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Understanding Medicare Supplement Plan G
Medicare Supplement Insurance plans, also called Medigap, work alongside Medicare Parts A and B (Original Medicare). Medicare Supplement Plan G (also called Medigap Plan G) offers the highest level of coverage among the eight standardized Medicare Supplement Insurance plans available for purchase in most states. (Massachusetts, Minnesota, and Wisconsin have their own standardized Medigap plans). As a result, Medicare Supplement Plan G is one of the most popular options for those looking to fill in the coverage gaps in Original Medicare.
What does Medicare Supplement Plan G cover?
Medigap Plan G is a robust plan with excellent coverage. With Plan G, you can expect to pay for very few, if any, out-of-pocket Original Medicare expenses. Your only out-of-pocket expense is the low Part B deductible of $203 in 2021.
Hospital Expenses: 100% Part A hospital expenses – all coinsurance and deductible expenses, up to 365 days after Original Medicare benefits are exhausted.
100% Part A hospital expenses – all coinsurance and deductible expenses, up to 365 days after Original Medicare benefits are exhausted.
Medical Expenses: Pays 100% of the Original Medicare Part B coinsurance or copayment (20% of Medicare-approved).
Pays 100% of the Original Medicare Part B coinsurance or copayment (20% of Medicare-approved).
Transfusions: Pays for the first three pints of blood you receive in a medical procedure.
Pays for the first three pints of blood you receive in a medical procedure.
Hospice Care: 100% covered – Pays Original Medicare Part A coinsurance or copayment.
100% covered – Pays Original Medicare Part A coinsurance or copayment.
Skilled Nursing: Pays facility care coinsurance.
Pays facility care coinsurance.
Excess Charges: Covers Original Medicare Part B excess charges. (Doctors are allowed to charge up to 15% more than what Medicare charges and they can pass that additional cost to the patient! Most Medigap plans do not cover excess charges.)
Covers Original Medicare Part B excess charges. (Doctors are allowed to charge up to 15% more than what Medicare charges and they can pass that additional cost to the patient! Most Medigap plans do not cover excess charges.)
Foreign Travel Medical Emergencies: Covers travel-abroad medical emergencies (80% of approved costs up to plan limits).
Foreign Travel Medical Emergencies
Covers travel-abroad medical emergencies (80% of approved costs up to plan limits).
Part B Deductible: The Medicare Part B deductible for 2021 was $203. After the deductible is met, you pay 20% of the Medicare-Approved Amount (this is the amount a doctor or supplier that accepts assignment can be paid in Original Medicare) for most doctor services, outpatient therapy and durable medical equipment.1
Part B Deductible
The Medicare Part B deductible for 2021 was $203. After the deductible is met, you pay 20% of the Medicare-Approved Amount (this is the amount a doctor or supplier that accepts assignment can be paid in Original Medicare) for most doctor services, outpatient therapy and durable medical equipment.1
Prescription Drugs: Medigap Plan G does not cover prescription drugs. However, you can buy an additional Medicare Prescription Drug plan to cover prescription drug costs.
Medigap Plan G does not cover prescription drugs. However, you can buy an additional Medicare Prescription Drug plan to cover prescription drug costs.
Who can benefit from this type of supplement plan?
Those who are ineligible for Plan F but want similar coverage, Plan G is a good alternative. This is also a good option for those who can handle higher out-of-pocket costs up front and want to go with a higher deductible plan.
Meet Theresa, a Medicare Supplement Plan G User
Theresa is 66 years old. A homemaker, she is married to Stan who runs a successful accounting business. Sam encouraged Theresa to look for the “gold standard” when she chose her Medicare Supplement Insurance Plan. One that would fill in most or all of the gaps that Theresa’s Original Medicare doesn’t cover.
Theresa looked at both Plan G and Plan F because she’d heard they were both comprehensive in their coverage. She did the math and decided that the lower premiums of Plan G were more attractive, even though she’d be responsible for paying the Original Medicare Part B deductible if she needed to be hospitalized at some point in the coming year.
But Theresa is in good health and felt the monthly savings outweighed that possibility.
For these reasons, Theresa chose Medicare Supplement Plan G.
Advantages to Medicare Plan G
- Robust plan with excellent coverage.
- Very few, if any, out-of-pocket Original Medicare expenses.
Drawbacks to Medicare Plan G
- Part B deductible isn’t covered.
- One of the most expensive Medigap coverages.
How much does Medicare Supplement Plan G cost?
Monthly premiums are set by the private insurance companies who offer Medicare Supplement Insurance plans and are based on age, health status, gender and various other factors. Depending on these factors including location, insurance companies may charge different premiums for the same Medicare Supplement Plan G. That’s why it is in your best interest to shop around to ensure you are paying the lowest amount possible for your Medigap coverage.
If you opt for the high-deductible Plan G, you must pay for Medicare-covered expenses—copayments, coinsurance, and deductibles—up to the deductible amount of $2,370 in 2021 before your plan pays for anything.
How Pricing Works For This Plan
Pricing for Medicare Supplement Plan G varies by company. Medigap policies can be priced in 3 ways: community-rated, issue-age-rated, and attained-age-rated.
- Community-rated: Generally, the same monthly premium is charged to everyone who has the Medigap plan, regardless of age. Premiums may go up because of inflation and other factors, but not because of your age.
- Issue-age-rated: The premium is based on the age you were when you bought the Medigap plan. Premiums are lowered for people who buy at a younger age and won’t change when you get older. Premiums may go up because of inflation and other factors, but not because of your age.
- Attained-age-rated: The premium is based on your current age, increasing your premium as you get older. Premiums are lower when you are younger, but continually increase as you age. Premiums may also increase because of inflation or other factors.2
When to Enroll in Medicare Supplement Plans
When you’re first eligible: The best time to enroll in a Medicare Supplement plan is when you’re first eligible. You are eligible to purchase a Medicare Supplement policy (Medigap) on the first day of the month in which you turn 65. This marks the beginning of your Medigap Open Enrollment Period which lasts for 6 months.
You must already be enrolled in Medicare Part A and Part B. During this period, you can buy any Medigap policy sold in your state, regardless of any health problems. You will generally see better prices and more choices among Medigap policies during this period.
Outside open enrollment: While it’s often better to get coverage when you’re first eligible, you can still apply for Medigap coverage after your initial enrollment period. However, if you apply for coverage after your initial enrollment period, there’s no guarantee that an insurance company will sell you a policy if you don’t meet the medical underwriting requirements.
FAQs About Medicare Supplement Plan G
Considering Medicare Supplement Plan G? Here are the answers to common questions about Plan G.
What is the deductible for Medicare Plan G?
Medicare Plan G will cover out-of-pocket expenses for services and treatment once you pay the Medicare Part B deductible, which was $203 in 2021.
How can I lower the costs of my Medigap Plan G?
Since the cost of Medigap plans vary by company, it’s important to shop around. By working with SelectQuote, we can compare all of your Medicare coverage options to find the right plan at a price that fits your budget.
Do Medigap plans vary by state?
Do Medicare Supplement plans cover pre-existing conditions?
While insurance companies can’t make you wait for your coverage to start, they may make you wait for coverage for a pre-existing condition. Coverage for pre-existing conditions can be excluded if the condition was treated or diagnosed within 6 months before the coverage starts under the Medicare Supplement plan.
After the 6-month period, the Medicare Supplement plan will cover the condition that was excluded. However, it is possible to avoid or shorten the waiting period for a pre-existing condition if you buy a Medicare Supplement plan during your Medigap open enrollment period to replace “creditable coverage” Medigap plan.3
Compare Medicare Supplement Plans
There’s no shortage of options when it comes to Medicare coverage. Explore the other standardized Medicare Supplement plans below.