by Russell Noga | Updated May 31st, 2024
If you’re an Original Medicare Part A & B beneficiary, you qualify for supplemental medical cover, also known as “Medigap.” Medigap Plan G is one of the most popular offerings in the range of plans, giving you the most comprehensive cover available to meet the gaps in Medicare Part A & B shortfalls.
You can enroll in Medigap Plan G six months from the day of your 65th birthday. If you leave it longer than this window to enroll, you can still get Plan G, but you’ll have to undergo the medical underwriting procedure.
This means the insurer can deny your application if you have a chronic or pre-existing condition and they feel you’re not worth the risk of insuring. If you enroll in the six-month window, the insurer must accept your application, regardless of your health status.
The coverage offered by Medigap Plan G is extensive, and it covers all the aspects of healthcare that Original Medicare covers, giving you no out-of-pocket costs. This post unpacks everything to do with this cover and what you need to know about Plan G.
How Does Medigap Plan G Work?
Medicare Supplemental Plan G offers you additional insurance coverage to meet the gaps left in the coverage provided by Original Medicare Parts A & B. While Original Medicare is a great way to ensure you don’t land up with hefty medical bills after receiving treatment, it doesn’t cover the entire costs.
Medigap Plan G covers all these shortfalls, ensuring you don’t have any out-of-pocket costs remaining after seeing the doctor, staying at the hospital, or at skilled nursing facilities. With your Medicare Supplement Plan G cover, you’ll have to make a monthly premium and a 20% coinsurance payment on treatment until you reach the Part A & B deductible of $1,600 and $226, respectively.
After you reach the deductible threshold, Plan G activates and takes care of all your inpatient and outpatient medical costs not covered by Original Medicare Parts A & B.
Plan G is available in “high-deductible” and standard options. If you take a high-deductible Plan G, the Part A threshold increases from $1,600 to $2,700 in 2023.
That means you must make a 20% coinsurance payment on your medical expenses until you reach this threshold and Plan G kicks in.
Not all insurers offer the high-deductible Plan G, and it’s unavailable in all states. Contact our team, and we can assist you in finding a high-deductible plan at the best rate if it’s available in your location.
What Does Medicare Supplement Plan G Cover?
Plan G provides you with a supplemental insurance policy to cover the shortfalls in Original Medicare Parts A & B. It covers the Part A deductible, Part B excess fees, hospice services, and the 80% of foreign travel emergency benefits Original Medicare doesn’t cover.
However, it doesn’t cover the Part B deductible of $226 nor preventative treatments and care, such as eye exams, glasses, dental costs, and hearing tests or hearing aids. However, some insurers offer add-on packages to your monthly Plan G premium that cover these costs, leaving you with nothing to pay for your annual healthcare expenses.
Here are the basic coverage benefits available in Plan G.
Benefits Plan G Coverage %
Medicare Part A Deductible ($1,600 in 2023) 100% Coverage
Medicare Part B Deductible ($226 in 2023) Not Covered
Medicare A Coinsurance Costs 100% Coverage
Medicare B Coinsurance Costs 100% Coverage
Skilled Nursing Facility Care 100% Coverage
Part A Hospice Coinsurance 100% Coverage
Part B Excess Charges 100% Coverage
How Much Does Medigap Plan G Cost?
Medigap Plan G is a supplemental insurance plan bolstering your existing Part A & B policies. It’s a Federally-regulated product, meaning you get the same coverage from all private insurers offering Medigap plans.
However, since private insurers sell the policies, they have the right to charge whatever they want for Plan G.
While all companies want to remain competitive and offer Plan G at similar rates, some are more expensive than others with the premium they charge you. For instance, one company may offer Plan G at a higher rate than another, but it might be more expensive than another firm.
The insurer might offer the most affordable premium for Plan G in one state but be the most expensive provider in another.
For this reason, you need an agent to assist you with finding the best quote on your Plan G premium in your state. We’ll help you find the best rate.
Premium costs also vary, depending on personal information. Your age, gender, and smoking history plan a role in your provider setting your premium.
Typically, men will pay higher premium costs than women for Plan G because they present a higher risk for providers to insure.
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Frequently Asked Questions
What is Medicare Supplement Plan G?
Medicare Supplement Plan G is a private insurance policy designed to complement Original Medicare, covering certain out-of-pocket costs not covered by Medicare Part A and Part B.
What does Medicare Supplement Plan G cover?
Medicare Supplement Plan G covers Medicare Part A coinsurance and hospital costs, Part B coinsurance or copayments, hospice care coinsurance, and the first three pints of blood for medical procedures.
Does Medicare Supplement Plan G cover the Medicare Part B deductible?
Yes, Medicare Supplement Plan G covers the Medicare Part B deductible, which is an expense beneficiaries would otherwise have to pay under Original Medicare.
Are there any coverage gaps with Medicare Supplement Plan G?
Medicare Supplement Plan G provides extensive coverage, but it does not cover the Medicare Part B deductible. Once that deductible is met, Plan G covers the remaining Part B costs.
Can I use any doctor or hospital with Medicare Supplement Plan G?
Yes, you can use any doctor or hospital that accepts Medicare assignment, giving you flexibility in choosing healthcare providers.
Does Medicare Supplement Plan G cover foreign travel emergencies?
Yes, Medicare Supplement Plan G provides coverage for foreign travel emergencies, up to a certain limit.
What is the difference between Plan G and Plan F?
Medicare Supplement Plan G covers all the same benefits as Plan F except for the Medicare Part B deductible. Plan F, however, is no longer available to new Medicare beneficiaries.
Is Medicare Supplement Plan G standardized?
Yes, Medicare Supplement Plan G is standardized across different insurance companies, meaning the coverage remains consistent, though premiums may vary.
Can I switch to Medicare Supplement Plan G from another plan?
Yes, you can switch to Medicare Supplement Plan G from another plan, but you may need to go through medical underwriting unless you are within your guaranteed issue rights.
How does Medicare Supplement Plan G affect my prescription drug coverage?
Medicare Supplement Plan G does not include prescription drug coverage. If you want prescription drug coverage, you will need to enroll in a separate Medicare Part D prescription drug plan.
Speak to the Professionals About Medigap Plan G
We understand that some may find understanding what Plan G covers confusing. You can reach out to our office at any time to discuss the details of Plan G, preferred providers, and premium costs.
Our team of experts is available to you at 1-888-891-0229.
Or complete our contact form on this site, and we’ll have a professional agent call you back to discuss your healthcare needs and how we can help. We’re the team you need to source the best premiums for Plan G in your state.
Russell Noga is the CEO and Medicare editor of Medisupps.com. His 15 years of experience in the Medicare insurance market includes being a licensed Medicare insurance broker in all 50 states. He is frequently featured as a featured as a keynote Medicare event speaker, has authored hundreds of Medicare content pages, and hosts the very popular Medisupps.com Medicare Youtube channel. His expertise includes Medicare, Medigap insurance, Medicare Advantage plans, and Medicare Part D.