What is Medicare Supplement Plan G?
This article was updated on: 01/08/2019
Medicare Supplement Plan G, also called Medigap Plan G, is one of 10 standardized Medicare Supplement plans that may be available in most states. Medigap is optional insurance (available from private insurance companies) that works alongside Medicare Part A (hospital insurance) and Part B (medical insurance). Medicare Supplement insurance can help you pay out-of-pocket costs for hospital care and medical services covered under Medicare Part A and Part B.
Medicare Supplement Plan G is not available if you live in Massachusetts, Minnesota or Wisconsin; these three states offer their own standard Medicare Supplement benefit plans.
Would Medicare Supplement Plan G be right for me?
If you have Medicare Part A and Part B and you’re shopping for a Medicare Supplement plan that may fill the gaps in your Medicare coverage, Medigap Plan G might suit your needs – depending on what your needs are. Plan G is one of the more comprehensive Medicare Supplement plans, but it might also have a higher premium than some less comprehensive plans. You may also want to read How Much Money Could a Medicare Supplement Plan Save Me?
Medicare Supplement Plan G generally provides the following benefits:
- Medicare Part B coinsurance/copayments
- Medicare Part A deductible, which in 2019 is $1,364 for each benefit period. A benefit period typically begins the day that you’re admitted as an inpatient to a hospital or skilled nursing facility and ends when you have not received inpatient hospital or Medicare-covered skilled care in a skilled nursing facility for 60 days in a row.
- Medicare Part A coinsurance (20% not paid by Medicare Part A) for hospital costs
- Up to 365 additional days of hospital care after your Medicare Part A benefits are exhausted
- Up to 3 pints of blood
- Skilled nursing facility coinsurance (20% not paid by Medicare Part A)
- Hospice care coinsurance or copayment amounts not paid by Medicare Part A
What other benefits might Medicare Supplement Plan G offer me?
If you travel outside the United States, you may be pleased to know that Medicare Supplement Plan G may also cover emergency medical care you receive while traveling abroad (at 80% of approved costs, up to the plan’s limits).
Medicare Supplement Plan G may also cover for the Medicare Part B “excess charge” if you use the services of health-care providers who do not accept Medicare assignment. That means these providers do not accept the amount determined by Medicare as reasonable and customary as full payment.
If you go to a doctor who does not accept Medicare assignment, he or she may be allowed to bill an “excess charge”. This excess charge is an amount above what Medicare approves for a specific procedure or office visit. The excess charge is limited to 15% over the Medicare approved amount. It does not apply to all services and supplies. Medicare Supplement Plan G may pay the excess charge if the procedure or service is covered by Medicare.
Generally insurance companies offering Medicare Supplement Plan G (or another Medicare Supplement plan) coordinate payments to health-care providers, and this can minimize the paperwork of medical claims for you. Plan G can also help to shield you from sudden out-of-pocket costs resulting from an unpredictable medical event. Most of your out-of-pocket costs for covered medical services will generally be limited to the Part B deductible (described below).
What else do I need to know before purchasing Medicare Supplement Plan G?
If you enroll in Medicare Supplement Plan G (as with most other Medicare Supplement plans), you may still need to pay your Medicare Part B deductible for outpatient services (such as doctor visits, diagnostic lab and radiology, therapies, durable medical equipment and Medicare-covered medical supplies) before Plan G starts paying for most covered services. In 2019 the Medicare Part B annual deductible is $185.00. Medicare Supplement Plan G might have a lower premium than Medicare Supplement Plan F, which generally covers all the services covered by Medicare Supplement Plan G as well as the Part B deductible. Keep in mind that premium costs may vary among plans.
Remember, Medicare Part B (not to be confused with Medicare Supplement Plan B) covers 100% of certain preventive care services. This means that you usually won’t have to pay your Part B deductible before you receive the benefits of your Medicare Part B coverage for services such as an annual flu shot, certain preventive cancer screenings, or your annual wellness visit with your doctor.
After you’ve paid the Part B deductible, Medicare Supplement Plan G may pay all the remaining expenses for outpatient diagnostic services and treatments covered by Medicare. Medicare typically pays 80% of your outpatient costs and your Plan G Medicare Supplement may pay the other 20%.
Availability: Insurance companies that provide Medicare Supplement plans don’t have to offer all of the standard benefit plans. You can check to see if Medicare Supplement Plan G is available where you live. One way to do this is to simply click the Compare Plans button on this page, select Medicare Supplement from the menu, and enter your zip code.
Cost: Although Medicare Supplement plans offer standardized benefit packages, insurance companies set their own monthly premiums, so you might want to compare prices among plans.
Enrollment: For many people the best time to apply for a Medicare Supplement plan is during the six-month Medicare Supplement Open Enrollment Period that begins when you are both enrolled in Medicare Part B and age 65 or older. Insurance companies cannot deny you coverage or charge you more because of your health status during this time period (although you might face a waiting period before coverage of a health condition starts). If you delay buying a Medicare Supplement plan until after this period, you could be subject to medical underwriting (that is, the plan can consider your medical history). You might not be able to buy a Medicare Supplement plan or you may have to pay more for the coverage.
If you would like to discuss your Medicare coverage options, I would be pleased to answer your questions and provide you additional information. You can learn more about me and my experience by clicking on my profile below. You can also use one of the links below to set up a phone call with me or request personalized information from me by email.
The purpose of this communication is the solicitation of insurance. Contact will be made by an insurance agent/producer or insurance company.
Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the Federal Medicare program.
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