Florida Medicare Supplement Plans: Easy 2025/2026 Guide
If you use Original Medicare (Parts A & B) and want help paying for the parts Medicare doesn’t fully cover, like deductibles, copays, and coinsurance, a Medicare Supplement (also called Medigap) is a private insurance policy you can add to reduce those out-of-pocket costs. You keep the freedom of Original Medicare where you can go to any doctor or hospital that accepts Medicare nationwide, and your Medigap policy “fills the gaps.”. In the article ” Florida Medicare Supplement Plans Easy 2025 / 2026 Guide” we will go over the details you need to know.
I intend to answer most of your questions in this article, but if I miss something, please email me at support@myphss.com, and I will answer your question.
What is a Medicare Supplement Plan (Medigap)
A Medicare Supplement plan, also known as Medigap, is a type of health insurance sold by private insurance companies in most Tampa Bay area counties to help pay the out-of-pocket costs associated with Original Medicare. These costs can include deductibles, coinsurance, and copayments. Medigap plans help pay for some of the healthcare costs not covered by Medicare Parts A and B, but still offer flexibility to choose any doctor or hospital that accepts Medicare nationwide.
Quick basics (plain and simple)
You must have Part A and Part B to buy a Medigap plan.
Medigap plans are standardized by letter (A, B, C, D, F, G, K, L, M, N). Plan G and Plan N are common choices for people new to Medicare; Plans F and C aren’t available to people new to Medicare on or after January 1, 2020.
Medicare pays first and Medigap pays the remainder (based on the plan you choose).
Medigap is not Medicare Advantage. Many people confuse all the different names used. Just remember, you can’t have a Medigap plan with an Advantage plan (Part C).
💰 What Medigap does and doesn’t cover
If you have Original Medicare Parts A and B, and you go to the doctor or hospital, on average, Original Medicare will pay 80% of the bill for all approved services. Once Medicare pays its share, you are left with the balance. If you buy, for example, a supplement plan G, that plan will pay the remaining 20%. Of course, there are different plans and requirements; this is just an example. A Medicare Supplement plan is not a standalone insurance plan. It only works with Original Medicare Part A and B.
Original Medicare does not pay for prescription drugs, so neither will your Medigap plan. You have to buy a Part D prescription plan to get help paying for your meds.
✅ When to enroll (and why timing matters)
The best time to buy a Medigap plan is during your Medigap Open Enrollment Period, which is a one-time, 6-month window that starts the first month you’re 65 or older and enrolled in Part B. During this time, insurance companies can’t deny you or charge you more, even if you have health problems. You don’t have to answer any medical questions on the application. After this period, your options to buy a Medigap policy may be limited and the policy may cost more.
There’s no annual “open enrollment period” like Medicare Advantage Part C or Part D has. In most states—including Florida—changing Medigap after your initial 6-month window usually involves medical underwriting, where insurance companies can deny you or charge you more because of your health.
🧾 What are guaranteed issue rights?
Guaranteed issue rights refer to specific situations where an insurance company is legally obligated to sell you a Medigap policy, regardless of your health status, pre-existing conditions, or age (within certain limits). This means they cannot deny you coverage or charge you a higher premium based on your health history.
- No Medical Underwriting: During a guaranteed issue period, you don’t have to undergo medical underwriting, which is a process where insurance companies evaluate your health to determine if they will cover you and how much they will charge.
- Coverage for Pre-Existing Conditions: Insurers must cover all your pre-existing health conditions without imposing waiting periods or higher premiums.
- Guaranteed Acceptance: If you qualify, insurance companies are required to accept your application for a Medigap policy.
When do guaranteed issue rights apply?
Open Enrollment Period:
- a one-time 6-month window that starts when you are 65 or older and enrolled in Medicare Part B
- During this period, you have guaranteed issue rights, meaning insurance companies cannot deny your application or charge you more due to pre-existing health conditions
Losing Employer or Union Coverage:
- If your employer-sponsored retiree plan or union coverage ends, you have a guaranteed issue right to purchase a Medigap policy.
- This applies to both the end of coverage and situations where benefits are reduced or eligibility is lost.
- You generally need to apply within 63 days of the end of your coverage.
Medicare Advantage Plan Issues:
- If your Medicare Advantage plan discontinues coverage in your area, you have a guaranteed issue right.
- Moving out of your Medicare Advantage plan’s service area also triggers this right.
- If your plan is terminated or if the plan commits fraud, you can also switch back to Medigap.
- You have 63 days to apply for a Medigap policy after the plan’s termination, or after moving out of the service area.
Trail Period for Advantage Plans (Part C)
- If you enroll in a Medicare Advantage plan when you first become eligible for Medicare, you have a 12-month trial period to switch back to Original Medicare and a Medigap policy
- You can switch back within the first 12 months of your Medicare Advantage enrollment.
Other Situations:
- If your Medigap insurer goes bankrupt or your policy is terminated through no fault of your own, you can switch.
- If you have a Medicare SELECT policy and move outside the service area, you have a guaranteed issue right.
- State laws can also provide additional guaranteed issue rights, such as the “birthday rule” in some states, allowing you to switch to a different insurer’s version of your current Medigap plan.
Which Plan Should I Buy?
Every person is different and we create plans based on your personal needs. But in general terms, most people buy Plan G and Plan N. From our experience, these two plans fit most needs.
Plan G
Medicare Supplement Plan G, also known as Medigap Plan G, is a popular choice that helps cover the out-of-pocket costs associated with Original Medicare. It covers most of the expenses not paid by Medicare Parts A and B, including coinsurance, copayments, and deductibles, except the Medicare Part B deductible. After the Part B deductible is met, Plan G provides comprehensive coverage for the rest of the year, including Part B excess charges.
Plan N
Medicare Supplement Plan N, also known as Medigap Plan N, is a popular option that offers a lower monthly premium than some other Medigap plans in exchange for some cost-sharing on certain services.
You’ll typically pay a copayment for certain doctor’s office visits and emergency room visits. For example, you might pay $20 for a doctor’s visit and $50 for an emergency room visit that doesn’t result in an inpatient admission. Plan N does not cover Part B excess charges. This means that if a doctor charges more than what Medicare approves, you’ll be responsible for paying the difference
In essence, Plan N provides comprehensive coverage but requires you to pay some cost-sharing at the point of service (copays and excess charges), which helps keep the monthly premium lower.
🧾 Can I switch Medigap plans?
There’s no annual “open enrollment” like Medicare Advantage or Part D in most states, including Florida. Changing Medigap after your initial 6-month window usually involves medical underwriting unless a guaranteed-issue right applies.
If you need to switch plans for any reason, we can check if you qualify for any guarantee issue rights or if you can pass the underwriting requirements for a new plan.
Medigap vs. Medicare Advantage (which path fits you?)
Choose Original Medicare + Medigap + Part D if you want:
Any doctor/hospital nationwide that takes Medicare
Predictable out-of-pocket costs
Simple travel coverage in the U.S., with some plans offering foreign travel emergency benefits
Here in Pasco, Hernando, Hillsborough, Pinellas, Citrus, and Polk, Medigap can be a great fit if you:
See multiple specialists and want zero or low bills after Medicare pays
Snowbird or travel and want flexibility with any Medicare-accepting provider
Prefer to avoid prior authorization hurdles typical in many Advantage plans (Medigap follows Original Medicare’s rules)
Consider Medicare Advantage instead if you’re okay with:
Using a plan network (HMO/PPO), possible referrals, and plan rules
Bundled coverage (Parts A, B, and usually Part D) with extras (like dental/vision), the plan may include
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We serve clients in:
Pasco County: New Port Richey, Dade City, Zephyrhills, Land O’ Lakes
Hernando County: Spring Hill, Brooksville
Pinellas County: Clearwater, Largo, St. Pete, Tarpon Springs
Hillsborough County: Tampa, Brandon, Plant City, Lutz
Polk County: Lakeland, Winter Haven, Bartow
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I intended to answer most of your questions in this article, but if I missed something, please email me at support@myphss.com, and I will answer your question.
Disclaimer: This guide is for general education for Tampa Bay residents and isn’t legal, tax, or plan advice. Always review your specific benefits and plan documents.
