- Medicare Supplement (Medigap) Plan J was discontinued on June 1, 2010. People already on the plan may keep it, but no new enrollees are accepted.
- Medicare Supplement (Medigap) Plan J was unique because it had built-in drug coverage, and provided benefits for at-home recovery and preventive services.
- Regulation changes in 2006 and 2010 made these unique benefits obsolete with the creation of Medicare Part D and with Original Medicare now covering at-home recovery and preventive services.
- If you’re on Medigap Plan J, it may be worth noting that premiums typically rise, likely due to the lack of new enrollees. This phenomenon, known as an “insurance death spiral,” can cause premiums to increase year after year. Because of this, some people are switching to other Medigap plans.
- Medicare Supplement (Medigap) Plan G is a similar alternative to Medigap Plan J and it is available for all Medicare enrollees today.
- New state protections—including Delaware’s Birthday Rule (effective January 2026) and Rhode Island’s AEP switching window (effective since 2025)—are making it easier for Medigap Plan J enrollees to switch plans without medical underwriting.
Medicare Supplement (also known as Medigap) Plans are always evolving.
20 years ago, Medigap Plan J was widely popular but today, many people haven’t even heard of it!
That’s because the unique coverage Medicare Supplement Plan J provided became obsolete in 2010, and was discontinued. However, people who were already enrolled in Medigap Plan J were allowed to keep their plan, and a lot of people chose to do this.
In this article, we’ll go over everything you need to know about Medigap Plan J including:
- Everything Medigap Plan J covered,
- Why exactly Medigap Plan J was discontinued,
- Why you may want to switch out of Medigap Plan J if you’re eligible, and
- The alternative plans for Medigap Plan J.
- How the Inflation Reduction Act affects your decision to keep or switch from Medigap Plan J.
We’ve been helping people get out of grandfathered plans for over 14 years.
We’re hoping this article will help you understand everything you need to know about Medigap Plan J.
What is Medicare Supplement Plan J?
Medigap Plan J was a type of Medicare Supplement Plan that people could sign up for to help cover the gaps in Original Medicare. It was considered popular during its time because many people considered it to provide comprehensive coverage.
However, with major changes to Medicare in both 2006 and 2010, Medigap Plan J’s unique coverage became obsolete and the plan was soon discontinued. People already on the plan were permitted to keep it, but no new enrollees were allowed.
People who chose to stay on Medigap Plan J are now generally paying double or even triple for coverage that’s already included in Original Medicare. Medigap Plan J’s costs may also be getting higher every year at a rapid rate because Plan J is now considered to be on an insurance “death spiral.”
But to fully understand that, let’s first take a look at what exactly Medicare Supplement (Medigap) plans are.
What Are Medigap Plans?
Original Medicare (Parts A and B) typically covers roughly 80% of your healthcare costs. One way to cover the remaining 20% is to sign up for a Medicare Supplement (Medigap) plan.
When you sign up for Medicare Part A (hospital coverage) and Medicare Part B (medical coverage), there are still six out-of-pocket costs you have to make aside from the monthly costs.
These are:
- Medicare Part A deductible – In 2026, you pay $1,736 out-of-pocket at the hospital before Medicare Part A starts covering you.
- Hospital copayments – After 60 days in the hospital, you start making copayments. These are $434/day for the 61-90 day range, $868/day for the 91-150 day range (using your 60 lifetime reserve days) and Medicare Part A will stop covering you after 150 days at the hospital.
- Skilled nursing facility copayments – After 20 days at a skilled nursing facility, you’ll start making a $217/day copayment until day 100. After day 100, you pay 100% of the costs.
- Medicare Part B deductible – In 2026, you pay $283 out-of-pocket for medical services before Medicare Part B starts covering you.
- Medicare Part B coinsurances – You generally pay 20% for your medical services.
- Medicare Part B excess charge – Some healthcare providers can charge up to 15% more than the Medicare-approved amount. If they do, you’re responsible for paying this excess charge out-of-pocket.
Medicare Supplement (Medigap) Plans are provided by insurance companies to help you pay for these “gaps” (that’s why they’re called Medigap plans).
Today, there are ten Medigap plans you can choose from – Plan A, B, C, D, F, G, K, L, M, and N. Before June 2010, people could also sign up for Medigap Plan J.
Even though these plans are provided by private insurance companies, Medigap plans are standardized by the government. This means that all Medigap Plan F’s, Plan G’s, or Plan N’s cover the same thing, regardless of which insurance company you get it from.
Now that you know exactly what Medigap Plans are, let’s take a closer look at Medigap Plan J.
What Did Medigap Plan J Cover?
To give you a better idea of what Medigap Plan J covered, let’s compare it to Medigap Plan G, which is the most similar Medigap plan to Medigap Plan J available today. (See the full Medigap plan comparison chart on Medicare.gov.)
| Benefit | Medigap Plan J | Medigap Plan G |
| Medicare Part A coinsurance and hospital costs (up to 365 days after Medicare benefits are used up) | ✅ | ✅ |
| Medicare Part B coinsurance and copayments | ✅ | ✅ |
| Blood transfusion (first three pints) | ✅ | ✅ |
| Medicare Part A hospice care coinsurance and copayments | ✅ | ✅ |
| Skilled nursing facility care coinsurance | ✅ | ✅ |
| Medicare Part A deductible | ✅ | ✅ |
| Medicare Part B deductible | ✅ | ❌ |
| Medicare Part B excess charge | ✅ | ✅ |
| Foreign travel emergencies | ✅ (up to plan limits) | ✅ (up to plan limits) |
| Out-of-pocket limit | ❌ | ❌ |
| At Home Recovery* | ✅ ($1,600/yr) | ❌ |
| Preventive Services* | ✅ ($120/yr) | ❌ |
| Prescription Drugs** | ✅ ($250 deductible) | ❌ |
*Benefits that Original Medicare started covering in 2010
**Benefit phased out in 2006 by the Medicare Prescription Drug, Improvement, and Modernization Act
Many people considered Medigap Plan J as the most comprehensive plan of its time because of all the boxes it checked.
It had higher monthly payments, but it covered all six gaps in Medicare, ensuring that people typically had almost no out-of-pocket costs aside from the drug coverage deductible and the plan’s monthly fee.
Medigap Plan J also included perks for at-home recovery and preventive services, which weren’t covered by Original Medicare before 2010.
It also had a built-in drug plan before the Medicare Prescription Drug, Improvement, and Modernization Act went into effect in 2006, which created Medicare Part D.
What About High-Deductible Medigap Plan J?
Before its discontinuation, Medigap Plan J was also available in a high-deductible format. This operated with the same core principle as modern High-Deductible Plans F and G: you pay all Medicare-covered out-of-pocket costs until a specific annual threshold is met, after which the plan pays 100% of covered benefits.
Even though Medigap Plan J has been discontinued, CMS continues to update the high-deductible amount annually based on the Consumer Price Index. For 2026, the high-deductible amount for legacy Plan J (as well as Plans F and G) is set at $2,950.
This means if you’re still enrolled in a high-deductible Medigap Plan J, your potential out-of-pocket liability (excluding premiums) has nearly doubled since the plan’s inception, when the deductible was only $1,500.
Why is Medigap Plan J No Longer Available?
Medicare regulation changes in 2006 and 2010 meant that Medigap Plan J now provided exactly the same coverage as Medigap Plan F. Therefore, Medigap Plan J was officially discontinued on June 1, 2010.
The changes that affected Medigap Plan J were the creation of Medicare Part D in 2006, and the inclusion of at-home recovery and preventive services to Original Medicare in 2010.
The Creation of Medicare Part D (2006)
Medicare Part D (Medicare’s prescription drug coverage plans) didn’t exist before 2006. That’s one reason Medigap Plan J was widely considered a popular Medigap plan at the time since it was one of the only Medigap plans that offered drug coverage.
However, in 2003, the Medicare Prescription Drug, Improvement, and Modernization Act was passed, which is considered one of the biggest overhauls in Medicare of all time. With it, Medicare Part D was created, and Medigap Plan J’s drug coverage was dissolved.
The Act came into effect on January 1, 2006.
People who had drug coverage through their Medigap Plan J before that time were allowed to keep it. For those who are still on the plan, Medigap Plan J’s drug coverage is still honored.
However, many people prefer Medicare Part D’s prescription drug coverage to Medigap Plan J’s drug coverage. If you are using Medigap Plan J’s drug coverage, be sure to compare them and come to your own decision about what’s right for you.
Original Medicare Includes At-Home Recovery and Preventive Services (2010)
The final nail to Medigap Plan J’s coffin was the Medicare changes in 2010.
Regulation changes meant that Original Medicare now covers in-home recovery (including medical devices) and preventive services (like vaccines and other screening services).
These were the only two differences between Medigap Plan J and Medigap Plan F. So, with Original Medicare now covering in-home recovery and preventive services, both plans now provided exactly the same coverage.
That’s why, on June 1, 2010, Medigap Plan J was officially discontinued. People still on the plan were allowed to keep it. However, no new enrollees can sign up for Medigap Plan J anymore.
Should You Keep or Get Out of Medicare Supplement Plan J (If Eligible)?
If you or a loved one are still enrolled in Medigap Plan J, there are some things you should be aware of.
Aside from paying double for perks already included in Original Medicare, Medigap Plan J may also be on an insurance death spiral. If you’ve noticed your Medigap Plan J monthly payments going up every year, this may be the reason why.
What are Insurance Death Spirals?
Insurance death spirals happen when the amount a plan spends on claims is greater than the income the plan gets from monthly payments. This often happens when a Medigap plan stops accepting new enrollees – and the pool of people enrolled in the plan starts to age and get sick.
Insurance companies rely on the monthly payments of healthy people in a plan to offset the costs for the claims of sick people.
With no new healthy people entering the plan, insurance companies may feel forced to raise the monthly premium significantly to pay for the rising cost of the insured’s treatment.
That’s why people on discontinued plans like Medigap Plan J may experience the monthly payments going up continuously, whereas they may not experience the same thing in a different plan.
What only cost $157 – $211/month in 2010 now typically costs $400 – $650 or more per month in 2026 (and it’s predicted to only get higher).
That’s why if you’re eligible, switching out of Medigap Plan J might save you a lot of money.
How to Switch Out of Medigap Plan J
If you are healthy, you may be able to switch from Medigap Plan J to any other Medigap Plan at any time. You do not have to wait for any Enrollment Period to do this.
One way to do this would be to call a licensed insurance agent. They can help you learn about all the options in your area and get any extra help you may need at no cost to you.
Note: Need help reassessing your Medicare situation? Call or text our team of licensed insurance agents at +1 877-360-6565 (TTY: 771)!
However, keep in mind that you may no longer be eligible to switch from Medigap Plan J to another Medigap Plan if you have a pre-existing health condition.
This is because most Medigap Plans have a medical underwriting process before you can enroll.
When you first enrolled for Medicare Part B, there was a six-month Open Enrollment Period that allowed you to get into a Medigap Plan without this medical underwriting process.
But if you’re enrolled in Medigap Plan J, this Open Enrollment Period should be already long gone. That’s why if you have any health condition, most Medigap companies will reject your application.
However, some states allow you to switch anytime, regardless of your health condition through “Birthday Rules” or other consumer protection laws. (For example, see California’s Medigap regulations.) Here are the states with special switching protections:
| State | Switching Rules |
| CONTINUOUS OPEN ENROLLMENT | |
| Connecticut | Guaranteed enrollment year-round. Any Medigap plan, any carrier. |
| New York | Guaranteed enrollment year-round. Any Medigap plan, any carrier. |
| ANNUAL GUARANTEED ISSUE WINDOWS | |
| Maine | Can switch to Medigap plan with same or lesser coverage without underwriting year-round, if you have continuous coverage (no gaps over 90 days). |
| Massachusetts | Guaranteed enrollment February 1 – March 31 every year. Some carriers offer year-round enrollment. |
| Rhode Island (NEW) | Guaranteed enrollment October 15 – December 7 (Fall AEP). Any Medigap plan. Requires continuous coverage since initial enrollment. |
| BIRTHDAY RULES — ANY CARRIER | |
| California | 60 days from the 1st of the birth month. Any carrier; equal or lesser benefits. |
| Delaware (NEW) | 30 days before/at least 30 days after birthday. Any carrier; same or lesser benefits. Effective January 2026. |
| Idaho | 63 days from birthday. Any carrier; equal or lesser benefits. |
| Maryland | 30 days from birthday. Any carrier; equal or lesser benefits. |
| Nevada | 60 days from the 1st of the birth month. Any carrier; equal or lesser benefits. |
| Oklahoma | 60 days from birthday. Any carrier; equal or lesser benefits. |
| Oregon | 30 days before/30 days after birthday. Any carrier; equal or lesser benefits. |
| Wyoming (NEW) | 63 days from birthday. Any carrier; same or lesser benefits. Effective June 2025. |
| BIRTHDAY RULES — SAME PLAN LETTER, DIFFERENT CARRIER | |
| Indiana (NEW) | 60 days from birthday. Can switch to different carrier, but must keep same plan letter. Effective January 2026. |
| Kentucky | 60 days from birthday. Can switch to different carrier, but must keep same plan letter. |
| Virginia (NEW) | 60 days from birthday. Can switch to different carrier, but must keep same plan letter. Effective July 2025. |
| BIRTHDAY RULES — SAME CARRIER ONLY | |
| Illinois | 45 days from birthday (ages 65-75 only). Must stay with same carrier or affiliate; equal or lesser benefits. |
| Louisiana | 63 days from birthday. Must stay with same carrier or affiliates; equal or lesser benefits. |
| Utah (NEW) | 60 days from birthday. Must stay with same carrier; equal or lesser benefits. Effective May 2025. |
| ANNIVERSARY RULE | |
| Missouri | 30 days before/30 days after your policy anniversary date. Any carrier, but must keep same plan letter. |
| CONDITIONAL YEAR-ROUND SWITCHING | |
| Washington | Year-round if you have 90+ days of coverage. Plan A can only switch to Plan A. Plans B-N can switch to any Plan B-N. |
| ALL OTHER STATES | |
| Other states | You must undergo a medical underwriting process to switch Medigap plans. Approval depends on your health history. |
What This Means for Medigap Plan J Enrollees: Because Medigap Plan J includes more coverage categories than any other standardized plan, it qualifies as ‘greater than’ all modern plans under Birthday Rule regulations. This means Medigap Plan J enrollees, in states with switching protections, can switch to any modern plan they choose…
In Louisiana, Illinois, and Utah, you can only switch to a plan from your current insurance company (or its affiliates).
In all other states, you must undergo medical underwriting before you can change your Medigap plan.
Federal Guaranteed Issue Rights
Even if you don’t live in one of the states above, there are specific federal situations where you may have the right to switch plans regardless of your health history (see Medicare’s Guaranteed Issue Rights guide).
These include:
• Involuntary Loss of Coverage: If your Medigap insurance company goes bankrupt, stops offering your plan in your area, or terminates your coverage through no fault of your own.
• Trial Period Rights: If you dropped your Medigap policy to join a Medicare Advantage plan for the first time and decide to leave within 12 months, you have the right to return to your exact same Medigap plan with the same insurance company (if still offered).
If your original plan is no longer available, you are guaranteed the right to purchase Plans A, B, C*, D, F*, G, K, or L from any insurance company in your state. (*Plans C and F are only available if you became Medicare-eligible before January 1, 2020.)
• Insurer Misconduct: If the insurer materially misled you or committed fraud in connection with your policy, federal law may grant a guaranteed issue window to switch carriers.
• Loss of Employer Coverage: If your employer-sponsored retiree health plan that supplements Medicare is involuntarily terminated or stops paying benefits.
Important: You must apply for a new Medigap policy no more than 63 days after your previous coverage ends to preserve your guaranteed issue rights. Keep copies of all termination notices as proof.
Popular Alternatives to Medigap Plan J
If you’re healthy, or you live in one of the states mentioned above, here are your other coverage options:
Medigap Plan G – Medigap Plan G is considered a popular alternative for Medigap Plan J today. For someone turning 65, it has an average cost of roughly $150 – $300/month depending on the state you live in, according to Medicare.gov. Aside from Medigap Plan J’s perks that are now obsolete, the only difference between Medigap Plans J and G is that Medigap Plan G doesn’t cover the Medicare Part B deductible (which is $283 in 2026). Plan G covers 100% of Part B excess charges and has no copays at the doctor’s office or emergency room. Because Plan G is open to all new Medicare enrollees, it benefits from a growing risk pool, which generally results in more predictable premium increases compared to closed plans like J or F.
Medigap Plan N – Medigap Plan N has less coverage than Medigap Plan G but also typically has lower monthly payments with a rough average of $80 – $250/month. (We sifted through all the numbers so you don’t have to.) Aside from the Medicare Part B deductible, Medigap Plan N also doesn’t cover the Medicare Part B excess charge and has a copay (up to $20) for office visits and ER visits (up to $50). Because Plan N requires you to pay a small copay when you visit the doctor or ER, it tends to keep monthly premiums lower and more stable over time.
Medicare Advantage Plans – Medicare Advantage Plans are different from Medigap Plans. They are provided by private insurance companies, and they aren’t standardized – so insurance companies can offer as much or as little coverage as they want. Medicare Advantage Plans usually offer low to $0 premiums. They also typically partner up with local hospitals and doctors in your area to provide low-cost healthcare within their network.
Conclusion: Medicare’s Ever-Evolving Nature
Medicare is always changing, and Medigap Plan J is an example of this.
From one of the most popular plans 20 years ago, to most people not knowing it today, Medigap Plan J shows us that Medicare can change very fast.
If you’re not aware of these changes, you can end up spending a LOT more than you have to. People who are still on Medigap Plan J today are likely spending hundreds of dollars unnecessarily to keep their grandfathered plan.
That’s why Medicare education is critical!
Hopefully this article has cleared up any questions you might have had about Medigap Plan J.
If you have any more questions, or if you need help finding the best plan fit for you, call or text our team of licensed insurance agents today. Our services are no cost to you and we’re happy to help!