Medicare Supplement for Couples: How to Choose Plans Together and Save

Spouses make a lot of financial decisions together as a household, and Medicare is no exception. Most married couples enroll in the same Medicare plans. However, this may not be the wisest financial decision, particularly since premiums can range from $2,500 to $4,000 combined annually. You should choose a Medicare Supplement plan based on your household financial needs, your individual health status, and risk tolerance. Choosing the right plan for each of you – instead of the same for both – may save hundreds of dollars a year while offering the best coverage for your personal healthcare needs. Read on to learn more about choosing a Medicare Supplement plan for couples based on our data and insights, or Listen to the Article read aloud below:

How Medigap works for couples: The basics

The employer health plan you’re used to offered one option for the entire household. But each individual must enroll in Medicare Part A and Part B themselves and choose their own Medicare Supplement plan. 

A Medicare supplement policy is offered through different carriers via a plan letter (A, B, C, D, F, G, K, L, M, and N) that corresponds with its health coverage and cost. Each Medicare-eligible person in the household can choose their own letter and insurance carrier. Note: Each spouse’s 6-month Medigap Open Enrollment window is tied to their own Part B start date — it may not align.

Premiums are also individualized. They are based on things like your age, gender, zip code, and tobacco use. Medigap premiums are not based on a combination of a couple’s demographic information as a whole.

How couples choose a supplement: What our data shows

When we looked at current enrollment information for our customers, most couples opt for the same plan letter (12% have different plan letters). This makes sense, since it’s likely the easiest way to choose the same plan. According to our customer database:

• 87.7% of couples choose the same plan letter for both spouses
• 80% use the same carrier,
• 53% of all couples are both on Plan G,
• 23% of couples are both on Plan N,
• 10% of couples are both on Plan F.

Note: This is looking at our current database of customer enrollment through United Medicare Advisors.

The most common “mixed” pairings

Some couples may realize that it fits their budget and health needs better to opt for different plan types. According to our data, these are the most common types of plans chosen when couples don’t have the same one:

Plan G + Plan N is the most common combination. This often reflects different health needs or risk tolerance between spouses. Plan G offers more comprehensive coverage but has higher premiums. With Plan N, you’ll pay small copays, but lower monthly premiums.

Plan F + Plan G is the second most common and often happens when one spouse enrolled in the Medigap policy before 2020, and the other does after. Plan F is no longer available to people who weren’t eligible for Medicare before January 1, 2020.

Here’s what your monthly and annual premiums might look like with various plan combinations.

This chart shows how much can be saved by making small plan changes. For instance:

• Both partners have Plan G – $3,204 per year
• Both Partners have Plan N – $2,529 per year
• Equals a difference of = $675 per year or $56 per month in savings

Strategies to save on Medigap as a couple

As described above, one of the best ways to save on Medigap is for one spouse or both spouses to consider Plan N instead of Plan G. A plan that has higher copays typically saves money in premiums. Opting for Plan N keeps you well covered, with the potential for just a small amount of higher costs throughout the year.

Both plans have the same benefits, but with Plan N you’ll have a small copay — $20 for office visits and $50 for emergency room visits that don’t result in hospital admission. You are also responsible for Part B excess charges. These are fees of up to 15% more than the Medicare-approved amount for treatments. Doctors who treat Medicare patients but don’t accept the Medicare-approved fees for services can include these charges.

Plan N is typically a good choice if you and your partner:

• Are relatively healthy,
• Don’t have major chronic health conditions,
• Don’t require frequent doctor visits,
• Don’t seek out a lot of emergency care.

Mix plan types based on each spouse’s needs

You may be able to save money if one spouse sees the doctor fewer times than the other spouse. The spouse with fewer healthcare needs could opt for a plan with lower premiums and small copays.

For instance, you could choose Plan G if you have higher healthcare needs and Plan N for your spouse if they have fewer needs and save about $262 in premiums over the course of a year for the household (compared to having both people on Plan G).

Use the same carrier for household discounts

Many couples use the same carrier for convenience, but there’s also a financial benefit. Just like home and auto insurers who offer a household discount, a lot of Medigap carriers do, too. Many carriers will offer 5% to 12% off each person’s premium when you both have active policies with them.

According to our data, couples using the same carrier pay an average of $2,961 in premiums each year. Couples with different carriers for that same coverage pay about $3,138 annually – an increase of $177 per year.

Note: It’s important to shop competitively, because a discount on a higher-priced carrier may still cost you more than separate policies from a lower-cost insurer.

Explore high-deductible plans for significant premium savings

Just like you may choose a high deductible for your car insurance to save on premiums, you can do the same with your health insurance. When you do this, though, you’re risking the chance that you may have to pay more healthcare costs during the plan period should you have an accident or get diagnosed with a chronic health condition. This tends to be best for healthy couples who have enough savings to pay deductibles, should they get sick.

Customers enrolled in a Medigap plan through United Medicare Advisors see these kinds of savings:

• Two High-Deductible Plan G premiums for a year average $1,279 – saving $1,925 per year over traditional Plan G.
• But each spouse pays a deductible of about $2,870 in 2027 before the plan covers anything. A bad health year could cost more than $5,700 in healthcare spending to meet the deductibles.

Note: If one spouse tends to have fewer medical visits than the other, you can choose a hybrid – one person on Plan G and the other on the High-Deductible Plan G. This provided premium savings of more than $880 per year to some of our customers while providing a cushion for the partner with high medical bills.

Special considerations for couples

There are a few things to consider when enrolling as a couple, as opposed to choosing a plan for an individual.

Your enrollment windows don’t align

Each spouse’s Medigap Open  Enrollment window is tied to their own Part B start date (a six-month window that begins the first day of the month that you’re at least 65 and enrolled in Part B). If these enrollment periods don’t align, you’ll have to wait until the second partner enrolls and ask about a discount through your carrier.

One spouse has Plan F

Plan F is no longer available to anyone newly eligible for Medicare after 2020, but people who were already on Plan F can keep it. Couples with just one partner ineligible for Plan F, but want similar coverage for both, often choose a Plan F + Plan G pairing. Just remember that Plan F premiums could rise quicker than other plans because the plans don’t have an infusion of younger, healthier people to expand the risk pool.

Remember Part B premiums and IRMAA

When tallying your Medigap plan costs, it’s important to remember the total household Medicare cost. Aside from your Medigap premiums, you’ll also pay each spouse’s Part B monthly premium ($202.90 monthly in 2026).

• A couple on Plan G can anticipate about $8,074 in premiums a year: $4,870 for Part B premiums and $3,204 for Medigap.

Higher-income couples in 2026 may also face Income-Related Monthly Adjustments (IRMAA) – extra charges added to your Part B and Part D premiums. These charges are based on your tax returns from two years ago. If your total modified adjusted gross income was over $218,000 in 2024, it could add between $70 to upwards of $400 per month to your premium costs.

If one spouse passes away

If one spouse passes away, that won’t impact your Medigap policy – plans are sold to people individually. You could, however, lose your household discount. If this happens, talk to your carrier to see how it will impact your costs.

A checklist for couples choosing Medigap

Following is a checklist for couples that can help save money while getting the best coverage for each person when enrolling in a Medigap plan.

1. Understand each spouse’s enrollment period: Medigap Open Enrollment period is a six-month window that begins the first day of the month that you are at least 65 and enrolled in Part B.
2. Discuss your health needs individually — does one spouse need more comprehensive coverage than the other?
3. Decide whether to match plans, which is simpler and done by most couples, or if you can mix plans for potential cost savings.
4. Compare Plan G and Plan N household costs — is the annual savings (around $675 per year for our customers) worth the copays you could face with Plan N?
5. Check if high-deductible plans fit your financial situation. Some of our customers save more than $1,900 a year if they have infrequent doctor visits.
6. Shop carriers together and ask about household discounts on your monthly premiums.
7. Talk to a licensed agent, like those at United Medicare Advisors, who can quote both of you at once.

Next Steps

Remember, when it’s time for one, or both, of you to enroll in Medicare, do your due diligence. Talk with a licensed United Medicare Advisors agent who can help you shop around and compare different plan types for your individual health and financial needs. While it may be easier to enroll in the same plan, switching things up and choosing different Medigap plans could save you hundreds or more a year.

Disclaimer: The insights in this article are based on United Medicare Advisor’s internal enrollment data. This information is provided for educational purposes to illustrate broader Medicare Supplement trends and assist consumers in making informed decisions. It doesn’t represent a complete or exhaustive picture of all Medicare Supplement plans, carriers, or ZIP codes nationwide. Plan availability and costs vary by geographic location. To evaluate all coverage options tailored to your specific healthcare needs and location, work with a licensed insurance agent. United Medicare Advisors is not affiliated with or endorsed by the federal Medicare program or any government agency.