Tennessee · Life, Accident & Health SampleInteractive Mind Map
Medicare Supplement Insurance (Medigap)
A visual breakdown of Medicare Supplement Insurance (Medigap) — one of the concepts you can count on seeing on the exam.
The TESTivity Interactive Mind Mapping Graphic we picked for the Tennessee Life & Health sample is Medicare Supplement Insurance (Medigap) — and this is a concept you can count on seeing on your pre-licensing exam. Get the structure straight once and those questions turn into free points.
So explore it. Click through, see how the pieces relate, and let the layout do some of the remembering for you.
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Medigap fills the gaps in ORIGINAL Medicare — and federal law makes every plan letter identical across insurers.
Because a Plan G is a Plan G everywhere, consumers can shop on price alone. Medigap works only with Original Medicare, never with Medicare Advantage.
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Standardized Plans & the Basic Rules
Same benefits per letter; one policy per person
Must be enrolled in Original Medicare Parts A and B — Medigap cannot be used with Medicare Advantage
Plan letters A, B, D, G, K, L, M, N are sold to all new beneficiaries; benefits are identical across insurers for each letter
A person may hold only one Medigap policy at a time — selling a second without cancelling the first is prohibited
Plans C and F phase-out
Plans C and F covered the Part B deductible. Under MACRA, they are no longer sold to anyone newly Medicare-eligible on or after January 1, 2020. Those already eligible before 2020 may keep or buy them.
The trap they setA stem offers “Plan F, the most comprehensive” to someone newly eligible in 2024 — but F is off the table for post-2020 enrollees. For them, Plan G is the most comprehensive choice.
For new enrollees, the choice usually comes down to Plan G (most comprehensive) vs Plan N (lower premium, some copays).
The single difference between G and the old F is the Part B deductible — G covers everything F did except that.
🏆 Plan G
💰 Plan N
Coverage level
Most comprehensive plan available to new enrollees.
Coverage level
Lower premium; covers most gaps but with trade-offs.
Part B excess charges
Covered — pays the up-to-15% a non-participating provider may bill.
Part B excess charges
Not covered.
Office-visit copays
None.
Office-visit copays
Small copays for office and ER visits.
Part B deductible
Not covered (no current plan covers it).
Part B deductible
Not covered.
Core benefits across plans: all plans cover Part A hospital coinsurance + 365 extra days; most cover the Part A deductible, Part B coinsurance, and SNF coinsurance; only G (and legacy F) cover Part B excess charges; only the old C and F covered the Part B deductible. Plans K and L are cost-sharing plans with an annual out-of-pocket limit.
How they test thisA Plan G holder sees a non-participating provider — G pays both the 20% coinsurance and the excess charge. The same scenario on Plan N would leave the excess charge unpaid. Excess-charge coverage is the headline G-vs-N difference.
The Medigap open enrollment period is the one guaranteed-issue window — miss it, and your health can be held against you.
It is the single most important consumer protection in Medigap, and the most tested.
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Medigap Open Enrollment Period (OEP)
6 months of guaranteed issue
Trigger: begins the first day of the month the beneficiary is both age 65+ AND enrolled in Part B, and lasts 6 months
During the OEP: insurers must sell any available plan at standard rates — no health questions, no pre-existing exclusions, no surcharge
After the OEP: insurers may use medical underwriting — they can decline, surcharge, or exclude conditions
The trap they setThe OEP starts when the person is both 65 and enrolled in Part B — not on the birthday alone and not when the Medicare card arrives. Enroll in Part B at 65 on March 1, and the OEP runs March 1 through August 31.
Guaranteed issue outside the OEP can arise from qualifying events: an MA plan leaving the area or terminating, a 12-month trial right when first trying MA and returning, or losing employer coverage that supplemented Medicare.
Benefits are standardized, but PRICING is not — the rating method drives lifetime cost.
Two identical Plan G policies can cost very differently over time depending on how the insurer prices them.
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Community-Rated
Everyone with the same plan pays the same premium regardless of age. Premiums rise with inflation but not with the policyholder’s aging. Best long-term value for older buyers.
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Issue-Age-Rated
Premium is set by your age at purchase and does not climb as you age (inflation aside). Locking in young keeps it predictable.
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Attained-Age-Rated
Premiums rise as you age, on top of inflation. Lowest initial premium but highest long-term — and the most common method in the market.
How they test thisLock the extremes: attained-age = lowest to start, most expensive over time (rises with age); community-rated = same price for all ages, best for long-lived older buyers. A stem comparing two identical Plan G policies is testing the pricing method, since the benefits are standardized.
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Top Exam Tips — Medigap
1. Medigap works only with Original Medicare, never Medicare Advantage; benefits are standardized by plan letter, so shop on price. 2. Plans C and F are closed to anyone newly eligible on or after January 1, 2020 (they covered the Part B deductible). 3. Plan G is the most comprehensive plan for new enrollees — everything F covered except the Part B deductible. Plan N is cheaper but has copays and no excess-charge coverage. 4. Only Plan G (and legacy F) covers Part B excess charges (up to 15%). 5. Medigap OEP: 6 months, starting when the beneficiary is BOTH 65+ AND enrolled in Part B — guaranteed issue, no underwriting. 6. After the OEP, insurers may medically underwrite (deny, surcharge, exclude). 7. Pricing: attained-age = lowest initial, highest long-term; community-rated = same for all ages, best long-term for older buyers; issue-age = locked at purchase.
Exam vocabulary
Key Terms to Know
Medigap (Medicare Supplement)
Private insurance filling Original Medicare Parts A and B cost-sharing gaps; works only with Original Medicare, not Medicare Advantage.
Standardized Medigap Plans
Federal law standardizes benefits by plan letter (A–N); benefits are identical regardless of insurer, so consumers compare on price.
Plans C and F (Phase-Out)
No longer sold to anyone newly Medicare-eligible on or after January 1, 2020; they covered the Part B deductible, eliminated by MACRA.
Plan G
The most comprehensive Medigap plan available to new enrollees; covers everything Plan F did except the Part B deductible.
Plan N
A lower-premium option; covers most gaps but has office-visit copays and does not cover Part B excess charges.
Part B Excess Charges
Up to 15% above Medicare’s approved amount charged by non-participating providers; covered by Plan G (and legacy Plan F).
Medigap Open Enrollment Period (OEP)
6-month guaranteed-issue window beginning when the beneficiary is both age 65+ and enrolled in Part B; no medical underwriting allowed.
Guaranteed Issue (Medigap)
During the OEP (and certain qualifying events), insurers must sell any available plan at standard rates regardless of health.
Community-Rated Pricing
All policyholders with the same plan pay the same premium regardless of age; lowest long-term cost for older buyers.
Issue-Age-Rated Pricing
Premium based on age at policy issue; does not increase with age, though it may rise for inflation.
Attained-Age-Rated Pricing
Premiums increase as the policyholder ages; lowest initial cost but highest long-term cost; the most common method.
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