Medicare Supplement (Medigap) Plan G

by David Bynon, last updated

If you’re turning age 65 this year, Medicare Supplement Plan G is the most comprehensive Medicare supplement you can buy. It’s also the most popular. You might think that Medicare Supplement Plan F is the best, but that’s only true if you turn 65 before 2020.

Here’s why.

Medicare Plan G, sometimes mistakenly called Medicare Part G and Plan G Medicare, has coverage that’s very similar to Medicare Plan F. In one way it’s actually more economical than Plan F, especially for beneficiaries who don’t mind paying the Medicare Part B annual deductible themselves. In fact, this deductible, which is less than $200 per year, is the only difference between Plan G and F. Here’s how it works.

With a Plan F policy, you pay a higher monthly premium but your Medigap plan pays all costs. With a Plan G policy get a lower monthly premium but pay the deductible out-of-pocket. After that, you get full coverage on all of the gaps in your Original Medicare coverage, just like you do with Plan F.

A Medigap Plan G policy pays all of your hospital deductibles, coinsurance, and copays. It also covers the 20% copays that Medicare Part B doesn’t cover, including excess charges.

What Does Medicare Supplement Plan G Cover: Infographic

What Does Medicare Supplement Plan G Cover?

Medicare Supplement Plan G covers all the gaps in Medicare except for your Medicare Part B deductible. This is the amount you payout-of-pocket to see your doctor before Medicare starts paying its share, which is $198 per year (2020 rate).

There are 9 major gaps in Original Medicare coverage:

  1. Medicare Part A Coinsurance & Hospital Costs
  2. Medicare Part A Skilled Nursing Facility Coinsurance
  3. Medicare Part A Deductible
  4. Medicare Part A Hospice Care Coinsurance or Copayment
  5. Medicare Part B Deductible (<== annual cost not covered by Plan G)
  6. Medicare Part B Coinsurance or Copayment
  7. Medicare Part B Excess Charges
  8. Blood (first 3 pints)
  9. Foreign Travel Emergency

Plan G covers everything listed above, except item 5, the Part B deductible. For most people, this is the most insignificant cost in Original Medicare.

What Does Medicare Plan G Cover that Advantage Does Not?

Many people are surprised to learn that they have more out-of-pocket costs with a Medicare Advantage plan than they do with a Medicare Supplement Plan G. The reason for this is simple. With Medigap Plan G you pay most costs in advance (the monthly premium). However, with an Advantage plan, you pay the most costs (i.e., copays) when you use health care services. That’s the hidden “gotcha” with Advantage plans.

When you have a Plan G policy, it covers your share of all Medicare-approved healthcare services, except for your outpatient deductible. So, for the convenience of a single monthly premium, you’re fully covered for all of your major medical expenses once you’ve paid the $198 deductible (2020 rate).

With Medicare Advantage, it’s not so simple. First, you may or may not have a monthly premium. Most areas have one or more basic plans with a zero-dollar premium. However, you still make copayments when you use in-network healthcare services. In other words, when you see your doctor, there’s a copay. When you go to the emergency room, there’s a bigger copay. And, when you’re admitted into the hospital or need skilled nursing care, hold on tight, because those are big copays. The average Medicare Advantage plan copay is about $275 per day for the first 5 days.

With Medicare Plan G, you don’t worry about any of that copay nonsense, because it’s all taken care of for you. Plan G helps cover all of your major inpatient hospital costs, such as blood transfusions, skilled nursing, and hospice care. Plus, it covers your outpatient medical services, including doctor visits, lab work, x-rays, ambulance, surgeries, diabetic supplies, durable medical equipment, and a whole lot more.

Plus, you never have to get permission to see a specialist. In fact, you are free to use any healthcare provider you want, so long as they accept Medicare. When you see your doctor or use the hospital, Medicare pays first, then your Plan G pays all the rest after you pay your annual deductible. And, Plan G offers its beneficiaries up to $50,000 in foreign travel emergency benefits. You can’t get that with an Advantage plan.

Medicare Plan F vs. G: Big Savings with a Small Deductible

In many areas of the country, the difference in the monthly premium between a Medicare Supplement Plan G and Plan F is about 15%, resulting in savings upwards of $300 per year for Plan G policyholders. For people with a chronic condition or two, there isn’t much of a year-end cost difference. However, for healthy people who rarely see their doctor, the savings really add up. Here’s why.

Medicare Part B covers 100% of most preventive services, such as screenings, vaccines, and counseling. As a result, if you’re healthy you can see your doctor for your annual screenings and vaccines and pay nothing out-of-pocket, not even your Part B deductible. So, for every five years that you stay healthy, you save $1,500 as compared to people who buy a Plan F policy.

If you do come down with a chronic condition that requires regular care or have an inpatient stay, Plan G has great coverage.  Remember, for all inpatient stays, it covers all your hospital expenses, including the big hospital deductible, which is more than $1,400 per benefit period.

For your outpatient care, Medicare Plan G pays everything except the first $198. This is the Part B deductible that will pay yourself each year. Once you’ve met the deductible, Medicare Supplement G pays all of your remaining costs. Medicare pays the first 80% of your outpatient expenses and your Medigap plan pays the remaining 20%.

If you are just starting your research into Medicare supplements, you might also read what Medicare covers, before you choose which supplemental coverage is right for you.

If you want to know which companies offer the best Medicare Plan G policies (i.e., lowest premium and fewest rate increases), you can ask for a free Medigap plan rate analysis report.

Medicare Plan G: Best Coverage for Diabetics

More than 25% of American seniors have diabetes (diagnosed and undiagnosed). It is the epidemic of our times, and the treatment costs are staggering. An estimated 1.5 million Americans are diagnosed with diabetes every year. If you’re turning age 65 and you’re diabetic or prediabetic, you can keep more money in your pocket with Medicare Supplement Plan G.

Here’s how it works.

Most type 2 diabetics see their endocrinologist several times a year to have their A1C checked and to renew their prescriptions. After each office visit, the specialist bills Medicare, which pays 80%. If it’s the first visit of the year, Medicare sends the remaining 20% to the Medigap plan, minus the annual $198 outpatient deductible, which is billed to you. After that, all of the endocrinologist bills are paid completely by Medicare and the Medigap plan.

For the rest of the year, you pay nothing out of pocket for all Medicare-covered Part A and B services. Your only other cost to manage your diabetes is for your prescription drug, which is covered by your Medicare Part D plan. Medicare and your Medigap plan even pay the cost of your diabetic supplies, including:

  • Blood sugar (glucose) test strips
  • Blood glucose monitors, lancet devices, and lancets
  • Glucose control solutions for checking the accuracy of test strips and monitors
  • Insulin if you are using a medically necessary insulin pump (see below)
  • Therapeutic shoes or inserts

All of these diabetic supplies are covered by Medicare Part B, which means Medicare Supplement Plan G covers them, too.

This means you don’t have any more copays for doctor visits, lab work, or imaging. Plus, if you need inpatient care, for diabetic surgery as an example, Medicare covers 80% and your Plan G covers the rest. Be aware, however, that Original Medicare does not cover these diabetic supplies:

  • Insulin (unless used with an insulin pump)
  • Insulin pens, syringes, or needles
  • Alcohol swabs or gauze

If you have Medicare prescription drug coverage (Part D), insulin and certain medical supplies used to inject insulin are covered by your Part D plan.

Medicare Plag G: Amazing Coverage for COPD

COPD (chronic obstructive pulmonary disease) is the third-leading cause of death in America. It’s an incurable inflammatory lung disease that causes the obstruction of airflow from the lungs. Many people may have the disease and don’t realize it. And, even though there’s no cure, COPD is treatable and Original Medicare plus a Medigap Part G cover most of the costs.

Two conditions commonly contribute to COPD, emphysema and chronic bronchitis. With emphysema, your lungs are damaged and are unable to take in as much oxygen. When you have chronic bronchitis, the lining of your lungs thickens with mucus, making it more difficult to breathe. In both forms of COPD, you struggle to get oxygen into your lungs and your lungs struggle to get it out to your body. As a result, COPD patients need lots of medical care.

Common treatments for COPD include smoking cessation therapy, medications, oxygen therapy, and pulmonary rehabilitation. Medicare helps cover many of these treatments.

Medicare Part B covers the cost of smoking cessation at no extra cost. Oxygen therapy and pulmonary rehabilitation are generally available as a Medicare-covered Part B service, so long as your doctor says they’re medically necessary. That means that these treatments are covered 100% by Medicare and a Medigap Part G plan after you have paid the annual Part B deductible. Plus, expensive medications, such as a bronchodilator, are covered if you have Medicare Part D prescription drug coverage.

If your doctor prescribes oxygen therapy, you’ll need durable medical equipment. Fortunately, oxygen pumps are covered under Medicare Part B, so a Medigap Plan G covers the 20% that you’d normally pay out-of-pocket. Medicare won’t pay for a portable oxygen concentrator, but it does cover the monthly rental of portable oxygen equipment.

Without comprehensive coverage, as you get with a Plan G policy, paying for COPD treatment would be very costly. Plan G protects you from these costs by working together with your Original Medicare benefits to pay the bills.

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