What Is Medicare Supplement Plan G?

What Is Medicare Supplement Plan G?

Medicare Supplement Plan G is private health insurance that pays some of the Original Medicare out-of-pocket expenses. According to U.S. government research, Plan G is one of the two most popular Medicare supplement plan options for Medicare recipients. 

Like other Medigap plans, Plan G is designed to limit your financial costs and medical expenses as a Medicare beneficiary. Plan G fills cost-sharing gaps, including deductibles, coinsurance,  and copayments. It goes the extra mile versus other Medigap plans by paying for excess physician charges and offering a high-deductible option with low premiums. 

Key Takeaways

• Plan G is the second most popular Medigap plan.
• Plan G covers more costs than most other Medigap plans, including the entire Part A deductible and 100% of doctor charges Medicare doesn’t pay. 
• There are two types of Plan G: Regular and High-Deductible Plan G.
• High-Deductible Plan G charges some of the lowest monthly premiums available.

How Plan G Works 

You pay a monthly premium to get Plan G Medigap from a private insurer, the same as any other Medicare supplement plan. Plan G provides the same required benefit package from every insurer. It is also the only Medigap plan available to new enrollees that covers Part B excess charges, which is the difference between a physician’s charges and the Medicare-approved amount.

Plan G was the second-most popular choice for Medicare recipients, with more than 4.5 million enrollees in 2021 (excluding California), according to a 2023 report from the Congressional Research Service. 

Here’s what Plan G covers. 

Medicare Part A:

• Coinsurance 
• Hospital coverage for up to an extra 365 days after using up your Medicare benefits
• Skilled nursing facility coinsurance
• Hospice care coinsurance or copayment
• Deductible

Medicare Part B:

• Coinsurance or copayment for any doctor that accepts Medicare assignment
• Blood (first three pints)
• Excess doctor charges or fees above what Medicare pays 
• Lab services

In addition:

• 80% of foreign travel emergency costs
• Durable medical equipment

Plan G doesn’t cover dental, vision, hearing exams or services, or prescription drug services. Medicare Advantage plans may include these benefits on top of health insurance, but Medigap plans do not. You could buy a Part D plan to cover your prescriptions along with Medigap Plan G.

You can buy Medicare supplement Plan G on Medicare.gov, through a private insurance company, from a licensed agent, or possibly with a group plan through your employer. 

Note

Some states have approved special benefits for Medigap Plan G on an insurer-by-insurer basis. For example, a Humana Medigap Plan G in Texas was approved to offer drug, hearing, and vision discounts, meal delivery after a hospital stay, and a 24-hour nurse advice line. 

Types of Plan G

Two types of Medigap Plan G exist, with differences in out-of-pocket costs, availability, and coverage. It’s important to compare different providers’ Plan G options to find the best for you. 

Plan G 

Plan G is more widely available than High-Deductible Plan G. This plan begins paying costs immediately and may be a better fit for those who think they could have more health expenses in most years, whether now or later. On average, Plan G monthly premiums are higher than the premiums on some Medigap plans (such as Plan A and B), but lower than others, such as Plan C and Plan F. 

As an example, 12 insurers in New York offer a regular Plan G, with location-based pricing differences ranging from $199 in Albany, New York to almost $776 in New York City. Plan G also has a higher monthly premium compared to high-deductible Plan G. 

Despite Plan G being more or less the same across insurers, prices may differ significantly based on your location or age. Insurers may offer lower rates after discounts for multiple policies, annual or automatic payments, or if you’re female, married, or a non-smoker.

High-Deductible Plan G

A High-Deductible Plan G can be a good fit if you don’t think you’ll have higher health expenses during an average year. It could also be a good fit if you’re concerned about future health costs when you’re older. 

With High Deductible Plan G, you must first pay expenses out of pocket until you reach the plan deductible ($2,800 in 2024). Then, your plan begins to pay for costs. The deductible consists of the out-of-pocket expenses (not including premiums) you’ll pay before the private insurer starts paying benefits. Once you meet the deductible, your insurer pays 100% for covered services for the rest of the year. 

The High Deductible Plan G counts your Part B deductible payment toward meeting the plan’s overall deductible. You’ll also pay a separate $250 per year deductible for foreign travel emergencies. 

Although High-Deductible Plan G typically charges lower premiums, it can be harder to find a High-Deductible Plan G. In contrast to the earlier example, only six insurers in New York State offer a High-Deductible Plan G, with monthly premiums ranging between $52.53 and $103.10, depending on location. 

Plan G vs. Plan F

Plan G and Plan F both have a high deductible option that works similarly, with the same 2024 deductible of $2,800. 

However, High Deductible Plan F is only available to those who were not new to Medicare before Jan. 1, 2020. In contrast, High Deductible Plan G is available to individuals new to Medicare on or after Jan. 1, 2020. Essentially, Plan G replaced Plan F. 

Plan F also covers the Part B deductible of $240. Plan G does not cover this deductible. 

Pros & Cons of Plan G 

Plan G tends to offer the most cost coverage combined with lower out-of-pocket expenses among the Medicare Supplement options. With Plan G, you can choose between a regular plan and a high-deductible plan, and you can use the plan anywhere in the U.S. with any physician accepting Medicare. Plan G provides some coverage for emergency foreign care, addressing at least one coverage gap.  

Plan G also covers excess costs a physician may charge if you don’t live in one of the eight states prohibiting excess charges. 

However, if you buy Plan G instead of a Medicare Advantage plan, you’ll need additional coverage for drugs, vision, dental, and hearing services. You must pay the Part B annual deductible before the costs are covered. In addition, your premiums will likely rise with age if your state uses age to set premiums. 

Finally, in most states, you have a very short window to enroll in Plan G at a reasonable rate—and trying to get the plan later may be too expensive, as the insurer can factor in your pre-existing conditions when deciding if you qualify and setting your monthly premium. 

Requirements for Plan G

To qualify for Plan G, you must typically be 

• Turning 65 on or after Jan. 1, 2020
• Enrolled in Original Medicare (not Medicare Advantage) Parts A and B
• In the initial enrollment period for Medicare at age 65
• In 33 states, people who qualify for Medicare due to a disability can potentially be eligible for Plan G or other Medicare supplement policies

During the one-time, six-month initial enrollment period for new Medicare beneficiaries, insurers can’t turn away beneficiaries for preexisting health conditions, refuse to sell an individual any Medigap policy offered, or charge more based on health history. If you stay enrolled and pay the premium, the insurer can’t cancel your Medigap Plan G. 

States regulate Medigap plans. In some states, Medigap enrollment is extended or occurs at other times beyond the initial six-month period. 

It’s wise to familiarize yourself with Medicare plans and prices long before the six-month enrollment window. You want to avoid making a less-than-optimal decision under time pressures.

If you qualify for Plan G and purchase a plan after comparing options, you’ll pay monthly premiums to the insurance company you bought the plan from. Generally, you can expect an increase in the plan premium every year. You can also expect a yearly increase in the Plan G deductible if you purchased a High-Deductible Plan G. 

Frequently Asked Questions (FAQs)

Is Plan G Better Than F?

Unlike Plan F, Plan G does not cover the Part B deductible. That Plan F deductible coverage appealed to many consumers. However, Plan G tends to be less expensive than Plan F. Plan G is more widely available, as Plan F is only available to those who became eligible for Medicare before 2020. 

What Is the Cost of Plan G for 2024?

Costs for Plan G vary and depend on your location, age, and whether you enrolled during your guaranteed issue right period. But on average, Medicare Supplement Plan G costs $237 to $409 per month, while High-Deductible Plan G costs $64 to $144 per month. 

Can I Still Get Plan G If I Missed the Open Enrollment Window?

Yes, it could still be possible to get Plan G, even if you missed the Open Enrollment Window. At this point, most states would allow insurers to consider your health for the application. If you don’t have serious pre-existing conditions, you could still get plan G. Even if you have health issues, there are other ways to qualify, including living in a state with expanded enrollment, moving away from your Medicare Advantage plan service area, or being within your trial period for a Medicare Advantage plan. Speak with a professional insurance agent to determine whether you qualify.

How Is the Plan G Deductible Calculated?

The deductible for Plan G is based on section 1882(p)(11)(C)(i) of the Social Security Act. For 1998 and 1999, the act prescribed a $1,500 deductible and has increased it since based on increases in the Consumer Price Index for All Urban Consumers (CPI-U). Since 1998, the Plan G deductible has increased by about 60%, from $1,500 to $2,800.  

The Bottom Line

Plan G can be a good option for people who are enrolled in Medicare Part A and Part B and want more cost coverage than other Medicare Supplement plans can offer. Although you may be healthy and have plenty of extra funds at retirement, Plan G can help contain costs if you face more illness as you age. A High-Deductible Plan G can help split the difference, with low premiums and a cost-assistance plan for a worst-case scenario year or set of years.    

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