Are you interested in Medicare (Medigap) Plan G?

It’s a great policy for supporting the out-of-pocket costs of Original Medicare.

Medicare Plan G is one of the ten standardized Medigap plans available to Original Medicare members, offered by private insurers across the United States.

Supplemental plans are available in most US states. However, beneficiaries have different options:

• Massachusetts,
• Minnesota,
• and Wisconsin.

Plan G is the fastest-growing supplemental Medicare plan and for a good reason.

You get a comprehensive level of medical care for an affordable monthly premium.

Previously, Plan F was the only plan offering this level of financial support for medical costs, but it’s recently become unavailable from providers.

With Plan G, you get everything in Plan F, with the exception of coverage for the Part B deductible.

However, Plan G offsets this expense with more affordable monthly premiums than Plan F.

This post unpacks everything you need to know about Plan G and the costs of enrolling in this program.

If you want to skip ahead and get right down to business, contact our team at 1-888-891-0229. We offer professional advice on Plan G.

We’ll show you the best insurers in your state and calculate the most affordable premium for your unique situation.

Or fill out the contact form on our site, and we’ll have an expert get back to you for a free consultation.

Let’s start with understanding what Medigap Plan G covers to give you an idea of the value it offers your medical care.

Medigap Plan G Benefits

• Medicare Part A coinsurance and hospital costs.
• Medicare Part B copayment or coinsurance.
• Part A hospice care copayment or coinsurance.
• Coinsurance for a skilled nursing facility.
• Medicare Part A deductible.
• Medicare Part B excess charges.
• First 3 pints of blood.
• Foreign travel emergency medical expenses up to 80%.

Medicare Part A Coinsurance

Medicare Part A, also known as hospital insurance, includes cost-sharing initiatives, such as coinsurance.

Inpatient hospital stays exceeding 60 days require coinsurance fees. Plan G covers all these costs.

Medicare Part B Copayment & Coinsurance

Medicare Part B charges coinsurance for doctor visits and other outpatient care services. Medicare Part B usually pays 80% of Medicare-approved amounts for these covered services, leaving you with a 20% coinsurance payment.

Plan G takes care of this outstanding amount.

Part A Hospice Care Copayment or Coinsurance

Individuals with terminal illnesses require hospice care, and Medicare covers this service but requires a copayment.

These copayments include 5% of Medicare-approved amounts for inpatient care and $5 for each symptom and prescription for pain relief. Plan G covers all these additional costs.

First 3 Pints of Blood

Original Medicare covers you for the fourth pint of blood and beyond during transfusions. Plan G fills the gap, providing the first three points of blood.

Coinsurance for Skilled Nursing Facilities

Inpatient skilled nursing facilities require a coinsurance payment for stays over 20 days. This coinsurance charge amounts to $200 per day for days 21-10.

After day 100, the member is liable for all further costs unless you have Plan G, which takes care of these medical expenses.

Medicare Part B Excess Charges

If doctors charge above the standard Medicare rate, you’re liable for these additional charges, which can be up to 15% over the subsidized rate.

Plan G covers this additional excess fee.

Medicare Part A Deductible

Medicare Part A comes with an annual deductible of $1,600 in 2023.

Medigap Plan G covers your deductible in full for each benefit period required.

Foreign Travel Emergencies

You get coverage of up to 80% of all medical expenses incurred while outside of the United States after meeting the annual $250 deductible.

Plan G increased in popularity in 2020 due to Plan F and C no longer being available to new Medicare members eligible for the program after January 1, 2020.

If you were eligible for Medicare before this date, you could still opt to take Plan C or F.

However, considering the savings you make on the monthly premiums, the option for the high-deductible Plan G, and the low cost of the Part B deductible, it’s worth considering Plan G over these alternatives.

If you currently have Plan F or C, you can choose to remain on your current plan or switch to Plan F during the annual enrollment period.

Considering the comprehensive coverage Plan G offers, it’s worth making the change.

If you’re interested in making the switch, contact us, and we’ll advise you if it’s the right move for your unique situation.

The open enrollment period for Medigap starts on your 65th birthday, ending six months after the date. To qualify, you’ll need to enroll in Medicare Part B.

If you enroll during this period, you can’t get denied access to a Medigap plan if you have pre-existing health conditions. Nor can the insurer charge you more for your monthly premium based on your health status.

If you enroll outside the open window period, the insurer may subject you to “underwriting.”

The underwriting period may assess your health status and history to determine a suitable premium to the risk profile you present to the company. Or they have the option of refusing to insure you.

The only exception is if you qualify for a “guaranteed issue right.” However, not all plans are available to members with a guaranteed issue right.