Medicare Supplement Plan G covers more than most Medicare supplement insurance plans, also known as Medigap plans. Private medical insurance companies administer these plans, which help cover out-of-pocket costs in Medicare policies.
Medicare is a federal program that covers health costs for people 65 years old and over. Younger people with specified health conditions or disabilities may also qualify.
There are two parts to Original Medicare. Part A covers inpatient costs, and Part B covers outpatient services.
Both parts A and B have out-of-pocket costs that may include deductibles, copayments, or coinsurance. These expenses create gaps in coverage.
Medicare supplement insurance plans, also known as Medigap plans, help cover these additional costs.
Medicare Supplement Plan G currently offers the most comprehensive coverage. It is a popular alternative to the newly discontinued Medigap Plan F.
This article explains the coverage available through Medigap Plan G, how to compare Medigap plans, and the out-of-pocket expenses that may apply.
Glossary of Medicare terms
We may use a few terms in this piece that can be helpful to understand when selecting the best insurance plan:
- Deductible: This is an annual amount that a person must spend out of pocket within a certain time period before an insurer starts to fund their treatments.
- Coinsurance: This is a percentage of a treatment cost that a person will need to self-fund. For Medicare Part B, this comes to 20%.
- Copayment: This is a fixed dollar amount that an insured person pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
Medigap policies supplement Original Medicare benefits, and plans must follow standardized Medicare rules.
To have a Medicare Plan G policy, a person must have Original Medicare (parts A and B).
A Medigap plan covers one person only. Additional beneficiaries must have a Medigap policy of their own.
Medigap Plan G covers:
- Part A deductible
- Part A coinsurance and hospital costs for an extra 365 days
- Part A coinsurance or copayment for hospice
- Part A coinsurance for skilled nursing facility care
- Part B coinsurance or copayment
- Part B excess charge
- first 3 pints of blood
- 80% of emergency care received outside the United States
Medigap policies, like Plan G, do not cover everything.
Medigap policies typically do not cover:
- long-term care
- dental care
- hearing aids
- eyeglasses
- private nursing
Medigap Plan G also does not cover the Part B deductible or have an out-of-pocket limit.
Medigap plans are additional plans that help pay costs that Original Medicare does not cover.
Private insurance companies administer Medigap policies, and the plans can help pay for:
- deductibles
- coinsurance
- copayments
- excess charges
There are 10 types of Medigap policies, each with a letter as its name.
Medigap Plan C and Plan F
Medicare Supplement Plan C and Plan F include coverage for the Part B deductible.
As of January 1, 2020, Medigap policies are no longer able to cover the Part B deductible for people newly eligible for Medicare.
A person can still buy Medigap Plan C or Plan F if they were eligible for Medicare before that date but had not yet enrolled. If a person had Medigap Plan C or Plan F before January 1, 2020, they may keep the policy.
Medigap Plan G is currently a popular alternative to Plan F.
About prescription drugs
In the past, some Medigap policies paid for prescription drugs, but this stopped on January 1, 2006.
Currently, Medicare Part D policies pay for prescription medication.
Medicare Advantage and Medigap
A person cannot have a Medigap policy and a Medicare Advantage (Part C) plan at the same time.
It is illegal for a company to sell a person a Medigap policy while that individual has Medicare Advantage.
A person can buy Medigap policies offered in their area only. Not every policy is available in every state.
Private insurance companies decide what policies they administer. However, if they choose to administer in a particular state, they:
- do not have to sell every Medigap plan
- must sell Medigap Plan A
- must offer Medigap Plan C or Plan F to eligible individuals
More information
A person can look for policies sold in the area by:
- using the find a Medigap policy tool
- calling the State Health Insurance Assistance Program (SHIP)
- calling their State Insurance Department
It may be beneficial for a person to consider their current healthcare needs when researching plan options.
Compare
An individual may want to compare the policy benefits for those available in the area using the side-by-side Medigap plan chart.
The benefits and costs of the same Medigap plan may differ between companies. Although some main benefits are standardized, companies can charge different premiums. For example, Medigap Plan F and Plan G offer high deductible plans in some states.
Apply
Once a person has chosen a Medigap plan that best suits their needs, they can apply for the policy with the administering insurance company.
Individuals can usually complete the application online, by phone, or by calling the company to ask for a paper form, which the person can then complete and mail back.
Various costs are involved with Medigap plans. Costs can include premiums, deductibles, and other charges.
Premiums
A person is required to pay a premium for their Medigap policy. A person pays this directly to the private insurance company.
Individuals pay the premiums for Original Medicare directly to Medicare.
Part B deductible
People who are newly eligible for Medicare cannot choose a Medigap policy that covers the Medicare Part B deductible. The Part B deductible in 2024 is $240, according to the Centers for Medicaid & Medicare Services (CMS).
However, some plans pay the Part A deductible, which in 2024 is $1,632, per the CMS.
Excess charges
Excess charges are costs that are higher than the Medicare-approved amounts. Healthcare professionals are legally allowed to charge an excess.
Not all plans cover Part B excess charges, but Medigap Plan G does provide coverage for these costs.
Medicare resources
For more resources to help guide you through the complex world of medical insurance, visit our Medicare hub.
Medigap policies are supplement insurance plans that private medical insurance companies administer. The plans help pay for gaps in Original Medicare coverage.
Medicare Plan G coverage is comprehensive and is currently a popular alternative to Medicare Supplement Plan F, which is no longer available to people newly eligible for Medicare.
Not all Medigap plans are available in all areas, and companies can choose which policies they administer.
Medigap policies do have out-of-pocket costs, including a monthly premium.
A person with Medigap Plan G has no out-of-pocket limits and must also pay the Medicare Part B deductible.