Medicare Minute: Medigap Policies and Why You Should Be Reading Your Medicare Statements

Original Medicare Part B covers 80% of most services, leaving 20% and other out-of-pocket costs, like deductibles or inpatient copays. Medigaps help cover these costs.

What are they?

Medigaps are health insurance policies that offer standardized benefits to work with Original Medicare. They don’t work with Medicare Advantage plans. Medigaps are sold by private insurance companies. If you have a Medigap, it pays part or all of the costs after Original Medicare pays first. Medigaps may also cover health care costs that Medicare does not cover at all—for example, care when traveling abroad.

Choosing a Medigap

Insurance companies may offer up to 10 different Medigap policies to choose from: A, B, C, D, F, G, K, L, M, and N. Each lettered policy is standardized. This means that all policies labeled with the same letter have the same benefits. Companies may sell the same Medigap for different prices, even though they have the same coverage. Note: Massachusetts, Minnesota, and Wisconsin have different Medigap plans.

Listed below are things you should consider when choosing a Medigap plan. Make sure to review the Medigap chart on the next page for more information.

• Plan A offers the most basic coverage. It’s often the least expensive. 
• Plans F, C, and G are the most comprehensive Medigaps. They generally cost the most. 
• Plans F and C are only available if you were eligible for Medicare before January 1, 2020. 
• Medigap plans are guaranteed renewable. That means that as long as you pay the premium, you can keep your plan. However, premiums may change yearly. 
• Shop around. Different insurance companies charge different premiums for the exact same policy.

Download a full breakdown of Medigap policy benefits.

Read Your Medicare Statements

It is very important to understand and read your Medicare statements:

• If you have Original Medicare, with or without a Medigap, you should receive Medicare Summary Notices (MSNs).
  • Note: You receive MSNs every four months or you can also see them online at your Medicare.gov account.
•  If you have a Medicare Advantage plan or Part D (prescription drug) plan, you should receive an Explanation of Benefits (EOB).

Your Medicare statements explain what services and items were billed, the Medicare-approved amount for each line item, and the amount that you may owe. Remember that MSNs and EOBs are not bills. 

Reading your MSNs and EOBs is an important strategy for detecting potential Medicare fraud, errors, or abuse.

Keep the following tips in mind: 

• Review your or your loved one’s Medicare statements as soon as they arrive. 
• Confirm that everything listed on your statement is accurate—in other words, that you actually received and requested all listed services or items. 
• Keep notes of your medical appointments and compare them to your statements to ensure that your MSN or EOB is accurate. 
• Contact your health care provider or plan if you have any questions or notice any errors on your MSNs or EOBs. Your health care provider should be able to correct any billing mistakes that they have made. 
• Contact the SMP for a printed My Health Care Tracker (which helps you keep track of your appointments) or to receive assistance on how to read your Medicare statements.

NEW! SMP Medicare Tracker Mobile Application: The app includes a digital My Health Care Tracker, the ability to report fraud, the SMP Fraud Busters game, scam alerts, fraud schemes, and news. To learn more, go to smpresource.org/app and download from the Apple or Google stores.

Who to contact for help:

• Call us (866) 413-5337, your State Health Insurance Assistance Program (SHIP), in Florida its called SHINE, to learn about Medigap enrollment rules and to get help comparing plan options. 
• Go to the Medicare.gov website for online help comparing Medigaps in your area.
• If you decide to purchase a Medigap, call the plan directly to purchase the policy.
• Call us (866) 413-5337, your Senior Medicare Patrol (SMP), if you find any errors on your statements and your provider will not fix them. SMPs help Medicare beneficiaries, their families, and caregivers prevent, detect, and report potential Medicare fraud, errors, and abuse.

The Medicare Rights Center is the author of portions of the content in these materials but is not responsible for any content not authored by the Medicare Rights Center. The included document is supported by the Administration for Community Living (ACL), U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $2,534,081 with 100 percent funding by ACL/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by ACL/HHS, or the U.S. government.