Medicare Basics

Medigap: skip it with a wraparound — consider it without one

Medigap (Medicare Supplement) policies fill Original Medicare's deductibles and coinsurance for a monthly premium. TRICARE for Life and CHAMPVA households almost never need one — those programs already do the job free — which makes Medigap most relevant to the veteran this site meets constantly: VA Healthcare plus Original Medicare, with no wraparound behind it.

What Medigap is

Standardized private policies (lettered A through N) that pay Original Medicare's cost-sharing — the $1,736 Part A deductible, the 20% Part B coinsurance with its unlimited downside. Premiums vary by plan letter, insurer, age, and state; the benefits within a letter are identical everywhere. Plan G (everything but the $283 Part B deductible) and Plan N (small copays in exchange for lower premiums) dominate new sales; budget designs exist too — high-deductible G ($2,950 deductible in 2026) and the capped Plans K and L ($8,000 and $4,000 out-of-pocket limits).

The veteran sorting, in three rows

Your situation	Medigap verdict
TRICARE for Life	Skip — TFL already is one, premium-free, drugs included
CHAMPVA	Skip — the wraparound duplicates it
VA Healthcare + Original Medicare, no wraparound	The real candidate. Without Medigap, every civilian claim carries uncapped 20% coinsurance — read on

The VA-only case, argued both ways

A VA-enrolled veteran who keeps Original Medicare holds two systems with a seam down the middle: the VA covers VA care; Medicare covers civilian care minus its cost-sharing — and nothing stands behind that cost-sharing. One civilian hospitalization is a $1,736 deductible; a serious outpatient year is 20% of everything, uncapped. Medigap closes that seam for a premium.

The other side: a Priority Group 1 veteran who genuinely gets all care at the VA may rationally self-insure the seam — the premium buys protection against civilian care they don't use. Between those poles sits most of the audience, where honest inputs are your VA facility's distance and capacity, your travel, your tolerance for an uncapped tail risk, and the premium quote in front of you. (The third path — Medicare Advantage — caps the risk differently, trading provider freedom for a $9,250 ceiling and extras.)

The window is the whole ballgame

Your Medigap Open Enrollment — six months from the day Part B takes effect at 65 or later — is guaranteed-issue: no health questions, no declines. Miss it and most states allow underwriting forever after. This compounds the Part B decision: declining B doesn't burn the window (it starts whenever B eventually does), but a veteran who takes B at 65 and "decides later" about Medigap is betting on their insurability. A deliberate no beats a drifted one.

Medigap vs. Medicare Advantage: the breakeven, all four years at once

Medigap monthly premium quote (Plan G assumed) ($) MA plan monthly premium ($ — often 0) MA plan's in-network out-of-pocket maximum ($ — 2026 ceiling $9,250)

Bad-year protection gap:

ScenarioMedigap | MA (annual)

Light year (modeled $400 MA cost-sharing)

Typical year ($1,500)

Heavy year ($4,500, capped by MOOP)

Catastrophic year (MA hits its MOOP)

Medigap column = premium ×12 + the $283 Part B deductible (Plan G's one gap); identical in every row — that flatness is the product. MA cost-sharing figures are labeled scenario models, not plan quotes; drug coverage is excluded on both sides (VA, TFL, or CHAMPVA usually carries it, and an MAPD vs. PDP choice has its own calculator). Medigap underwriting outside your guaranteed-issue window is the constraint neither column shows.

Estimates for educational purposes only — not a quote, plan recommendation, or guarantee of benefits or costs. This website is not connected with or endorsed by the U.S. government or the federal Medicare program. For information on all of your options, contact Medicare.gov, 1-800-MEDICARE (TTY 1-877-486-2048), or your local State Health Insurance Assistance Program (SHIP).

The calculator needs JavaScript — the comparison: Medigap costs premium ×12 + $283 every year; MA costs its premium plus a year that lands anywhere between a few hundred dollars and its out-of-pocket maximum.

Medigap quotes are age-, state-, and carrier-specific — and the spread between insurers for identical coverage is routinely 30%+. Never buy the first quote.

Compare Medigap Quotes

Or compare plans yourself at PlanMatch’s plan finder, or contact Medicare.gov / 1-800-MEDICARE.

Frequently asked questions

Do veterans with TRICARE for Life need Medigap?

Almost never — TFL already pays Medicare's gaps, includes drug coverage, and costs nothing beyond Part B. The same logic covers CHAMPVA households.

Should a veteran with only VA Healthcare buy Medigap?

It's the group with the strongest case: VA + Original Medicare leaves civilian cost-sharing uncapped. Whether the premium is worth it depends on VA access, travel, and risk tolerance — the honest trade-offs are above.

When can I buy Medigap without health questions?

During your one-time open enrollment: the six months starting when Part B takes effect at age 65 or later. Outside it, most states permit medical underwriting.

Does Medigap cover prescription drugs?

No — modern Medigap plans exclude drugs. VA pharmacy covers that side for VA-enrolled veterans; others pair Medigap with a Part D plan.

Can I have Medigap and use the VA?

Yes — Medigap follows Medicare on the civilian side while VA care continues separately. The two never conflict, just like Medicare and the VA themselves.

You earned these benefits. Make them work together.

Whether you keep exactly what you have or add Medicare coverage alongside it, the right answer depends on your health, budget, and how you like to get care.

Find a Medicare Agent Compare Plan Options

No cost, no obligation. You can also get help from Medicare.gov, 1-800-MEDICARE (TTY 1-877-486-2048), or your local SHIP office.