Medicare Supplement Insurance, known as Medigap, helps fill gaps in Original Medicare coverage. Plan G ranks among the most popular options due to its broad protection. It covers many out-of-pocket costs that Original Medicare leaves behind.
Medigap Plan G provides comprehensive benefits for hospital stays, doctor visits, and more. It differs from other plans by excluding just one key item. This makes it appealing for those seeking strong coverage without full exposure to certain deductibles.
This article details what Plan G covers, its advantages, and limitations. It uses current information for clarity. Always verify details with official sources or insurers for your situation.
Understanding Medigap Plan G Basics
Medigap Plan G is a standardized Medicare Supplement policy sold by private insurers. All Plan G policies offer identical core benefits regardless of the company. Premiums vary based on location, age, and insurer.
Original Medicare (Parts A and B) pays first for covered services. Plan G then covers most remaining costs. It works only with Original Medicare, not Medicare Advantage plans.
Plan G became especially popular after changes in 2020. New Medicare enrollees can no longer buy plans covering the Part B deductible. This positions Plan G as a top comprehensive choice.
Core Benefits Covered by Plan G
Plan G covers 100% of Part A coinsurance and hospital costs. This includes up to 365 extra days after Medicare benefits end. It provides extended protection during long hospital stays.
The plan pays the full Part A deductible per benefit period. For 2025, this amount covers inpatient hospital entry costs. No out-of-pocket remains for this after Medicare pays its share.
Part B coinsurance or copayments receive full coverage. This applies to doctor visits, outpatient services, and preventive care. After meeting the Part B deductible, Plan G handles the 20% share.
Additional Key Coverages in Plan G
Skilled nursing facility coinsurance gets full payment. This covers days 21 through 100 in a benefit period. It helps after hospital stays requiring rehab care.
Hospice care coinsurance and copayments fall under Plan G. It covers costs for terminal illness care under Medicare rules. This ensures support during sensitive times.
The first three pints of blood receive coverage each year. This benefit aids in surgeries or treatments needing transfusions. Plan G pays what Medicare does not.
What Plan G Does Not Cover
Plan G excludes the annual Part B deductible. In 2025, this stands at $257 for outpatient services. You pay this amount before coinsurance coverage begins.
Routine dental, vision, and hearing services stay uncovered. Medicare excludes these, so Medigap follows suit. Separate policies or plans handle those needs.
Long-term care, like nursing home stays beyond skilled care, remains uncovered. Prescription drugs require Part D coverage. Plan G focuses on Parts A and B gaps.
High-Deductible Option for Plan G
Some states offer high-deductible Plan G versions. For 2025, the deductible reaches around $2,870. You pay this before the plan covers benefits.
This option suits healthier individuals with lower expected costs. Premiums tend to be lower than standard Plan G. It covers the same benefits after meeting the threshold.
Availability varies by state and insurer. New enrollees since 2020 can purchase this version. Consider your health and finances before choosing.
| Benefit | Plan G Coverage | Part B Deductible Impact | Typical 2025 Amount Example |
|---|---|---|---|
| Part A Deductible | 100% covered | None | $1,676 per benefit period |
| Part B Coinsurance | 100% after deductible | You pay first $257 | 20% of approved amounts |
| Skilled Nursing Coinsurance | 100% for days 21-100 | None | $209.50/day |
| Foreign Travel Emergency | 80% up to limits | None | Lifetime max $50,000 |
| Part B Excess Charges | 100% covered | None | Above Medicare-approved |
Comparing Plan G to Other Medigap Options
Plan G mirrors old Plan F but skips Part B deductible coverage. It offers more protection than Plan N, which adds copays for visits. Premiums often fall between comprehensive and limited plans.
Plan K and L provide partial coverage with out-of-pocket limits. These suit lower-premium seekers but leave more responsibility. Plan G avoids yearly caps by covering most costs outright.
Plan D covers similar items minus excess charges. Plan G adds this benefit for provider overcharges. Choose based on expected usage and budget.
Who Should Consider Plan G
Individuals wanting minimal out-of-pocket surprises often pick Plan G. It covers major gaps like hospital deductibles and excess charges. This provides peace of mind for frequent care needs.
Those new to Medicare after 2020 find Plan G accessible. It replaces unavailable comprehensive options. Healthy people might weigh premiums against rare usage.
Budget-conscious beneficiaries compare premiums across insurers. Shopping saves money on identical benefits. Plan G balances coverage and cost effectively.
How Premiums and Enrollment Work
Premiums depend on attained-age, issue-age, or community rating. Attained-age rises with time. Shop during Medigap Open Enrollment for best rates.
Open Enrollment starts when you turn 65 and enroll in Part B. It lasts six months with guaranteed issue. No health questions apply during this window.
Outside this period, medical underwriting may occur. Pre-existing conditions could affect approval or rates. Check state rules for extra protections.
Foreign Travel Emergency Benefits
Plan G covers 80% of emergency care abroad after a $250 deductible. Lifetime maximum reaches $50,000 in most policies. This aids international travelers.
Coverage applies to medically necessary emergencies in the first 60 days of a trip. It fills gaps Original Medicare ignores overseas. Confirm details with your policy.
Many appreciate this perk for vacations or family visits. It adds value beyond domestic care. Travel insurance might supplement for full protection.
Managing Costs with Plan G
Track spending to meet the Part B deductible early. Use preventive services, often free under Medicare. This minimizes later out-of-pocket hits.
Choose providers accepting Medicare assignment. This avoids excess charges Plan G covers anyway. It streamlines billing and reduces surprises.
Review Explanation of Benefits statements regularly. Verify Plan G payments match expectations. Contact your insurer for discrepancies.
Tips for Getting the Most from Plan G
- Compare quotes from multiple insurers for the same plan.
- Enroll during your Medigap Open Enrollment Period.
- Pair with a Part D plan for prescription coverage.
- Use Medicare’s plan finder tool for options in your area.
Plan G and Prescription Drugs
Plan G does not include drug coverage. Enroll in a separate Medicare Part D plan. This handles outpatient prescriptions effectively.
Coordinate Part D with Original Medicare and Medigap. Avoid gaps in medication access. Review formularies annually during enrollment.
Some insurers bundle options, but Part D remains separate. Budget for premiums and copays. This completes your protection package.
Future Considerations for Plan G
Medicare costs adjust yearly with inflation. Deductibles and limits change accordingly. Stay informed through official updates.
Plan G remains stable as a standardized option. Insurers may add perks like fitness programs. Compare additions when renewing.
Policy changes occur rarely but monitor announcements. Advocacy groups track reforms affecting supplements. Knowledge helps long-term planning.
Conclusion
Medicare Supplement Plan G delivers strong coverage for most Original Medicare gaps. It offers reliable protection with minimal uncovered costs. Review your needs and compare options to decide if it fits.
FAQ
What is the main difference between Plan G and Plan F?
Plan G covers everything Plan F does except the Part B deductible. You pay the annual Part B deductible yourself. After that, benefits match closely for comprehensive protection.
Does Plan G cover the Part A hospital deductible?
Yes, Plan G pays 100% of the Part A deductible per benefit period. This covers inpatient hospital entry costs fully. No out-of-pocket remains for this after Medicare approval.
Is Plan G available to everyone on Medicare?
New enrollees after January 1, 2020, can buy Plan G. Those eligible before may have more options like Plan F. Guaranteed issue applies during Open Enrollment.
What does Plan G cover for doctor visits?
Plan G covers 100% of Part B coinsurance after the deductible. This includes 20% of approved amounts for visits. Preventive services often cost nothing under Medicare.
Does Plan G include coverage for foreign travel emergencies?
Yes, it covers 80% of emergency care abroad after a $250 deductible. Lifetime limit typically reaches $50,000. This helps with unexpected needs overseas.
How much is the Part B deductible with Plan G?
In 2025, it equals the Medicare Part B deductible, around $257. You pay this once yearly for outpatient services. Plan G covers everything afterward.
Can Plan G have a high-deductible version?
Yes, some states offer high-deductible Plan G with a $2,870 threshold in 2025. You pay this before benefits start. Premiums are usually lower for this option.
Does Plan G cover skilled nursing facility stays?
Plan G covers coinsurance for days 21-100 fully. This applies after three hospital days. Beyond 100 days, no coverage exists as Medicare limits apply.
Dr. Usman is a medical content reviewer with 12+ years of experience in healthcare research and patient education. He specializes in evidence-based health information, medications, and chronic health topics. His work is based on trusted medical sources and current clinical guidelines to ensure accuracy, transparency, and reliability. Content reviewed by Dr. Usman is for educational purposes and does not replace professional medical advice.