Plan G Coverage & Benefits

What is covered in Plan G?

If you have Original Medicare, a Medicare Plan G policy can reduce your out-of-pocket expenses.

Plan G is a Medicare Supplement Insurance plan, also known as a Medigap plan, designed to cover gaps in Original Medicare. This includes expenses like coinsurance, copayments, and deductibles. As a secondary plan, Plan G pays after Original Medicare. Some services will be fully covered.

However, remember that you’ll need to pay two separate monthly premiums: one for Part B and another for Plan G.

Plan G does not include extra benefits such as dental or vision care. For those additional benefits, a Medicare Advantage plan might be a better fit, as it offers coverage for services like dental, vision, and prescription drugs. Whether you're new to Medicare or reassessing your current coverage, you might find gaps in your coverage. With Original Medicare, out-of-pocket costs can accumulate quickly, including copayments, coinsurance, and deductibles. Medicare Plan G can help mitigate these costs.

Understanding Medicare Plan G

Medicare Plan G is a Medigap policy that helps cover the costs that Original Medicare doesn’t. For instance, while Medicare Part B covers 80% of certain healthcare costs, Plan G covers the remaining 20%.

Medigap Insurance Overview

Medigap, or Medicare Supplement plans, are additional policies designed to cover some or all of the costs not covered by Original Medicare, including copayments and out-of-pocket expenses.

There are various Medigap plans available, labeled from "A" to "N." Note that plans "E," "H," "I," and "J" are no longer available. Each plan offers different levels of coverage, with some covering all out-of-pocket costs and others providing partial coverage.

Plan G vs. Part G

The correct term is “Plan G,” not “Part G.” Plan G is one type of Medigap policy, and Medigap plans are distinct from the parts of Medicare itself.

Medigap plans supplement Medicare, providing additional coverage according to federal standards but sold by private insurers.

Coverage Provided by Medicare Plan G

Plan G is among the most comprehensive Medigap options, covering:

100% of the Medicare Part A deductible
100% of Part A coinsurance and copayments for hospital care
100% of Part A hospice care coinsurance and copayments
100% of Part B coinsurance and copayments for covered services
100% of skilled nursing facility care coinsurance
100% of the cost for the first three pints of blood
100% of Part B excess charges
80% of emergency foreign travel expenses, up to plan limits

What Plan G Doesn’t Cover

Plan G does not cover the Medicare Part B deductible. For 2024, this deductible is $240, which you’ll need to pay before Plan G covers any remaining copayments and coinsurance. Plan G also does not provide additional benefits beyond those offered by Original Medicare, such as dental and vision care.

Comparing Plan G and Plan F

Plan G and Plan F are both comprehensive Medigap options, but Plan F is not available to those who became eligible for Medicare on or after January 1, 2020.

Plan G vs. Plan F

Plan G

Covers 100% of most Original Medicare services
Covers 80% of foreign travel emergency care
Does not cover the Part B deductible
Generally has lower premiums

Plan F

Covers 100% of most Original Medicare services
Covers 80% of foreign travel emergency care
Covers the Part B deductible
Typically has higher premiums

Deciding Between Plan F and Plan G

The main distinctions are cost and the coverage of the Part B deductible. Plan F covers the deductible, while Plan G does not. Consider the total cost of Plan G (including the Part B deductible) and compare it to the cost of Plan F. Choose the plan that offers the best value for your situation.

Monthly Premiums for Plan G

Medigap plans like Plan G are offered by private insurers, so premiums can vary based on your state, provider, and specific policy. On average, Plan G premiums range from $100 to $200 per month.

Pricing Methods for Medigap Policies

Community-rated: A single premium for all enrollees; subject to adjustments for inflation and other factors.
Issue-age-rated: Premiums based on your age when you first enroll; typically lower if purchased earlier, with adjustments for inflation.
Attained-age-rated: Premiums based on your current age; often initially lower but can increase significantly over time.

Remember, your Plan G premium is in addition to your Part B premium.

Medicare Plan G vs. Medicare Advantage

You cannot have both Medicare Plan G and a Medicare Advantage plan. Medicare Advantage plans replace Original Medicare and may offer additional benefits like dental, vision, hearing, and prescription drug coverage. Plan G, however, only covers out-of-pocket costs for Original Medicare services.

If you prefer the basic coverage provided by Original Medicare and want to reduce costs, Plan G is suitable. For more comprehensive benefits, including additional services, a Medicare Advantage plan may be a better option. Keep in mind that Medicare Advantage plans often have provider networks, which can affect your costs based on whether you use in-network services.

Medicare Plan F vs. Medicare Plan G vs. Medicare Plan N Comparison

Key Differences

Plan F: Identical to Plan G below, in addition also covers Part B Deductible
Plan G: Offers comprehensive coverage including 100% of Part B excess charges, but generally has higher monthly premiums.
Plan N: Has lower monthly premiums but does not cover Part B excess charges and includes copayments for some office visits.

Get a Free Consultation