Does Plan G Cover Medicare Deductible?

Over the course of your entire working life, you have paid into Medicare. Now that you’re 65, you’re ready to take advantage of the federally-sponsored health insurance program that you’ve helped to fund. While Medicare does cover a large portion of health-related expenses, it doesn’t cover everything, and you’re required to pay for what it doesn’t cover. One of the out-of-pocket expenses that you’re responsible for is the deductible.

Medigap insurance – supplemental insurance that you can purchase to cover the “gaps” in Medicare coverage – can help pay for some of the out-of-pocket expenses. There are a total of 10 Medicare Supplemental Insurance plans available. For new Medicare enrollees, Plan G is one of the most comprehensive, meaning that it provides the most coverage for the costs that Medicare doesn’t cover. But does it cover the deductible? Let’s take a closer look.

Before your healthcare plan kicks in and covers the expenses that your insurance provides, you’ll need to pay a pre-determined amount of money yourself. That pre-determined amount of money is known as a deductible. All health insurance plans have a deductible, including Medicare.

To illustrate, if your annual deductible for Medicare is $100, you have to pay for the initial $100 for health-related services or products that you receive yourself. Once the deductible is paid, Medicare will pay for a percentage of the expenses that are related to the services and products that your plan provides for the remainder of the year.

Both parts of Original Medicare – Part A and Part B – have a deductible. The following is an overview of this out-of-pocket expense for each part.

Medicare Part A Deductible

Part A of Original Medicare covers the cost of inpatient care that you receive, such as hospitals and skilled nursing facilities. The deductible for Part A is unique because, unlike deductibles for other health insurance plans (including other Medicare plans), it doesn’t operate on an annual basis; rather, it functions on the basis of a benefit period. This period starts on the day that you are admitted as an inpatient at a medical facility and it stops when 60 consecutive days that you have not received care in an inpatient setting have gone by.

Given the way the benefit period for Part A works, if you are admitted to a facility as an inpatient several times over the course of a year, you could potentially have several benefit periods. In that case, you would need to reach the full cost of the deductible for each new benefit period. The Part A per benefit period in 2023 is $1,600. If you were to receive treatment in a hospital as an inpatient, you would have to pay $1,600 out of your own pocket before Medicare Part A will kick in. If you are admitted to the hospital again a minimum of 60 days after the previous benefit period has concluded, a new benefit period will start and you would, again, need to pay another $1,600 before Medicare Part A will kick in

Medicare Part B Deductible

Medicare Part B covers a portion of the cost of medical care that you receive as an outpatient; doctor visits, outpatient surgeries, rehab, and preventative treatments, for example. Like Part A, Part B also has a deductible that you are responsible for paying before your coverage kicks in; however, the deductible for Part B resets on January 1 each year, so you only need to pay it once a year. Once you have met the Part B deductible, you will only be responsible for paying a 20 percent copay for any other covered services during the course of the year.

In 2023, the yearly deductible for Part B is $226, which is $7 less than the previous year. To reiterate, you are responsible for paying the full amount before Part B kicks in.

With Medicare Supplement Plans, you’ll be able to find the most affordable rates on supplemental Medicare insurance, including Plan G. To start looking for quotes, simply fill out the form on this page or call 1-888-891-0229 and one of our licensed agents will be more than happy to assist you.