Medigap Coverage by Race, Income, Health Status, and Age
This commentary is a breakdown of Figure 1 detailing each of the results and purposes of Medicap. I favor graphs as it is far easier to understand than reading a few pages. The charts do show issues such as income to afford Medigap and restrictions. I have Plan N which covers most of what I need covered with some copays.
Part A Hospital Costs: Covers 100% of coinsurance and the $1736 deductible (as of 2026), plus up to 365 extra hospital days after Medicare benefits end.
Part B Medical Costs: Covers 100% of coinsurance, except for a $20 copay for office visits and a $50 copay for ER visits.
Better description for Plan N can be had at this site as well as other plans.
Some “Key Facts About Medigap Enrollment and Premiums for Medicare Beneficiaries.” KFF
Characteristics of People with Medigap
A larger share of traditional Medicare beneficiaries with Medigap than traditional Medicare beneficiaries overall are White (94% vs 86%), have incomes of $40,000 or above (54% versus 47%), and report their health as excellent, very good, or good (88% versus 82%) (Figure 1; See Appendix Table 1 for a comparison of Medigap enrollee characteristics to beneficiaries with other types of coverage).
Medigap premiums can be costly making it more difficult for people with lower incomes to afford a Medigap policy. This, along with relatively high supplemental coverage under Medicaid, could be a factor in lower enrollment of Black and Hispanic Medicare beneficiaries in Medigap relative to Medicare Advantage, since Black and Hispanic beneficiaries have lower income and assets compared to White beneficiaries. Black and Hispanic beneficiaries are also more likely to report relatively poor health and have higher prevalence rates of certain chronic conditions that would be classified as pre-existing conditions by Medigap insurers, which could also make it difficult for individuals in these groups to obtain Medigap, particularly outside of guaranteed issue periods when medical underwriting is not allowed.
Health insurance through Medicare provides important financial protections for 67 million Americans. However, people with Medicare can face substantial cost-sharing requirements for Medicare-covered services, and unlike most health insurance policies, Medicare has no limit on out-of-pocket spending. Many Medicare beneficiaries have modest incomes and little savings to draw on to pay for expensive medical care, and medical debt is a concern for more than one in five (22%) older adults. In light of these facts, the Medicare supplement insurance market, also known as Medigap, plays a key role in helping beneficiaries afford medical care by limiting their exposure to catastrophic out-of-pocket medical costs.
During these defined periods, Medigap insurers cannot deny a Medigap policy to any qualifying applicant based on factors such as age, gender, or health status. Further, during these periods, Medigap insurers cannot vary premiums based on an applicant’s pre-existing medical conditions or exclude coverage for a pre-existing medical condition (i.e., medical underwriting).
However, under federal law, Medigap insurers may impose a waiting period of up to six months to cover services related to pre-existing conditions if the applicant did not have at least six months of prior continuous creditable coverage. For qualifying events that trigger guaranteed issue rights, people ages 65 and older in Medicare generally have 63 days to apply for a Medigap policy.
In 2022, 12.5 million, or four in 10 (42%) people in traditional Medicare had a Medigap policy. Compared to all traditional Medicare beneficiaries in 2022, traditional Medicare beneficiaries with a Medigap policy are more likely to be White, have higher incomes, and report better health. Among traditional Medicare beneficiaries, a smaller share of beneficiaries under age 65 with disabilities have a Medigap policy compared to beneficiaries ages 65 and older (7% vs 46%), due in part to a lack of Medigap guaranteed issue protections under federal law for those under age 65.
States can choose to establish Medigap consumer protections that go further than the minimum federal standards. Four states – Connecticut, Massachusetts, Maine, and New York – require Medigap insurers to offer policies either continuously throughout the year or once per year to Medicare beneficiaries age 65 and older without regard to their medical conditions.
Other states have also expanded on the federal minimum standards to allow beneficiaries to purchase Medigap on a guaranteed issue basis after certain qualifying events or for beneficiaries under 65 with disabilities to purchase Medigap during an initial open enrollment period.