Medicare Supplement (Medigap).

A Medicare Supplement plan, also called Medigap, pays the share of your medical bills that Original Medicare leaves on you. Original Medicare covers about 80% of approved Part B costs and leaves you the other 20% with no cap, plus deductibles like the $1,736 Part A hospital deductible (2026). A Medigap plan steps in and pays most or all of that gap, so you can walk out of a hospital or specialist visit owing little or nothing. These plans are sold by private insurers but standardized by the federal government, which means a Plan G is a Plan G no matter whose name is on it. Apex Health Advisors sells Medigap and can compare the same plan across a wide bench of carriers on price and rate history. Call us at 623-292-4360.

The gap Medigap actually fills

This is the part most people never hear until they get a bill. Original Medicare pays 80% of your approved Part B costs and you owe the other 20%, and there is no annual out-of-pocket maximum on that 20%. Picture a $200,000 surgery. Medicare pays its share, and you are still looking at roughly $40,000 with nothing to stop the bleeding. On the hospital side, the Part A deductible is $1,736 per benefit period in 2026, and it resets per benefit period rather than per calendar year, so two separate hospital stays in one year can mean paying it twice.

A Medigap plan absorbs those gaps. Depending on the plan letter you choose, it pays the Part A deductible, the hospital coinsurance, the daily skilled nursing charges, and most or all of that uncapped 20%. That is the whole job: it turns an open-ended risk into a predictable monthly premium.

Same plan, different price: why the letter is what matters

Medigap plans are standardized by letter under federal law. A Plan G from one well-known carrier covers the exact same benefits as a Plan G from another. The insurer cannot add or subtract benefits. What changes from company to company is the premium and how aggressively that company raises rates over time.

This is the single most useful thing to understand before you buy, because it means you do not have to compare benefit charts across ten companies. You pick the plan letter that fits how you use care, then you shop that one letter on price and on the carrier's rate history. A company with the lowest sticker price today but a habit of steep annual increases can cost you more over ten years than one that starts a few dollars higher and holds steady.

Plan G or Plan N: the two that matter for new enrollees

Plan F is closed to anyone who turned 65 after January 1, 2020, so for new enrollees the real choice is between Plan G and Plan N. Plan G is the most comprehensive plan still available. After you pay the Part B deductible ($283 in 2026), Plan G leaves you with essentially nothing at the doctor or hospital. No copays, and it covers Part B excess charges. That clean bill at the door is why frequent users and people who just want zero surprises tend to land here.

Plan N runs a lower premium and asks you to share a little. Office visits carry a copay of up to $20, the ER up to $50 if you are not admitted, and Plan N does not cover Part B excess charges. For someone who sees the doctor a couple of times a year and is comfortable with a small copay, Plan N often wins on total cost. One Arizona note: this state does not prohibit Part B excess charges. Very few providers bill them, but on Plan N a provider who does not accept assignment could add up to 15% to the bill, where Plan G would have covered it. You can sidestep this by asking up front whether a provider accepts Medicare assignment.

Any doctor that takes Medicare, no network games

There are no networks with Medigap and no referrals. If a doctor or hospital accepts Original Medicare, they accept your Medigap plan. You do not have to check a directory or get a primary-care physician to sign off before you see a specialist.

The claim runs itself. The provider bills Medicare, Medicare pays its share, your Medigap carrier pays the rest, and you owe nothing beyond any copay your plan has. This is the freedom people are usually trying to protect when they choose a supplement over Medicare Advantage.

You still need a drug plan, and the timing trap that bites people

Medigap does not cover prescriptions. Plans sold since 2006 dropped drug coverage entirely, so you pair your supplement with a standalone Part D plan. You choose each piece separately, and you can change the Part D plan every fall during Annual Enrollment if your medications change. In 2026 Part D carries a $2,100 annual out-of-pocket cap and a $35 monthly insulin cap.

Do not skip Part D thinking you will add it later. The late enrollment penalty is 1% of the national base premium for every full month you go without creditable coverage, and it sticks to your premium for as long as you have Part D. We help you line up both pieces at the same time so there is no gap and no penalty.

When to enroll, underwriting, and the California birthday rule

Your Medigap open enrollment is a one-time, six-month window that starts the month you are both 65 and enrolled in Part B. Inside it, you can buy any plan from any carrier with no health questions. This window does not come back. The most common and most expensive mistake we see is a healthy person waiting past it, assuming they can sign up whenever, then learning that outside the window most states let carriers underwrite and deny based on health history. People who wait until a diagnosis often find the door has closed.

California works differently in one helpful way. Under the birthday rule, each year you get a 60-day window starting on your birthday to switch to an equal or lesser Medigap plan without answering a single health question. If you live in California, that is an annual chance to shop for a better rate, and missing it leaves money on the table. There are also federal guaranteed-issue rights with a 63-day window for qualifying events like a carrier leaving your area.

What an independent agency does that a captive agent can't

Carriers build the commission into the premium whether you use us or buy direct, so our help costs you nothing and your premium is the same either way. The difference is reach. A captive agent represents one company and quotes one company's rates. We contract with a wide bench of Medigap carriers, so Brent can pull the same Plan G benefit from many companies in minutes and show you how the premiums and rate histories stack up.

That is the entire value: identical coverage, and our job is to compare premiums and find the most stable carrier, then handle the paperwork and the Part D pairing. Call 623-292-4360 and we will run your quotes while you are on the phone.