What is Plan G and What Does it Cover?
Plan G is 1 of 10 standardized Medicare Supplements. It is the most popular plan sold today because it covers all costs except the Part B deductible. And, it is one of two plans with a high deductible option.
We have identified 9 Medicare Plan G pros and cons we think you should know about.
Table of Contents
- Medicare Plan G is supplemental insurance, called Medigap, that works with Original MedicareOriginal Medicare is private fee-for-service health insurance for people on Medicare. It has two parts. Part A is hospital coverage. Part B is medical coverage..
- There are 10 standardized Medigap plans. Plan G is the most popular.
- Medicare Plan G offers the most comprehensive coverage you can get if you turned age 65 on or after January 1, 2020.
- Plan G covers all deductiblesA deductible is an amount a beneficiary must pay for their health care expenses before the health insurance policy begins to pay its share., coinsuranceCoinsurance is a percentage of the total you are required to pay for a medical service. , and copaymentA copayment, also known as a copay, is a set dollar amount you are required to pay for a medical service. out-of-pocket expenses in Orginal Medicare, except the annual Part B deductible.
- For a non-smoking 65-year-old, Medicare Plan G costs between $120 and $140 per month in most areas.
- High Deductible Plan GThe high deductible version of Medicare Supplement Plan G has the same coverage benefits as the regular Medigap Plan G, but you pay all costs until your Medicare-approved costs reach the annual deductible. High Deductible... costs around $50 per month in most areas.
What is Medicare Plan G?
Medicare Plan G is one of ten standardized Medicare Supplement plans. Also known as Medigap, Medicare Supplements are additional insurance you can buy to help pay some of the out-of-pocket costsOut-of-Pocket Costs for Medicare are the remaining costs that are not covered by the beneficiary's health insurance plan. These costs can come from the beneficiary's monthly premiums, deductibles, coinsurance, and copayments. in Original Medicare. Plan G is currently the most popular plan sold. The other lettered plans are A, B, C, D, F, K, L, M, and N.
It’s easy to confuse Medicare Part AMedicare Part A is hospital coverage for Medicare beneficiaries. It covers inpatient care in hospitals and skilled nursing facilities. It also covers limited home healthcare services and hospice care., B, C, and D with Medigap plans. Here’s the difference. Private insurance companies sell plans. Medicare organizes its benefits in parts (i.e., there isn’t a Medicare Part G).
The easiest way to understand what Medigap coverage is used for is to look at a Medigap chart:
Get a Free Medicare Supplement Plan GIf 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 be thinking that Medicare Supplement Plan F is... Rate Comparison
As you can see, only Plan F covers more out-of-pocket costs than Plan G. However, those of us qualifying for Medicare as of 2020 can’t get Plan F or Plan C. Congress passed a law that prohibits plans from covering the Medicare Part BMedicare Part B is medical coverage for people with Original Medicare benefits. It covers doctor visits, preventative care, tests, durable medical equipment, and supplies. Medicare Part B pays 80 percent of most medically necessary healthcare services. deductible. That’s the only difference between Plan F and Plan G.
As a result of Plan F going away, Plan G is the most coverage new beneficiaries can buy. This is why Plan G is the most popular Medigap policy sold and why people compare Medicare Supplement Plan G costs and benefits more than any other plan. Plan G is the best Medicare Supplement plan available to new Medicare beneficiaries.
RELATED: Do I Need Supplemental Insurance If I Have Medicare?
Medicare Plan G Costs
Medicare Plan G costs vary by age, gender, location, and use of tobacco. And, even though all private insurance companies that sell Plan G must provide the same benefits, they get to set their own price. For this reason, the only way to know what a Plan G policy will cost you is to get a quote.
That said, in most areas, Medicare Plan G rates start at around $120 to $140 per month. In some areas, they may cost a little less. But, in high-cost areas, they will cost more.
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What Does Plan G Cover?
Original Medicare, which includes Medicare Part A (hospital coverage) and Medicare Part B (medical coverage), only pays for about 80% of your major medical bills. The remaining 20% is your responsibility.
How you choose to pay your 20% share is up to you. Here are some of the options:
- Directly out of pocket.
- Retiree healthcare benefits.
- Veteran or military TRICARE benefits.
- MedicaidMedicaid is a public health insurance program that provides health care coverage to low-income families and individuals in the United States. benefits.
- Purchase a Medigap plan.
You also have the option to enroll in a Medicare Advantage plan, but generally, these plans have similar, and sometimes higher, out-of-pocket costs than Original Medicare.
RELATED: The True Cost of Medicare Advantage Plans
Medicare Plan G Pays the Part A Deductible and Coinsurance
Inpatient careInpatient care refers to care provided in a hospital or other inpatient facility. Inpatients are admitted and stay at least one night depending on their condition. is the most expensive healthcare coverage in the United States. This is why we pay Medicare taxes during the years we work. The taxes we pay cover the cost of our Part A premiumsA premium is an amount that an insurance policyholder must pay for coverage. Premiums are typically paid on a monthly basis. In the federal Medicare program, there are four different types of premiums. .
However, without additional coverage, our 20% share can be very costly.
Fortunately, the two biggest costs in Medicare, the Part A deductible and the Part A coinsurance are completely covered by a Plan G policy.
How much are these costs? In 2023, the Part A deductible is $1,600 per benefit periodA benefit period is a method used in Original Medicare to measure a beneficiaries use of hospital and skilled nursing facility (SNF) services. With each new benefit period, the beneficiary is charged a new benefit.... You pay this amount every time you are hospitalized unless you are readmitted for the same issue within a 60-day period.
The benefit period deductible covers you for up to 60 days of inpatient care. On the 61st day, you start paying the Part A coinsurance at $400 per day. On day 90 the rate goes up to $800 per day.
Not if you have Plan G. All of those costs, and your skilled nursing facility care after hospitalization, are 100% covered.
Medicare Plan G Covers Blood
If you have an emergency or a planned surgery, and you need blood, you pay for the first three pints. After that, Medicare kicks in and starts paying its share.
And, blood isn’t cheap. It can run as much as $1,500 per pint.
A Medicare Supplement plan G covers your first 3 pints of blood, so you don’t have to worry about it.
Medicare Plan G Covers Doctor Visits, Tests, Diagnostics, Supplies, and DME
As we age, most of us begin using more healthcare services. Some folks age into Medicare with chronic health issues, such as diabetes, hypertension, and other common problems.
With a Medigap Plan G policy, you don’t have to worry about it. It covers all Part B out of pocket expenses except the Part B deductible. You pay the $226 deductible yourself, and then Medicare and your Medigap plan start paying their share.
This is important because the 20% coinsurance on medical bills is costly. And, with Original Medicare and Medigap, there are no restrictions. You can see any doctor or specialist you want, so long as they are approved by Medicare.
And, if your provider adds excess chargesA Medicare Part B excess charge is the difference between a health care provider’s actual charge and Medicare’s approved amount for payment., a Plan G policy covers these, too. Part B excess charges are an additional 15% cost some doctors can add to your bill. If you don’t have a Medigap plan that covers this upcharge, you pay it directly.
What Plan G Does Not Cover
The federal government regulates what Medicare Supplement InsuranceMedicare Supplements are additional insurance policies that Medicare beneficiaries can purchase to cover the gaps in their Original Medicare (Medicare Part A and Medicare Part B) health insurance coverage. can cover. This is why plans are standardized.
In the past, certain Medicare Supplement plans were able to include prescription drug coverage and other extra benefits, just like Medicare Advantage plansMedicare Advantage (MA), also known as Medicare Part C, are health plans from private insurance companies that are available to people eligible for Original Medicare (Medicare Part A and Medicare Part B).. These plans are no longer sold. As a result, if you want dental coverage, prescription drug plan coverage, and other benefits, you need to buy separate coverage.
There is one small exceptionIn a Medicare Part D plan, an exception is a type of prescription drug coverage determination. You must request an exception, and your doctor must send a supporting statement explaining the medical reason for the....
Multiple Medicare Supplement companies offer free gym membership benefits to their members, such as Silver Sneakers. This is most common among health insurance companies, like Humana, that sell both Medicare Advantage plans and Medicare Supplements.
What Makes Plan G the Best Plan?
When it comes to Medicare Supplements, the word “best” is subjective. Best might mean the plan with the most coverage. It could also mean the lowest average premium.
Is it the best plan for you?
It all depends on your health, financial status, and the risk you are willing to take. For example, if you are in excellent health, and you believe you are likely to remain in good health, Medicare Supplement Plan NMedicare Supplemental Plan N is one of the ten standardized Medigap plans. Although it is one of the newest plans available, Medicare Plan N is quickly becoming a favorite with Baby Boomers aging into their... might be a better option.
When you compare Plan N vs. Plan G, you will see that Plan N has a little less Part B coverage, but the monthly premiums are considerably less. But, before you decide, the get average cost of Medicare Supplement plans in your area.
Get a Free Medicare Supplement Plan G Rate Comparison
High Deductible Plan G
Continuing our discussion just above, if you can afford to take a little risk with your coverage, you might want to have a look at High Deductible Plan G (HDG) as an option.
Once you have paid the annual deductible, an HDG plan has the exact same comprehensive coverage as the regular Plan G. This year the high deductible is $2,700. The deductible amount increases every year or two.
This is a good plan to consider if you want to save money on your monthly premium and you can afford to take the risk of the high deductible. There’s a secret to making this plan work for you over the long term.
In most areas of the country, an HDG plan starts at $75 to $90 per month less than a regular Plan G. But by putting the amount saved away every month, savvy savers have the full amount of the high deductible tucked away in just over two years.
Most of the best supplemental insurance companies offer the High Deductible Plan G option, including:
- AARP/United Healthcare
- Mutual of Omaha
This plan works great if you’re healthy. Discuss it with your insurance agent to see if it is a good option for you. Or, ask us for a report on the “Lost-Cost Plans”.
Get a Free High Deductible Medicare Supplement Rate Comparison
Compare Plan G Rates
It isn’t difficult to find an insurance company that offers Plan G. All Medicare Supplement insurance carriers sell this plan.
What is difficult is getting all rates from all companies so you can compare them. That’s why we offer a free Medicare Supplement quoting service.
Most insurance agents won’t provide you with this information. They will show you the rates of the companies they work with. We get it. They are in business to sell you a policy, not to promote the other guy.
MedicareWire is not an insurance agency. We are here to help you. We have no stake in the insurance you choose. That’s why we will provide you with a full report, from all carriers. No strings attached. None!
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Medicare Plan G Pros and Cons
We promised 9 pros and cons on Plan G, and here they are.
Medicare Plan G Pros
- For new beneficiaries, Plan G is the most comprehensive coverage you can buy to cover the gaps in Original Medicare.
- If you buy a Plan G policy when you first qualify for Medicare, you cannot be denied coverage for any reason.
- The only Medicare-approved cost Plan G does not cover is the annual Part B deductible.
- There are no provider networks to worry about. Use any Medicare-approved provider that will see you.
- You do not need a referral from your primary care physician to see a specialist.
- You don’t need pre-authorization to receive Medicare-approved services.
- A Medigap Plan G policy travels with you anywhere you go in the USA and its territories.
- In most cases, you can keep your Medigap Plan G policy if you move (does not include Medicare SELECTMedicare SELECT is a type of Medigap policy (Medicare supplement plan) that requires its members to get their primary care from a contracted provider. Plan G).
- A Plan G policy gives you foreign travel emergency coverage, paying 80% of any medical emergencies you might have outside of the USA.
Medicare Plan G Cons
- Unlike Plan F, Plan G does not offer first-dollar coverage because it does not cover the Part B deductible.
- If you do not buy a Plan G policy while you have a guaranteed issue rightGuaranteed-issue is a right granted to Medicare beneficiaries and applies to Medicare Supplement insurance (aka, Medigap plans). All states and the federal government enforce this essential right, which protects Medicare beneficiaries from medical underwriting., your application can be denied.
- If you buy a Plan G policy when you first qualify, and your carrier jacks up your rates, you may not be able to get a policy with a lower premium from a different carrier.
- A Plan G policy may not be affordable in all areas.
- Plan G policies do not include any extras. To get prescription drug coverage and routine dental care, you will need to buy additional insurance.
- A High-Deductible Plan G policy is affordable, but the annual deductible is too risky for most people.
- Over the long run, a Plan G policy may be too much coverage for a healthy person. Plan N might be a better option.
- Not all doctors accept Medicare, and many that do are not accepting new patients.
- Plan G premiums go up every year. On average, Plan G premiums increase between 6% and 9% per year.
These are just the cons of Plan G. There may be other disadvantages of Medigap plans that we have not mentioned here.
Medicare Plan G Reviews
At last count, there were more than 200 companies offering Medicare Plan G. It would be a daunting task to provide Medicare Supplement reviews on all of these companies.
So, what should you be looking for?
First and foremost, you’ll want to narrow down your options to the companies with the lowest rates, best rate increase history, and good financial strength. We are happy to provide you with this information at no cost (and no spam or phone calls!).
Once you have a short list of carriers, Google them with queries like these:
- “blue cross blue shield medicare supplement plan g reviews”
- “aetna medicare supplement plan g reviews”
- “human plan g reviews”
- “cigna plan g reviews”
- “medco medicare supplement reviews”
- “mutual of omaha plan g reviews”
Be specific, and you will find comments from people who have or have had a Plan G policy from the carrier of interest. Take these reviews with a grain of salt. Most people post negative reviews because they are upset.
How Do I Get Medicare Plan G?
If you are about to sign up for Medicare for the first time, you have a guaranteed issue right to buy the Medicare Supplement policy of your choice. But, you will need to work with a licensed insurance agent in your state.
MedicareWire has teamed with HealthCompare, an Allstate company, to assist you if you don’t already have an insurance agent. You can reach them toll-free at 1-855-728-0510 (TTYT 711).
HealthCompare has licensed agents in all 50 states and works with AARP/United Healthcare, Humana, Aetna, Cigna, Mutual of Omaha, and many of the Blue Cross Blue Shield companies.
You do not need to wait until the annual Medicare open enrollment periodDuring the Medicare Open Enrollment Period, Medicare Advantage and Part D plan members can change, switch, or drop a plan they chose during the Annual Election Period. OEP starts on January 1 and ends on March 31. in the fall. This is a Medicare Advantage enrollment period.
Your next step is to get Medicare Plan G rates in your area. MedicareWire is here to help do that without marketing interference or a sales pitch.
We don’t sell insurance. We are senior advocates. Our service is free.
Frequently Asked Questions
No. Plan G covers everything Medicare Part A and B cover at 100% except for the Part B deductible. This means you won't pay anything out-of-pocket for covered services and treatments after paying the deductible. That said, both Medicare Plan G and Original Medicare do not cover services that are not considered medically necessaryServices or supplies that are needed for the diagnosis or treatment of your medical condition and meet accepted standards of medical practice., including routine dental and vision care. For more information, read 7 Disadvantages of Medigap Plans.
On average, Medicare Plan G costs $132.25 per month for a 65-year-old. You'll often see a range of prices for these plans because each insurance company uses a different pricing (rating) method. MedicareWire offers a free Medigap quoting service with rates from all carriers in your area. For more information, read 7 Disadvantages of Medigap Plans.
Medigap Plan G covers all Medicare Part A and Part B deductibles, copays, and coinsurance, except the Part B deductible. Plan G covers Skilled Nursing and rehab facility stays, as well as HospiceHospice is a special way of caring for people who are terminally ill. Hospice care involves a team-oriented approach that addresses the medical, physical, social, emotional, and spiritual needs of the patient. care. You also won't have to worry about any excess charges, also known as balance billing. For more information, read 7 Disadvantages of Medigap Plans.