Plan G is one of 10 Medigap plans and one of only two supplemental plans with a high deductible option. It covers all out-of-pocket costs, except the Part B deductible, and works seamlessly with Original Medicare coverage.
We have identified 9 Medicare Supplement Plan G pros and cons we think you should know about.
Table of Contents
What is Medicare Supplement 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 out-of-pocket costs 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. All of these plans work with Original Medicare insurance. They are not compatible with Medicare Advantage.
It’s easy to confuse Medicare Part A, B, C, and D with the lettered Medigap policies. Here’s the difference. Private insurance companies sell plans. The federal Medicare program organizes Medicare benefits in parts. So, if you hear someone say “Part G,” they are talking about a Medigap Plan G policy.
How Does Plan G Work?
Medigap plans do not offer additional benefits like Medicare Advantage plans. Instead, they help cover the out-of-pocket costs in Original Medicare.
For example, your hospital insurance, Medicare Part A, has a big deductible. It’s $1,600 per benefit period. A Plan G policy covers this cost for you.
Similarly, when you see your doctor, need emergency care, or require other outpatient services covered by Medicare Part B, there’s a 20% coinsurance. A Plan G policy covers the Part B coinsurance once you’ve reached the annual Part B deductible.
The easiest way to understand what Medigap coverage is used for is to look at a Medigap chart:
As you can see, only Medicare Supplement Plan F covers more out-of-pocket costs than Plan G. However, those qualifying for Medicare as of 2020 can’t get Plan F or Plan C. Congress passed a law prohibiting new Plan F and Plan C policies because they cover the Medicare Part B deductible. That’s the only difference between Plan F and Plan G.
As a result of Medigap Plan F going away, Plan G is the most coverage new beneficiaries can buy. This is why Plan G is the most popular Medicare supplement 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.
How Much Do Plan G Policies Cost?
Medicare Supplement Plan G costs vary by age, gender, location, and tobacco use. And, even though all private insurance companies that sell Plan G must provide the same benefits, they get to set their price. For this reason, the only way to know what a Plan G policy will cost you is to get a quote.
Medicare Plan G rates in most areas start at around $120 to $140 per month. In some areas, they 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 covers 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.
- Medicaid 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.
Plan G Pays the Part A Deductible and Coinsurance
Inpatient care 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 Medicare Part A premiums.
However, your 20% share can be very costly if you don’t have additional coverage.
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 period. You pay this amount every time you are hospitalized unless you are readmitted for the same issue within 60 days.
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 a Medigap Plan G policy. 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 need blood, you pay for the first three pints. After that, Medicare kicks in and starts paying its share.
And blood is costly. 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.
Plan G Covers Doctor Visits, Tests, Diagnostics, Supplies, and DME
As we age, most of us begin using more healthcare services and need more preventive care. Some folks age into Medicare with chronic health issues like diabetes, hypertension, and other common problems and need even more healthcare provider services.
With a Medigap Plan G policy, you don’t have to worry about hospital costs or how frequently you see your healthcare providers. It covers all Medicare 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 if Medicare approves them.
And, if your provider adds excess charges, 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 Isn’t Covered by Plan G?
The federal government regulates what Medicare Supplement Insurance can cover. This is why plans are standardized and only cover approved Medicare benefits.
In the past, certain Medicare Supplement plans were able to include prescription drug coverage and other extra benefits, just like Medicare Advantage plans. These plans are no longer sold. As a result, if you want dental coverage, prescription drug plan coverage (Medicare Part D plan), and other benefits, you need to buy separate insurance plans.
There is one small exception.
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 Medicare Advantage plans and Medicare Supplements.
What Makes Plan G the Best Medigap Plan?
The word “best” is subjective when it comes to Medicare Supplements. Best might mean the plan with the most coverage. It could also mean the lowest average premium.
A better question to answer is: 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 N 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, get the average cost of Medicare Supplement plans in your area.
High Deductible Medicare Supplement Plan G
Continuing our discussion above, if you can afford to take a little risk with your coverage, you should have a look at High Deductible Plan G (HDG) as an option.
Once you have paid the annual deductible, an HDG plan has the 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 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, HDG plans cost $75 to $90 per month less than a regular Plan G. Is the cost difference worth the risk?
Here’s a trick savvy savers are using.
By putting the amount saved away every month, it’s possible to 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. Or, ask us for a report on the “Lost-Cost Plans.”
Comparing Plan G Rates
Finding an insurance company that offers Plan G is easy. All Medicare Supplement insurance companies sell this plan. However, it isn’t easy to compare the rates of all companies.
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’re in business to sell new Medicare enrollees a policy, not to promote the other guy.
MedicareWire is not an insurance agency. We are here to help you make an informed decision. 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!
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. There’s no medical underwriting if you buy a policy within 6 months of turning age 65.
- 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 in the USA and its territories.
- You can usually keep your Medigap Plan G policy if you move (does not include Medicare SELECT 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 right, 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 only be affordable in some areas.
- Plan G policies do not include any extras. You will need to buy additional insurance to get prescription drug coverage and routine dental care.
- 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 do not accept 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 yet to mention here.
Medicare Plan G Reviews
More than 100 insurance companies sell Medicare Supplement 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 must work with a licensed insurance agent in your state.
MedicareWire has teamed with HealthCompare, an Allstate company, to assist you if you still need 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 Blue Cross Blue Shield companies.
You do not need to wait until the Medicare Open Enrollment Period in the fall to buy a plan. This Medicare enrollment period is for Medicare Advantage and Medicare Part D plan enrollment. The Medigap Open Enrollment Period is based on when you first qualify for Medicare.
Your next step is to get Medicare Plan G rates in your area. MedicareWire can help do that without marketing interference or a sales pitch.
We don’t sell insurance. We are senior advocates. Our service is free.