How Medigap Select Plans Work and What They Cover

What Medigap Select Insurance Is

Medigap Select is a type of supplemental insurance sold by private companies that works alongside Original Medicare (Parts A and B). Unlike standard Medigap plans, Select plans require you to use doctors and hospitals within a specific network to receive full coverage. If you go outside that network, you pay more out of pocket—sometimes the full cost of the service.

Select plans are available in most states and typically cost less in monthly premiums than comparable standard Medigap plans. The trade-off is the network restriction: you must use in-network providers except in emergencies. This structure appeals to people who are willing to accept a smaller provider network in exchange for lower monthly costs.

Medigap Select plans are regulated by state insurance departments and must follow federal rules about what they cover. They are not the same as Medicare Advantage (Part C), which is a different type of plan run by private insurers that replaces Original Medicare entirely.

Key Takeaways

• Medigap Select plans cost less per month than standard Medigap plans but require you to use in-network doctors and hospitals for full coverage.
• You must have Original Medicare (Parts A and B) to buy a Medigap Select plan; these plans only supplement Medicare, they do not replace it.
• Each state regulates which Medigap Select plans are sold and what they must cover, so available plans vary by location.
• You can switch from a Medigap Select plan to a standard Medigap plan during certain enrollment periods, though you may face medical underwriting if you wait.

How Network Restrictions Affect Your Coverage

The core difference between Medigap Select and standard Medigap is the network requirement. When you see an in-network provider, your Select plan covers its share of the cost just like a standard Medigap plan would. When you see an out-of-network provider, the plan typically covers nothing, and you pay the full bill yourself.

Emergency care is the main exception. If you have a medical emergency and go to an out-of-network hospital or urgent care center, most Medigap Select plans will cover their share of the cost. You should check your plan documents to confirm what counts as an emergency in your specific plan.

The network includes doctors, hospitals, labs, imaging centers, and other providers. Before you enroll, you can ask the insurance company for a list of in-network providers in your area, or you can search online through their provider directory. If your current doctors are not in the network, switching to a Select plan may not make sense for you.

Which Medigap Select Plans Are Available

Medigap Select plans are labeled with letters (Plan A, Plan B, Plan C, Plan D, and so on), just like standard Medigap plans. The letter tells you what benefits the plan covers—for example, Plan G covers the same benefits whether it is a Select plan or a standard plan. The only difference is the network requirement and the monthly cost.

Not all lettered plans are available as Select plans in every state. Some states offer Select versions of Plans A, B, C, and D. Others may offer different combinations. You can contact your state insurance department or call insurance companies directly to find out which Select plans are sold where you live.

The benefits covered by each lettered plan are set by federal law, so a Plan G Select plan covers the same medical services as a Plan G standard plan. The difference is purely in cost and network access. Comparing plans side by side—looking at the monthly premium, the network size, and which doctors you use—is the best way to decide whether a Select plan makes sense for you.

Enrollment Periods and When You Can Buy

You can buy a Medigap Select plan during your Medigap open enrollment period, which begins the month you turn 65 and are enrolled in Medicare Part B. This period lasts for six months. During this time, insurance companies cannot deny you coverage or charge you more based on your health history.

If you miss your open enrollment period, you can still buy a Medigap Select plan outside that window, but the insurance company may require medical underwriting. This means they will review your health history and can deny you, charge you more, or exclude certain conditions from coverage. Some states have additional protections that limit medical underwriting, so rules vary by location.

You can also buy a Medigap Select plan if you are switching from another Medigap plan or from Medicare Advantage. Timing matters: if you switch from Medicare Advantage to Original Medicare, you have a limited window to buy Medigap without medical underwriting. Contact your state insurance department or a Medigap seller to confirm the rules in your state.

Cost Comparison: Select Plans Versus Standard Medigap

Medigap Select plans typically have lower monthly premiums than standard Medigap plans with the same letter designation. For example, a Plan G Select plan might cost $100 per month while a Plan G standard plan costs $140 per month in the same area. The savings come from the network restriction—fewer people use out-of-network care, so the insurance company's costs are lower.

However, the monthly premium is not the only cost to consider. If you regularly see doctors outside the network or travel frequently, you may end up paying more out of pocket with a Select plan than you would with a standard plan. Calculate your total expected costs—premiums plus out-of-pocket expenses—based on the doctors you actually use.

Costs vary significantly by state, by insurance company, and by age. There is no single "average" price for a Medigap Select plan. You can get quotes from multiple insurance companies in your area to compare premiums and network size before you decide.

How to Find and Compare Medigap Select Plans

Start by contacting insurance companies that sell Medigap in your state. You can ask them directly which Select plans they offer, what the monthly premium is, and whether your doctors are in their network. Most companies have online provider directories where you can search by doctor name or location.

Your state insurance department can also provide a list of Medigap sellers and may have educational materials about how Select plans work. Some states publish comparison charts showing which plans are available and which companies sell them. Your local Area Agency on Aging may offer counseling to help you compare plans.

When you compare plans, write down the monthly premium, the network size (how many doctors and hospitals are included), and whether your current providers are in the network. Ask each company about their process for adding new providers to the network and how often the network changes. These details matter more than the premium alone.

Switching Plans and Your Rights

You can switch from a Medigap Select plan to a standard Medigap plan, or from one Select plan to another, during your annual Medigap open enrollment period (which runs from October 15 to December 7 each year). During this window, insurance companies cannot deny you or charge you more based on health history, even if you have developed new medical conditions since you first enrolled.

If you switch outside the open enrollment period, medical underwriting may apply. This means the new insurance company can review your health and potentially deny you or charge you more. Some states have protections that limit this, so check with your state insurance department about your rights.

If you are unhappy with a Select plan because the network is too small or your doctors left the network, you have options. You can wait for the annual open enrollment period to switch to a standard plan, or you can contact your state insurance department to ask about your rights to switch outside the normal period.

Frequently Asked Questions

Can I use my Medigap Select plan when I travel out of state?

Most Medigap Select plans only cover in-network providers within the state where you bought the plan. If you travel frequently or spend part of the year in another state, a standard Medigap plan may be better because it typically works nationwide. Check your plan documents or call your insurance company to confirm the geographic limits of your specific plan.

What happens if an in-network doctor refers me to an out-of-network specialist?

A referral from an in-network doctor does not automatically make an out-of-network specialist covered under a Medigap Select plan. You are responsible for confirming that the specialist is in-network before you go. If you see an out-of-network specialist, you will likely pay the full cost yourself. Always check the network status before scheduling an appointment.

Do Medigap Select plans cover prescription drugs?

No. Medigap Select plans, like all Medigap plans, do not cover prescription drugs. You need a separate Medicare Part D prescription drug plan for that coverage. You can enroll in Part D when you first become may be able to access for Medicare, or during the annual open enrollment period, without penalty if you act on time.

Can I switch from Medicare Advantage to a Medigap Select plan?

Yes, but timing is important. If you switch from Medicare Advantage to Original Medicare, you have a limited window (usually two months) to buy a Medigap plan without medical underwriting. After that window closes, the insurance company can deny you or charge you more based on your health. Contact your state insurance department to confirm the exact timeline in your state.

What if my doctor leaves the network after I enroll?

If your doctor leaves the network, you will need to either find a new in-network doctor or pay out of pocket to continue seeing them. Some Medigap Select plans allow you to switch to a standard Medigap plan outside the normal enrollment period if your doctor leaves the network, but this varies by state. Contact your insurance company or state insurance department to ask about your options.