Definition. Medigap, also called Medicare Supplement Insurance, is a private policy that helps pay costs Original Medicare leaves to you, such as deductibles and coinsurance. Plans are standardized by letter, work only with Original Medicare, and in Oregon are regulated by the Division of Financial Regulation.
What it means
Medigap policies are sold by private insurance companies, but the benefits are standardized by federal law: a Plan G from one company covers the same things as a Plan G from another. Companies differ in price, how they set and raise prices, and service. Medigap pays after Original Medicare pays; you keep your Medicare card and can see any provider in the U.S. that accepts Medicare.
The plan letters are A, B, C, D, F, G, K, L, M and N, plus high-deductible versions of F and G (the 2026 deductible is $2,950). Plans C and F (including high-deductible F) are sold only to people first eligible for Medicare before January 1, 2020. Plans K and L have yearly out-of-pocket limits ($8,000 and $4,000 in 2026). Medigap doesn't include drug coverage, so for drug coverage you need a stand-alone Part D plan or other creditable drug coverage.
In Oregon
- Birthday rule. From 30 days before to 30 days after your birthday each year, you can replace your Medigap policy with one that has the same or lesser benefits, from any company, and the company can't deny you or charge more because of your health (OAR 836-052-0143; window in effect since January 1, 2023). The Division of Financial Regulation defines "same or lesser" with a chart. Policies issued before 1990 don't qualify.
- Under 65. If you have Medicare because of a disability, you get a six-month Medigap open enrollment when you enroll in Part B; companies must offer every plan they sell, at no more than they charge a 65-year-old (OAR 836-052-0138).
- 30-day free look. You can return a new policy within 30 days of delivery for a premium refund (OAR 836-052-0160).
- Pricing. Oregon allows companies to price by attained age, and some use other methods; ask how a policy is priced.
Questions or complaints about a Medigap policy or company go to the Oregon Division of Financial Regulation's consumer advocates at 1-888-877-4894. To compare policies from the companies they work with, you can request a call from a licensed insurance agent.
Sources
- Oregon Administrative Rules 836-052-0143 — Annual opportunity to select another Medicare supplement policy
- Oregon Administrative Rules 836-052-0138 — Open enrollment
- Oregon Administrative Rules 836-052-0160 — Required disclosure provisions
- Medicare.gov — Medigap (Medicare Supplement Insurance)
- Oregon Division of Financial Regulation — Contact us
Frequently asked questions
Can I have both Medigap and Medicare Advantage?
No. Medigap works only with Original Medicare. It can't be used to pay a Medicare Advantage plan's copays or deductibles, and it's illegal for anyone to sell you a Medigap policy while you're in Medicare Advantage unless you're switching back to Original Medicare.
Does Oregon have a Medigap birthday rule?
Yes. If you have a Medigap policy, you can switch to one with the same or lesser benefits, from the same or a different company, from 30 days before to 30 days after your birthday each year, without health questions (Oregon Administrative Rules 836-052-0143).
Are Medigap plans the same in every state?
The plan letters and their benefits are standardized nationally (except in Massachusetts, Minnesota and Wisconsin). States add their own rules on when you can buy, such as Oregon's birthday rule and its under-65 protections.
Medicare in your Oregon county
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