If you’re researching Medicare options, there’s a good chance you’ve been told that a Medicare Supplement plan (also called Medigap) is the “best” you can get.
I understand why. These plans are popular, especially among higher income retirees who don’t want the restrictions of Medicare Advantage. On paper, Medigap looks like the safer choice: no networks, fewer surprise bills, and predictable out-of-pocket costs. But that doesn’t mean they’re perfect.
I work with people every day who are trying to decide what to do as they approach 65. And I’ve seen what catches people off guard—sometimes after they’ve already enrolled in a supplement plan and are stuck.
If you’re trying to make a smart choice for the long haul, these are the things you need to know up front. These are the real drawbacks of Medicare Supplement plans that most agents don’t bring up.
1. Medicare Supplement Plans Don’t Cover Everything
People are often shocked to learn what a Medigap plan doesn’t cover.
Here’s what you still have to deal with, even if you buy the most comprehensive supplement on the market:
- Prescription drugs (you’ll need a separate Part D plan)
- Dental
- Vision
- Hearing aids
- Routine physicals
- Long-term care
A Medigap plan only fills in the gaps in Original Medicare, and Original Medicare doesn’t cover much outside of hospital and medical care. That means you could pay for a supplement and still face big out-of-pocket costs for things like hearing aids or assisted living.
2. Premiums Can Be High—And They Usually Go Up
Medicare Supplement plans are paid for with a monthly premium. Depending on your age, zip code, and the company you choose, this can range from $100/month to over $200/month, just for the supplement.
And those premiums don’t stay flat. Even plans that say they use “community rating” (where your age doesn’t factor into the starting rate) will usually raise rates over time.
Some companies raise rates once a year. Others sneak in multiple increases.
Here’s what that means in real life: someone who starts with a $125/month Plan G at age 65 may be paying $225/month or more by the time they’re 75—and they may not even notice until it’s become unaffordable.
3. You Still Need a Separate Drug Plan
Medicare Supplement plans don’t include drug coverage.
You’ll need to shop for a standalone Part D plan, even if you don’t take any medications. If you skip it, you’ll owe a penalty down the road—and you’ll be totally exposed if your health changes.
This surprises a lot of people. They think they’ve “finished” enrolling once they get their supplement. But if they don’t add a Part D plan at the same time, they could be paying out of pocket for prescriptions or facing a lifetime penalty later.
The good news is, Part D plans aren’t expensive if you don’t take many meds. But picking the right one is a different story. There are usually 15–20+ options in each zip code, and they vary a lot based on what prescriptions you take.
4. You May Not Qualify Later
When you first enroll in Medicare Part B, you get a 6-month window to buy any Medicare Supplement plan you want—no health questions asked.
After that? You may have to go through medical underwriting. That means answering questions about your health history, medications, recent hospitalizations, and more. The company can say no. Or they can offer you a plan with a higher rate.
This catches a lot of people off guard. They assume they can just switch plans later if their rate goes up or if they want more coverage. But if their health has changed, it may not be that simple.
There are a few exceptions, but most people only get one guaranteed shot.
5. All Plans Aren’t Created Equal—Even if the Benefits Are
Here’s what most agents won’t say: Plan G is not the same with every company.
Yes, the benefits are standardized. A Plan G from one company pays the same way as a Plan G from another. But the price, service, and rate increases are very different.
I’ve worked with all of the major companies. I know who raises rates aggressively and who’s more stable. That’s why I don’t just compare Plan G rates—I compare the carriers too.
6. No Help with Non-Medical Costs Like Nursing Homes
This is one of Medicare’s biggest blind spots—and it surprises people the most.
Even with a top-tier Medicare Supplement plan, you’re on the hook for long-term care. That means:
- Assisted living facilities
- Home health aides
- Memory care
- Extended nursing home stays
Original Medicare covers short-term skilled nursing, but only if you meet certain conditions—and even then, it’s limited to 100 days. After that, it’s all on you.
A private room in a nursing home can cost $8,000–$12,000/month or more. And it’s not unusual for people to need help with daily activities for several years.
If you want to protect against this risk, you’ll need to look at separate coverage. That could be a traditional long-term care insurance policy, a hybrid life/long-term care plan, or something simpler like a short-term care or home recovery plan.
7. You Might Be Overpaying for Coverage You Don’t Use
Most brokers default to Plan G because it’s the most comprehensive—but that doesn’t mean it’s always the smartest.
For someone healthy and willing to handle occasional copays, Plan N might be a better fit. They can save $30–$70/month, and still give you strong protection from big bills.
In some cases, clients are paying top dollar for a Plan G and barely using it. If you’re going to the doctor once a year and not taking any medications, you might be over-insured.
I walk people through the tradeoffs. Sometimes it still makes sense to go with full coverage. But sometimes a more efficient plan puts money back in your pocket—money that could be used for dental, travel, or just better peace of mind.
Final Thoughts
I’m not against Medicare Supplement plans. I sell a lot them. I help people choose them all the time.
But I’m not going to pretend they’re perfect. Every choice comes with tradeoffs, and what works for one person may not be right for another.
If you’re feeling overwhelmed, confused, or just want someone to help you make sense of it all—I can help. I’ll look at your doctors, your budget, your prescriptions, your future plans—and give you honest advice about what actually makes sense for you.
If you’re already paying for a supplement and want to make sure you’re not overpaying, or if you’re still deciding what to enroll in, schedule a call with me. I’ll help you sort it out.