Medigap (Medicare Supplement) plans are designed to fill the cost-sharing gaps in Original Medicare — deductibles, coinsurance, and copays. But they do not expand what Medicare covers. If Medicare doesn't cover a service, Medigap won't either.
This page covers 55 specific items and services across 12 categories that are excluded from both Medicare and Medigap coverage, along with typical costs and alternatives.
The Core Rule
Medigap pays your share of Medicare-covered services — it does not add new covered services. If Original Medicare (Part A or Part B) doesn't cover something, no Medigap plan will cover it either. The only exception is foreign travel emergency coverage, which some Medigap plans add as an extra benefit.
| Category | Medicare Covers? | Medigap Covers? | Alternative |
|---|---|---|---|
| Long-term / custodial care | No | No | Long-term care insurance, Medicaid |
| Dental (routine) | No | No | Dental insurance, discount plans |
| Vision (routine exams & glasses) | No | No | Vision insurance, discount retailers |
| Hearing aids | No | No | OTC hearing aids, Medicare Advantage |
| Outpatient prescription drugs | No | No | Medicare Part D |
| Cosmetic surgery (elective) | No | No | Self-pay, medical financing |
| Massage therapy | No | No | Physical therapy (if covered) |
| Foreign travel emergency care | No | Plans C/D/F/G/M/N: Yes (80%, $50K limit) | Travel insurance |
| Private room in hospital | Only if medically necessary | Only if Medicare covers it | Pay out-of-pocket or document necessity |
| Routine foot care | Only with diabetes/neuropathy | Only if Medicare covers it | Podiatry discount programs |
| Incontinence pads | No | No | Medicaid, Medicare Advantage OTC benefit |
| Concierge medicine fees | No | No | Self-pay |
The Biggest Financial Risk: Long-Term Care
The average nursing home costs $90,000–$110,000 per year for a semi-private room. Medicare covers skilled nursing care for up to 100 days per benefit period — but only when skilled care is needed. Once you only need help with daily activities (bathing, dressing, eating), Medicare stops paying. Medigap does not fill this gap. This is the most common reason Medicare patients exhaust their savings.
Click any category to expand. Each item shows typical out-of-pocket costs and what you can do instead.
Medigap plans (especially Plan G and Plan N) are excellent at covering the cost-sharing gaps within Original Medicare:
Note: Plan G does not cover the Part B deductible ($257 in 2026). Plan N has copays up to $20 for office visits and $50 for ER visits.
SHIP (State Health Insurance Assistance Program)
Free, unbiased counseling on Medicare coverage and supplement options
Medicare.gov Coverage Finder
Look up whether Medicare covers any specific test, item, or service
BenefitsCheckUp (NCOA)
Find programs that help pay for dental, vision, hearing, and other non-covered services