Part Five: Your Four Best Options for Filling the Gaps
The good news is that the gaps in Medicare are well known, and an entire ecosystem of insurance products and programs has been built specifically to address them. Here are the four primary strategies retirees use, and what each one is best suited for.
Option 1: Medicare Supplement Insurance (Medigap)
Medigap plans are sold by private insurance companies and are designed to work alongside Original Medicare—paying for costs that Medicare leaves behind, such as deductibles, coinsurance, and copayments.
In most states, Medigap plans are standardized and labeled with letters: Plan G and Plan N are currently the most popular choices for new enrollees.
What Medigap Typically Covers: Medicare Part A coinsurance and hospital costs (up to an additional 365 days). Medicare Part B coinsurance or copayment (usually 80% of the remaining 20%). Part A deductible (depending on plan). Foreign travel emergency care (Plans C, D, F, G, M, N — up to plan limits). Skilled nursing facility coinsurance. Note: Medigap does NOT cover dental, vision, hearing, or long-term care
The best time to enroll in Medigap is during your six-month Medigap Open Enrollment Period, which begins the month you turn 65 and are enrolled in Part B. During this window, insurers cannot deny you coverage or charge you more based on your health history. Outside this window, medical underwriting applies in most states.
Monthly premiums for Medigap plans vary widely by plan type, insurer, age, and location — generally ranging from $100 to $400+ per month. For retirees who want maximum financial predictability and see many doctors, Medigap is often the most cost-effective long-term solution.
Option 2: Medicare Advantage (Part C)
Medicare Advantage plans are an alternative to Original Medicare — rather than supplementing it, they replace Parts A and B entirely and are administered through private insurers approved by Medicare. Most Medicare Advantage plans also include Part D drug coverage and frequently bundle in dental, vision, and hearing benefits that Original Medicare does not cover.
Medicare Advantage plans often have lower monthly premiums than Medigap — some plans have $0 premiums — but they typically use provider networks (HMO or PPO structures), meaning your choice of doctors and hospitals may be restricted. They also commonly require prior authorization for certain procedures and may have higher out-of-pocket costs if you need significant care.
Medicare Advantage works best for retirees who are relatively healthy, prefer a structured plan with bundled benefits, and are comfortable staying within a network of providers. It may be less suitable for retirees with complex medical needs who want unrestricted access to specialists.
Option 3: Medicare Part D (Prescription Drug Coverage)
Original Medicare does not cover most prescription drugs you take at home — that gap is addressed by Part D plans, which are purchased separately through private insurers or included in a Medicare Advantage plan. In 2026, significant changes have continued rolling in from the Inflation Reduction Act, including a $2,000 annual out-of-pocket cap on Part D drug costs — a major improvement for retirees who take expensive medications.
If you do not enroll in Part D when you are first eligible and do not have other creditable drug coverage, you may face a late enrollment penalty for as long as you have Medicare. Even if you currently take few medications, enrolling in a low-premium Part D plan at 65 is generally advisable.
Option 4: Long-Term Care Insurance
Because Medicare provides virtually no coverage for custodial long-term care, long-term care insurance remains an important planning tool for many retirees. A traditional long-term care policy pays a daily or monthly benefit when you need help with activities of daily living — typically two or more of bathing, dressing, eating, continence, toileting, or transferring.
The challenge: traditional long-term care insurance premiums have increased substantially over the years, and many insurers have exited the market. Hybrid products — such as life insurance policies with a long-term care rider — have become a popular alternative because they guarantee a death benefit even if long-term care is never needed.
Financial planners generally recommend evaluating long-term care coverage options in your mid-50s to early 60s, when premiums are lower and health qualifications are easier to meet. Waiting until your late 60s or 70s can significantly increase costs or make coverage unavailable.
