Understanding Medicare Plan G Coverage & Benefits
Are you a beneficiary of Original Medicare?
While it’s a great program for retirees and seniors to get assistance covering their medical bills, it’s not enough to cover all your expenses.
There are limitations on the benefits and reimbursements offered by Original Medicare, and you could be left holding the bag on your next trip to the hospital.
A supplemental Medicare policy removes the risk of you being stuck with medical bills you can’t afford to pay or dipping into your retirement savings to fund these expenses.
Supplemental Medicare plans, also known as “Medigap,” provide a gap cover to eliminate this financial risk from your healthcare.
Plan G is the fastest-growing Medigap plan due to the high level of comprehensive insurance it offers policyholders.
If you have no experience with Medicare or medical insurance, you might find it confusing to understand all the benefits and how these plans work. This guide will change that.
Contact the Professionals and Get Expert Advice
If you would rather skip the reading and speak with a professional, call us at 1-888-891-0229 or fill out the contact form on this site, and we’ll have an expert get back to you to answer your questions.
We have decades of experience matching our clients with the best Medigap plans to meet their needs and budget.
Let us guide you through the process and give you the professional advice you need to thrive.
Compare 2024 Plans & Rates
Enter Zip Code
What is Medicare Supplement Plan G?
Medicare Supplement Plan G covers the gaps in your medical bills not covered by Original Medicare Part A & B.
For instance, if you go to the hospital for surgery, Medicare only covers you for a few days stay, but what if you need to remain in inpatient care for longer than your coverage allows?
This scenario happens to seniors across America every day. Usually, they end up with a huge medical bill to pay.
If you don’t meet this financial responsibility, it could end up in the provider chasing you for the money and a reduction in your credit score.
Medigap plans for 2024 offer a range of policies that cover these additional costs. They cover hospital care and most of your medical expenses, especially those involved with inpatient and outpatient care, such as doctor’s visits.
Medigap Plan G offers you the most “comprehensive” level of protection because it takes care of these additional expenses.
So, in the scenario where you have an extended hospital stay, Medigap Plan G takes care of these added costs and kicks in after you meet your annual deductible threshold.
Provided you meet the deductible, you leave the hospital owing them nothing for your treatment and stay.
How Does the High-Deductible Medigap Plan G Work?
Medigap Plan G is available in standard and high-deductible versions. If you’re healthy, you likely never go to the doctor or have a chronic condition requiring regular medical monitoring.
However, you’ll still want the best medical care available if you’re involved in an accident or experience the sudden onset of a medical condition.
If that’s the case, taking a High-Deductible Plan G means paying lower annual premiums. You save money while maintaining the benefits of Plan G if something goes wrong with your health.
However, if you require medical treatment, your annual deductible threshold is $2,700 instead of $1,600, and you’ll have to reach this threshold before Plan G kicks in.
What is Medicare Supplement Plan G?
Medicare Supplement Plan G covers the gaps in your medical bills not covered by Original Medicare Part A & B.
For instance, if you go to the hospital for surgery, Medicare only covers you for a few days stay, but what if you need to remain in inpatient care for longer than your coverage allows?
This scenario happens to seniors across America every day. Usually, they end up with a huge medical bill to pay.
If you don’t meet this financial responsibility, it could end up in the provider chasing you for the money and a reduction in your credit score.
Medigap plans offer a range of policies that cover these additional costs. They cover hospital care and most of your medical expenses, especially those involved with inpatient and outpatient care, such as doctor’s visits.
Medigap Plan G offers you the most “comprehensive” level of protection because it takes care of these additional expenses.
So, in the scenario where you have an extended hospital stay, Medigap Plan G takes care of these added costs and kicks in after you meet your annual deductible threshold.
Provided you meet the deductible, you leave the hospital owing them nothing for your treatment and stay.
How Does the High-Deductible Medigap Plan G Work?
Medigap Plan G is available in standard and high-deductible versions. If you’re healthy, you likely never go to the doctor or have a chronic condition requiring regular medical monitoring.
However, you’ll still want the best medical care available if you’re involved in an accident or experience the sudden onset of a medical condition.
If that’s the case, taking a High-Deductible Plan G means paying lower annual premiums. You save money while maintaining the benefits of Plan G if something goes wrong with your health.
However, if you require medical treatment, your annual deductible threshold is $2,700 instead of $1,600, and you’ll have to reach this threshold before Plan G kicks in.
What Does Medigap Plan G Cover?
So, what is the Medicare Plan G coverage available to members?
Here are the basics of the medical expenses Plan G assists with when you need it:
- Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up.
- The Part A deductible.
- Part A hospice care copayment or coinsurance.
- Part B copayments or coinsurance.
- Part B excess charges.
- The first three pints of blood in transfusions (Medicare covers the fourth pint and beyond).
- Skilled nursing facility care coinsurance.
- Emergency health care for the first 60 days when traveling outside America.
What Isn’t Covered by Medigap Plan G?
Medigap Plan G won’t cover you for:
- preventative treatments like acupuncture and cosmetic procedures,
- or for dental, vision, and hearing expenses.
However, a few insurers offer extended Plan G benefits that include these costs.
These plans vary depending on the state you live in and the carrier you use. That’s why you can benefit from our advice in helping you select the best Plan G option available in your state.
Medigap Plan G doesn’t cover the Part B deductible.
You’ll need to pay that out-of-pocket.
Some other things Medigap Plan G doesn’t cover include the following:
- Prescription drugs.
- Long-term care (non-skilled care in nursing homes).
- Private-duty nursing.
What are the Premiums for Medigap Plan G?
Medigap Plan G is available in all US states from different private insurers, like Aetna and Blue Cross Blue Shield.
All insurers must meet Federal guidelines on the standardized coverage offered in each plan, so the minimum coverage requirements are the same across all insurers.
However, the insurers have the flexibility to choose what they want to charge for your monthly premium.
These monthly premiums can vary from state to state and insurer to insurer. For instance, Aetna is the lowest cost insurer in some states for some Medigap plans and the most expensive in other states.
Insurers complete a “risk profile” for members in that area based on their gender, age, smoking status, and other health-related factors. So, for instance, the cost of Medigap Plan G is usually higher for men than women because they present a higher insurance risk.
Our team can help you find the lowest premium for Plan G in your area. Our advice could save you hundreds of dollars on your annual premium costs.
That makes a big difference, especially for folks living on a fixed income.
Comparing Medicare Supplemental Plan G with other Options – Plan G vs. Plan F
Plan F offers Medigap policyholders the highest level of comprehensive coverage available on any plan.
The primary difference is that it covers the Part B deductible ($226 in 2023), which Plan G doesn’t.
However, you’ll likely save more than this deductible amount in the lower premiums offered by Plan G over the duration of the financial year.
Frequently Asked Questions
What does Medicare Plan G cover?
Medicare Plan G covers deductibles, coinsurance, copayments, skilled nursing care, excess charges, and foreign travel emergencies.
How much does Medicare Plan G cost?
Medicare Plan G costs vary based on factors like location, age, and health. Compare insurance providers for competitive rates.
Does Medicare Plan G cover prescription drugs?
No, Medicare Plan G does not cover prescription drugs. You need a separate Medicare Part D plan.
Can I use any doctor or hospital with Medicare Plan G?
Yes, Medicare Plan G allows you to see any Medicare-approved doctor or specialist.
Is Medicare Plan G the same as Medicare Advantage?
No, Medicare Plan G is a Medigap plan, while Medicare Advantage is an all-in-one alternative to Original Medicare.
Does Medicare Plan G cover pre-existing conditions?
Yes, Medicare Plan G covers pre-existing conditions during the open enrollment period.
Can I switch to Medicare Plan G from another supplement plan?
Yes, but switching may involve medical underwriting and potential changes in premiums.
Are there network restrictions with Medicare Plan G?
No, Medicare Plan G does not have network restrictions. You can choose providers anywhere in the U.S.
Does Medicare Plan G cover dental or vision care?
No, Medicare Plan G does not cover routine dental or vision care.
Can I get a Medicare supplement plan if I have Medicaid?
If you have both Medicare and Medicaid, you may have additional options, including Medicare Plan G or Special Needs Plans (SNPs).
Medicare Plan G Coverage - How to Start
Before you decide on a Medigap policy, it’s also important to compare quotes from several insurance companies.
To start comparing estimates from the most credible health insurers, submit the form to the right of the screen or call 1-888-891-0229 now!
Updated December 4th, 2022