Protect Your Medicare Rights.

When you first enroll in Medicare Part B, federal law gives you a six-month window during which private insurers must sell you any Medigap policy — including Plan G — without asking a single question about your health history. They cannot charge you more for pre-existing conditions, and they cannot deny you.

After that window closes, insurers in most states can use medical underwriting. That means they can review your health history, charge higher premiums based on your conditions, or decline to cover you at all. The window exists precisely because Congress recognized that people need a protected entry point into Medigap — but it only works if you know about it and use it in time.

The $0 premium refers only to the monthly amount you pay directly to the insurer. It does not mean the plan is free. The federal government pays private insurance companies a fixed monthly subsidy — set by CMS — for every Medicare beneficiary they enroll. That payment model means insurers are compensated per enrollee regardless of how much care you actually use.

Insurers use a portion of that subsidy to fund extras like gym memberships or basic dental, which are the benefits most prominently advertised. The trade-off is that Advantage plans use private networks, require prior authorization for many procedures, and have out-of-pocket maximums that can reach $9,350 or higher in-network — and up to $14,000 out-of-network for PPO plans. The $0 premium is real. The "free" framing is not.

The Trial Right is a federal consumer protection that applies specifically to people who enrolled in Medicare Advantage when they first became eligible for Medicare. If that describes you, you have exactly 365 days from your Advantage plan's start date to change course.

During that window, you can drop the Advantage plan, return to Original Medicare, and buy a Medigap plan — with guaranteed approval, no health questions. After the window closes, this specific right expires. You can still switch plans during the Annual Enrollment Period (October 15 – December 7), but the guaranteed-issue Medigap right does not apply. Use the calculator above to find your exact deadline.

The federal government standardizes Medigap benefits — a Plan G sold in Texas covers the same bills as a Plan G sold in Maine. What it does not standardize is the premium. Private insurers set premiums based on local factors: average hospital costs in your county, local cost of living, and the competitive landscape in your market.

High-cost metropolitan areas generally have higher baseline premiums than rural markets. Insurers also use different rating methods — some charge everyone the same rate regardless of age (community-rated), some increase premiums as you age (age-attained), and some set your premium based on your age when you first enrolled (issue-age). The rating method matters as much as the initial premium when projecting long-term costs.

Both plans cover hospital coinsurance, the Part A deductible, skilled nursing facility coinsurance, and foreign travel emergency care. The difference is in how you pay for routine outpatient care.

Plan G covers everything after the annual Part B deductible ($257 in 2026) — no copays for doctor visits, no coinsurance, and no exposure to Medicare excess charges. Plan N has a lower monthly premium — typically $30–$60 less than Plan G — but charges up to $20 per doctor visit and up to $50 per ER visit. Plan N also does not cover excess charges, which are fees some providers charge above the Medicare-approved rate. Use the break-even calculator above to see which plan costs less based on how often you use healthcare.

Yes — through omission. Agents are legally prohibited from making false statements, but they are not required to proactively explain multi-year financial risks, the 12-Month Trial Right, or state birthday rules during a sales conversation. The regulatory framework governs what agents cannot say, not what they are obligated to cover.

Because Medicare Advantage plans typically pay higher upfront commissions and ongoing renewal commissions than Medigap plans, agents who work on commission have a structural incentive to focus on Advantage enrollment. That does not make every agent acting in bad faith — many are genuinely helpful. But it does mean the information you receive in a sales context is shaped by the compensation structure of the person delivering it. The Clearing exists specifically to fill that gap.