does not cover Part B excess charges.
Are all Plan G policies the same?
The standardized basic medical benefits of Plan G are the same regardless of the insurer selling it. Premiums and certain company-specific factors, however, can differ.
Does Medigap include prescription coverage?
Modern Medigap policies generally do not include outpatient prescription drug coverage. Beneficiaries using Original Medicare commonly obtain drug coverage through a separate Medicare Part D plan.
Can I use Medigap when I travel?
Your underlying medical coverage remains Original Medicare, which generally allows broad access to Medicare-participating providers throughout the United States. Certain standardized Medigap plans also provide limited coverage for qualifying emergency medical care outside the United States.
Compare your Medicare coverage pathways.
Important: NevadaHealthPlans.com provides general educational information and is not currently acting as a licensed insurance agency. This website is not connected with or endorsed by the U.S. government or the federal Medicare program. Information on this page is not individualized insurance, legal, tax, medical or financial advice. Medicare Supplement availability, premiums, underwriting requirements and consumer protections can vary and can change. Verify current information with Medicare.gov, the Nevada Division of Insurance, the applicable insurer and an appropriately licensed insurance professional before making an enrollment decision.