Medicare Supplement (Medigap)

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Medicare Supplement plans, also known as Medigap plans, are insurance policies sold by private companies to help pay some of the out‑of‑pocket costs that Original Medicare (Part A and Part B) does not cover, such as deductibles, coinsurance, and certain other expenses. These plans work alongside Original Medicare as secondary coverage; they do not replace Medicare and do not include Part D prescription drug coverage.​

Minnesota is one of three states (along with Massachusetts and Wisconsin) that standardize its Medigap plans differently from the “lettered” plans used in most other states. In Minnesota, Medigap is built around a Basic Plan, an Extended Basic Plan, and several additional standardized variations (including copay‑style and cost‑sharing plans similar in concept to K, L, and N in other states).​

Basic Plan

Minnesota’s Basic Medigap plan is designed to cover core out‑of‑pocket costs that Original Medicare does not fully pay. By law, the Basic Plan includes:​

• Part A and Part B coinsurance and copayments for Medicare‑covered services, including up to 100 days of skilled nursing facility care per benefit period
• The first three pints of blood each year
• 80% of the billed charges for certain emergency care received outside the United States, up to plan limits
• State‑mandated benefits such as diabetic equipment and supplies, routine cancer screening, specified reconstructive surgery, and certain immunizations

Basic Plan – What it does not cover by default:

• Part A inpatient hospital deductible
• Part B deductible
• Part B excess charges (amounts above the Medicare‑approved rate when a provider does not accept Medicare assignment)

These gaps can be filled by adding optional riders.

Minnesota allows insurers to offer a set of standardized riders that can be added to either the Basic or Extended Basic plan to customize coverage. Common riders include:​

• Part A deductible rider – covers the full Medicare Part A inpatient hospital deductible
• Part B deductible rider – covers the Part B annual deductible (only available if you were first eligible for Medicare before 1/1/2020)​
• Part B excess charges rider – covers 100% of Part B excess charges
• Preventive care rider – adds coverage for certain preventive services that Medicare does not cover, up to an annual maximum

Each rider has its own monthly cost that is added to the base Basic plan premium; some carriers may also offer slightly different preventive‑benefit designs within the state standards.​

The Extended Basic Plan includes all of the Basic Plan benefits and adds a higher level of protection for hospital costs and other gaps. Under Minnesota law, Extended Basic typically includes:​

• 100% of the Medicare Part A inpatient hospital deductible
• 100% of Medicare Part A and B coinsurance (including an extended number of skilled nursing facility days – generally up to 120 days per benefit period)
• 100% of Part B excess charges (for beneficiaries allowed to purchase that benefit)
• 80% coverage of certain emergency medical care received outside the U.S., after a small deductible, up to plan limits
• State‑mandated additional benefits similar to those included with Basic, often with stronger protection and, for many carrier designs, an annual cap on your cost‑sharing for certain additional (non‑Medicare) covered services

Extended Basic generally has a higher monthly premium than Basic, but because more is built in, fewer riders are needed and your out‑of‑pocket risk for hospital and other large claims is lower.

Starting August 1, 2026, Minnesota will add a new way for many people age 65–70 to get into a Medigap plan even if they missed their original Medigap window or have health conditions.​

• During a special Medigap enrollment period that lines up with Medicare’s fall Annual Election Period, eligible Minnesotans age 65–70 will be able to enroll in a Medicare Supplement plan without medical underwriting or pre‑existing condition denials—a one‑time “second chance” to get Medigap coverage.​
• However, anyone who first enrolls in Medigap using this new protection will pay a permanent premium surcharge in addition to the plan’s standard community rate.​

The lifetime surcharge schedule is:

• 15% extra if you first enroll under this rule in the 2026 open enrollment period
• 20% extra in 2027
• 25% extra in 2028
• 30% extra in 2029
• 35% extra for 2030 and all later years​

This surcharge lasts for as long as the Medigap policy stays in force, so it is important to weigh the value of guaranteed acceptance against the higher long‑term premium before using this new law.

When selecting a Medigap plan in Minnesota, consider:

• Your current and expected future healthcare needs (frequency of doctor visits, likelihood of hospitalizations or skilled nursing stays)
• Monthly premium vs. potential out‑of‑pocket expenses (deductibles, coinsurance, and uncovered items)
• Whether you want to rely on riders to customize a Basic plan or prefer the simplicity of Extended Basic with more coverage built in
• How often you travel outside the U.S. and whether foreign emergency coverage is important to you
• Whether you are in (or approaching) your initial Medigap window, or might someday need to rely on the new 2026 law and its lifetime surcharge

If you enroll in a Medicare Supplement plan, you will also need to choose a separate Medicare Part D prescription drug plan to cover outpatient medications, since Medigap policies do not include Part D drug benefits.​

At Lakes Health Insurance, I’m committed to helping you navigate Minnesota’s Medigap options. I will work with you to assess your unique situation, compare plans and premiums from multiple insurers, and recommend the plan configuration (Basic with riders, Extended Basic, or another standardized option) that best aligns with your needs and budget.
 

The best time to enroll in a Medicare Supplement plan is during your Medigap Open Enrollment Period, which is a one‑time, 6‑month window that begins the first month you are both 65 or older and enrolled in Medicare Part B. During this period:​

• You can enroll in any Medigap policy sold in your state
• Companies cannot use medical underwriting to deny you coverage or charge you more based on your health or pre‑existing conditions
• You may be able to avoid or shorten pre‑existing condition waiting periods if you have at least 6 months of prior creditable coverage with no break longer than 63 days​

After this 6‑month window:

• You can still apply for Medigap, but insurers in most cases can use medical underwriting
• You may pay more, have fewer plan choices, or be declined based on health history​

Important: The regular Annual Election Period (AEP) each fall (October 15–December 7) is primarily for changing Medicare Advantage and Part D drug plans and does not normally give you a new federal guaranteed‑issue right for Medigap. Minnesota’s 2026 law will overlay a separate Medigap enrollment opportunity—with the lifetime surcharge described above—for certain people age 65–70 during that time.​

• Medicare Supplement (Medigap) plans help pay Medicare‑approved out‑of‑pocket costs such as deductibles, coinsurance, and some additional services.​
• Minnesota uses its own standardized Medigap structure, centered on Basic and Extended Basic plans plus several other variants; Basic, Extended Basic, and copay‑style options similar to Plan N are the most commonly chosen designs.​
• You can use a Medigap plan with any doctor or facility nationwide that accepts Medicare; there is no provider network like Medicare Advantage plans have.​
• You have a one‑time, 6‑month Medigap Open Enrollment Period tied to your Part B effective date at 65+ to buy Medigap with no health underwriting; later enrollment usually involves medical questions unless you qualify for a guaranteed‑issue right.​
• Beginning August 1, 2026, a new Minnesota law will give many people age 65–70 a one‑time, no‑underwriting Medigap enrollment opportunity during the fall period—but with a permanent premium penalty starting at 15% and rising to 35% for later years.​

If you have questions or would like help comparing Minnesota Medicare Supplement plans—or understanding how the 2026 law could affect your options—please contact me at Lakes Health Insurance. You will receive free, individualized guidance to understand your choices and make an informed decision.

Frequently Asked Questions

When can I get a Medicare Supplement Plan?

Under federal law, you get a 6 month Medigap Open Enrollment Period. It starts the first month you have Medicare Part B, and you are 65 or older. During this time, you: 

• Can enroll in any Medigap policy. 
• Will generally get better prices and more choices among policies.
• You can buy any Medigap policy sold in your state. An insurance company can’t use medical underwriting to decide whether to accept your application - they can’t deny you coverage due to pre-existing health problems.
• Can avoid or shorten waiting periods for a pre-existing condition if you buy a Medigap policy to replace creditable coverage. 

After this period, you may not be able to buy a Medigap policy, or it may cost more. Your Medigap Open Enrollment Period is a one-time enrollment period. It doesn’t repeat every year, like the Medicare Open Enrollment Period.

Generally, your Medigap policy will begin the first of the month after you apply, but you can decide when you want it to start.

IMPORTANT: Annual Election Period (AEP) that occurs each fall is NOT a time when you can get a Medicare supplemental insurance plan with no health questions asked. The AEP has nothing to do with Medigap plans. Instead, it’s a time when you can change your Part D drug plan. 

Beginning August 1, 2026, Minnesota will offer a new way for many people age 65–70 to get into a Medicare Supplement (Medigap) plan even if they missed their original Medigap Open Enrollment Period or were previously denied due to health. During a special annual window that lines up with Medicare’s fall Annual Election Period, eligible Minnesotans age 65–70 will be able to enroll in a Medigap plan without medical underwriting or pre‑existing condition denials—a one‑time “second chance” to get Medigap coverage.​

However, using this new Minnesota enrollment right comes with a permanent premium penalty that is added to the plan’s standard community rate. The lifetime surcharge is scheduled to grow over time:​

• 15% extra if you first enroll under this rule for 2026 coverage
• 20% extra for 2027
• 25% extra for 2028
• 30% extra for 2029
• 35% extra for 2030 and all later years​​

This penalty applies for as long as you keep that Medigap policy, so it’s important to compare the long‑term cost of the higher premium against the benefit of being able to enroll without health questions under the new Minnesota law.

What is Creditable coverage?

Previous health insurance coverage that can be used to shorten a pre-existing condition waiting period under a Medigap policy. 

How do I know if I have Creditable Coverage?

If you have had at least 6 months of continuous prior creditable coverage, the Medigap 

insurance company can't make you wait before it covers your pre-existing condition. Many types of health care coverage can count as creditable coverage for Medigap policies, but they’ll only count if your break in coverage was no more than 63 days. 

If a Medigap company wants to apply a pre‑existing condition waiting period, they must shorten or waive it based on any recent creditable coverage you had, as long as you did not have a break in coverage longer than 63 days. To do that, they may ask for proof of your prior coverage. You can usually provide this in one of the following ways:​

• A certificate of creditable coverage or termination letter from your employer group plan, union plan, retiree plan, or previous Medicare Advantage or Medigap plan
• A recent benefits or coverage letter showing the dates you were enrolled
• Other documentation from the plan or insurer that clearly shows when your prior coverage started and ended​

If you don’t have this paperwork, you can contact your former employer’s benefits department or your prior insurance company and ask them to send you written proof of your coverage dates. Keeping this documentation makes it easier to be sure any Medigap pre‑existing condition waiting period is reduced—or eliminated—correctly.

What if I miss my Medigap Open Enrollment Period?

Outside of your Medigap Open Enrollment Period:

• You may have to pay more for a policy.
• Fewer policy options may be available to you.
• The insurance company is allowed to deny you a policy if you don’t meet their medical underwriting requirements.

There are certain situations where you may be able to buy a Medigap policy outside of your Medigap Open Enrollment Period. Situations where an insurance company can’t deny you a Medigap policy are called “guaranteed issue rights” or “Medigap protections.”
 

What are guaranteed issue rights?

In most cases, you have a guaranteed issue right when your other health coverage changes in some way, like if you lose your other coverage. You may also have a "trial right" to try a Medicare Advantage Plan (Part C) and still buy a Medigap policy if you change your mind.

If you have a guaranteed issue right, an insurance company:

• Must sell you a Medigap policy
• Must cover all your pre-existing health conditions
• Can't charge you more for a Medigap policy because of past or present health problems

Learn more about guaranteed issue rights at Medicare.gov.

In certain circumstances, an insurance company must accept you for coverage without asking health questions. For example, if you are on Medicaid and you lose your Medicaid eligibility, you have a short window to apply for Medigap without health questions.

Another example would be for someone coming off employer health coverage that is primary to Medicare. They will have a short window to apply for certain Medigap plans under guaranteed issue rules.

Can I change my Medigap policy?

In most cases, you won’t have a right under federal law to switch Medigap policies, unless:

• You're within your 6-month Medigap initial enrollment period, or
• You're eligible under a specific situation or guaranteed issue right (when an insurance      company can’t deny you a Medigap policy). 

Important: If you buy a Medigap policy during your 6-month Medigap Initial Enrollment Period and decide you don’t like the policy during this period, you can switch to a different Medigap policy. When you get your new Medigap policy, you have 30 days to decide if you want to keep it (called a 30-day free look period). Don’t cancel your first Medigap policy until you’ve decided to keep your second Medigap policy. You’ll need to pay both premiums for the month that you have both. 

If you’ve had your current Medigap policy for less than 6 months and want to switch to a different Medigap policy, you may have to wait for the new policy to cover your pre-existing conditions. 

When will the new Medigap policy cover my pre-existing condition?

You might have a waiting period for up to 6 months before your new Medigap policy will cover your pre-existing condition (called the pre-existing condition waiting period). 

• Your new Medigap policy must subtract the number of months you’ve had your current Medigap policy or prior creditable coverage (like health insurance you recently had through your employer) from the time you must wait before covering your pre-existing condition. For example, if someone had a pre-existing condition and had coverage (as described above) for 2 months and then gets a new Medigap policy, the policy won’t cover that condition for another 4 months (6-2=4). 
• If your new Medigap policy has a benefit that isn’t in your current Medigap policy, you may still have to wait up to 6 months before that benefit will be covered, regardless of how long you’ve had your current Medigap policy. 
• If you’ve had your current Medigap policy longer than 6 months and it has the same benefits as your new policy, the new insurance company can’t exclude your pre-existing condition or make you wait before it covers it.
• If the insurance company agrees to issue the new policy, they can't write pre-existing conditions, waiting periods, elimination periods, or probationary periods into the replacement policy.

In Minnesota, a Basic plan with all the major riders added can look very similar to an Extended Basic plan for many day‑to‑day Medicare‑covered services, but there are still important differences in how the coverage is packaged and how far it goes.​

With Basic + riders, you start from the Minnesota Basic plan and then add optional rider(s) for:

• The Medicare Part A inpatient hospital deductible
• The Medicare Part B deductible (only if you were first eligible for Medicare before 1/1/2020)
• 100% of Part B excess charges
• Certain non‑Medicare preventive care, up to an annual maximum​

When all of those riders are in place, your protection for Medicare‑covered Part A and B services (hospital, skilled nursing, outpatient visits, etc.) can be very close to what you get with an Extended Basic plan: most or all of your coinsurance and deductibles are covered, and you have foreign emergency coverage at 80% up to plan limits.​

The Extended Basic plan includes all of the Basic benefits plus additional coverage built in by Minnesota law: it must cover the full Part A deductible, Part A and B coinsurance, Part B deductible for those allowed to buy that benefit, Part B excess charges, an extended number of skilled nursing facility days (typically up to 120 days), 80% of covered foreign travel emergency care, and broader protection for certain state‑mandated or non‑Medicare benefits. Many Extended Basic designs also include an annual cap on what you pay out of pocket for those additional (non‑Medicare) services, after which the plan pays 100% for the rest of the year.​

In practice:

• Basic + riders can be slightly cheaper and lets you pick only the riders you want, but you must manage those add‑ons and you may have less built‑in protection on some non‑Medicare, state‑mandated benefits.
• Extended Basic usually has a higher monthly premium, but more is standardized and built in—especially for hospital deductibles, extra skilled nursing days, Part B excess, and certain additional benefits—so there are fewer moving parts, and in some designs you get an extra safety valve on out‑of‑pocket costs for those additional services.​

If you have any questions or would like assistance in understanding and comparing the Medicare Supplement plans available in Minnesota, please don't hesitate to contact me at Lakes Health Insurance. I'm here to provide you with FREE, personalized guidance and support throughout the process.