by Russell Noga | Updated October 31st, 2023
What is Medicare Part G?
Medicare Part G Plan (also known as Medigap Plan G) is the most popular Medicare Supplement Insurance plan. That’s because this plan offers the most coverage for new Medicare members, including certain costs, like copayments, deductibles, coinsurance, and other expenses that aren’t covered by Original Medicare (or Medicare Part A and Part B).
While Plan G does provide a lot more coverage than other Medicare Supplement Insurance plans, the additional coverage does come at a price, as it’s also one of the most expensive plans; however, we’ll show you how to find the lowest rates easily.
Read on to find out what you need to know about Medigap Plan G to determine if it’s the right option for you.
What Does Medicare Part G Cover?
In order to understand what Medigap Plan G is, it’s first important to understand what Medicare is and how it works. Medicare is a health insurance plan that is sponsored by the federal government. It is intended for people who are aged 65 and older, though individuals who have been diagnosed with specific health conditions and are younger than 65 may also qualify.
Original Medicare consists of two parts:
· Part A. Covers the cost of hospital inpatient, skilled nursing facility, and hospice care.
· Part B. Covers the cost of outpatient care, such as doctor visits and preventative services
Patients are responsible for the deductibles, copayments, and coinsurance that are associated with Medicare Part A and B. Medicare Supplement Insurance (also known as Medigap) covers the cost of any “gaps” that Medicare doesn’t cover; the out-of-pocket expenses that Medicare Part A and B don’t cover. There are several different types of Medigap plans, and Plan G covers more out-of-pocket expenses than any other type of Medicare Supplement Insurance.
Medicare Plan G Benefits
As per Medicare.gov, Medicare Plan G covers the following:
Part A Out-of-Pocket Expenses
· Coinsurance and hospital expenses (up to an extra 365 days after standard Medicare benefits expire)
· Hospice care coinsurance and copayment
Part B Out-of-Pocket Expenses
· Coinsurance or copayment
· Excess charges (in the event that providers are allowed to charge more than the amount Medicare approved and the provider actually charges that amount)
Other Out-of-Pocket Expenses
· Blood transfusions for medical procedures, up to 3 pints per year
· Coinsurance for skilled nursing facility care
· Up to 80 percent of emergency health care that is deemed medically necessary while traveling outside of the United States, up to the plan’s limits
What Medicare Plan G Doesn’t Cover
While Medigap Plan G does provide coverage for a lot of the out-of-pocket expenses that Medicare Part A and Part B don’t cover, this supplemental insurance plan does not cover the following:
· Medicare Part B deductible
· Prescription medications
· Long-term care; non-skilled assistance provided in nursing home settings, for example
· Private-duty nursing care
· Vision care, including corrective lenses
· Dental care
Who is Eligible for Medicare Supplement Plan G Insurance?
New Medicare members can purchase Plan G for the first time within the 6-month period that starts the month before they turn 65, known as the open enrollment period.
6-Month Medigap Open Enrollment Period
Since your health and medical history cannot be taken into consideration when determining the premiums, it is more affordable and easier to purchase Medigap coverage during the open enrollment period.
Once this 6-month period ends, the costs may be higher or coverage may be denied as a result of your medical history and the current status of your health. You must sign up for Original Medicare, or Medicare Parts A and B, in order to purchase Medigap Plan G.
If you already have a Medicare Supplement plan, you can file an application to switch your carrier or your Medicap plan letter at any time. You can save money if you switch your carrier, so if you already have Medicare Plan G (or especially if you have a Plan F), reviewing the different options that are available to you each year is highly recommended.
How Medicare Plan G Works
As previously stated, you must be enrolled in Original Medicare in order to purchase Medigap Plan G. Once you are enrolled, you can purchase Medicare Part G from a private insurance company that offers this Medicare Supplemental Insurance plan and that serves your geographic location.
After purchasing Medigap Plan G, the manner in which this supplemental insurance coverage works is relatively simple and straightforward. The following is an overview of how Part G works:
· You pay the premium for your Medicare Part B insurance. Note: If you receive benefits from Social Security, the Office of Personnel Management, or the Railroad Retirement Board, your premium will be deducted from your benefit payment automatically.
· You pay a monthly premium for your Medicare Plan G coverage.
· When you receive a healthcare service that is covered by Original Medicare, Medicare will pay the approved amount.
· Medigap Plan G will cover the out-of-pocket expenses that your policy covers.
How Much Does Medicare Plan G Cost?
Medigap Plan G is only available through private health insurance companies, and the companies that sell the coverage set the premiums.
Prices vary and several factors affect premiums; the company you purchase the policy from, your geographic location, your sex, and whether or not you use tobacco products, for example.
Compare Plan G Rates in Your Area
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There is no obligation to use our FREE online quote engine to compare rates for Medicare Plan G in your area. Medicare Supplement plans are standardized, meaning each company offers the exact same plans and benefits.
The monthly rates between each company can and often do vary widely, however.
That’s why it’s important to compare rates from all the top companies, as there is no reason to pay anymore than you should for Plan G or any Medigap plan.
What is Medicare Supplement Plan G?
Medicare Supplement Plan G is a type of Medigap insurance policy designed to help cover the out-of-pocket costs not covered by Original Medicare (Part A and Part B). Plan G provides comprehensive coverage, including the Part A deductible, Part B excess charges, and foreign travel emergency care, with the exception of the Part B deductible.
How does Plan G differ from other Medicare Supplement plans?
Plan G offers one of the most extensive coverages among Medigap plans, similar to Plan F. The primary difference between Plan G and Plan F is that Plan G does not cover the Medicare Part B deductible. Plan G is often considered a more cost-effective option due to its lower premiums compared to Plan F.
Who is eligible for Medicare Supplement Plan G?
Individuals who are enrolled in Original Medicare (Part A and Part B) and are 65 years or older are eligible for Medicare Supplement Plan G. In some states, Plan G may also be available to individuals under 65 with specific disabilities or health conditions.
When can I enroll in Plan G?
The best time to enroll in Plan G is during your Medigap Open Enrollment Period (OEP), which starts on the first day of the month you turn 65 and are enrolled in Medicare Part B. During the OEP, you have a six-month window to purchase a Medigap policy without medical underwriting or being denied coverage due to pre-existing conditions.
How much does Medicare Supplement Plan G cost?
Plan G premiums vary by provider, location, age, and other factors. It is essential to compare multiple insurance carriers to find the most affordable and suitable option for your needs. On average, Plan G premiums range between $100 and $200 per month.
Are prescription drug costs covered under Plan G?
No, Medicare Supplement Plan G does not provide prescription drug coverage. To obtain coverage for prescription medications, you need to enroll in a separate Medicare Part D prescription drug plan.
Can I switch from another Medigap plan to Plan G?
Yes, you can switch from another Medigap plan to Plan G. However, outside of your OEP or other specific enrollment periods, you may be subject to medical underwriting and potentially be denied coverage or charged higher premiums based on your health status.
Does Plan G cover dental, vision, or hearing services?
Medicare Supplement Plan G does not cover routine dental, vision, or hearing services. To obtain coverage for these services, you may need to enroll in a standalone plan or consider a Medicare Advantage plan that includes these benefits.
Is Plan G affected by the MACRA legislation?
The Medicare Access and CHIP Reauthorization Act (MACRA) changed Medigap plans, prohibiting the sale of plans covering the Part B deductible to newly eligible Medicare beneficiaries starting on January 1, 2020. Since Plan G does not cover the Part B deductible, it remains available for both new and existing Medicare beneficiaries.
Can my spouse and I share a Medicare Supplement Plan G policy?
No, Medicare Supplement policies, including Plan G, are individual policies. Each person must have their own separate policy. However, some insurance carriers may offer a household discount if both spouses enroll in the same Medigap plan with the same insurance company.
Shop for Medicare Part G the Easiest Way
Whether you are a new Medicare member or you already have a Medigap plan and you’re thinking about switching supplement plans to save money, we can help.
In fact, we’re one of the only companies that will let you view rates before buying!
To view quotes, just enter your zip code above.
Or, If you have questions or you would like to request a quote over the phone, simply give us a call at 1-888-891-0229 and one of our knowledgeable and friendly licensed agents will be happy to answer all of your questions and assist you with all of your needs.
Russell Noga is the CEO of Medisupps.com, an online Medicare Agency and resource center helping Medicare beneficiaries learn about Medicare, Medigap and Part D drug plans, and Medicare Advantage plans since 2009. Russell is licensed in all 50 states and has been featured as a keynote speaker, and author of several publications, along with hosting the very popular Medisupps.com Youtube channel.