Medicare Part G: What Does It Cover? What Does It Cost?
Medicare Supplement Plan G is a popular and comprehensive MedSup plan. Here's why it may be the best MedSup plan for you.
Medicare Part G — or Plan G — is one of the most popular Medicare Supplement plans available. Plan G sits just behind Plan F in terms of popularity among American Medicare enrollees who want a bit more coverage.
Why? One reason is Medicare Supplement Plan G provides coverage that is nearly as comprehensive as what Plan F provides.
That’s just the tip of the iceberg as to why so many people buy MedSup Plan G or Medigap Plan G, as some call it, though. Keep reading to learn more about what makes Plan G so popular as well as:
- What Medicare Part G covers
- How MedSup Plan G and MedSup Plan F are different
- Why you might choose Medigap Plan G over Medigap Plan F
- Where you can buy a Medicare Supplement Plan G policy
- How much MedSup Plan G costs
What does Medicare Part G cover?
Medicare Part G fully pays these healthcare costs:
- Medicare Part A deductible.
- Part A coinsurance and hospital costs up to an additional 365 days after your standard Medicare benefits end.
- Part A hospice care coinsurance or copayment.
- Part B coinsurance or copayment.
- Part B excess charge.
- Skilled nursing facility care coinsurance.
- Up to three pints of blood for medical procedures each year.
Medicare Supplement Plan G also covers 80% of medical care you receive while traveling outside the U.S., up to your plan’s limits.
What doesn’t Medicare Part G cover?
Although MedSup Plan G helps you pay most of the healthcare costs Original Medicare, or Medicare Part A and Part B, doesn’t cover, it doesn’t help you pay all of them.
For example, MedSup Plan G doesn’t cover the Medicare Part B deductible. You’ll pay for all medical services or supplies until your out-of-pocket costs reach that amount if you enroll in Plan G.
For 2020, the Medicare Part B deductible is $198 per year. After your out-of-pocket costs hit that limit, you’ll pay 20% of the Medicare-approved amount for most of the services Part B covers. That includes care like doctor visits and outpatient therapy.
Also, Plan G usually doesn’t cover prescription drugs. Some MedSup policies used to, but that’s no longer the case. For that, you need to enroll in Medicare Part D.
Finally, Medicare Supplement Plan G also won’t cover any of these costs:
- Dental care.
- Eye care, including glasses.
- Hearing aids.
- Long-term care.
- Private-duty nursing.
Are all MedSup Plan G policies the same?
Once you know all the above, you’re set. Why? Because all Medicare Supplement Plan G policies provide the exact same coverage or benefits. This is what people mean when they say these plans are “standardized.”
That said, not all Plan G policies cost the same. Insurance companies are free to charge what they want for them, and so they do.
Given that, shop around and carefully compare quotes and plans before you settle on one. And don’t just consider their premiums. Look at their deductibles, copayments and coinsurance costs, too. Do that, and you’ll get the best Plan G bang for your buck.
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What are the differences between Medicare Supplement Plan G and Plan F?
The main difference between Medicare Supplement Plan G and Plan F is that MedSup Plan F covers your Medicare Part B deductible. Plan G doesn’t cover that cost.
Of course, the Part B deductible is just $198 this year, but a buck is a buck, right?
However, MedSup Plan G premiums tend to be cheaper than Plan F premiums. This means you’ll pay less per month to maintain Plan G coverage than you will to maintain Plan F coverage.
There's only one way to figure out which plan will best fit your budget and your medical needs. Whip out your calculator and add up what you’ll pay for each one in the long run.
Don’t be surprised, though, if you find MedSup Plan G to be the better deal.
Why should I choose Medicare Supplement Plan G over Plan F?
One reason to choose Medicare Supplement Plan G over Plan F is that insurance companies no longer offer MedSup Plan F to new Medicare enrollees.
Thanks to the Medicare Access and CHIP Reauthorization Act of 2015, insurers can’t sell MedSup Plan F to people who became eligible for Medicare on or after Jan. 1, 2020.
Don’t worry, if you’re already enrolled in Plan F, you’ll be able to keep it. If you don’t have MedSup coverage and you want to buy Plan F now, though, you won't be able to do so. The same is true if you’re enrolled in a different MedSup plan and you want to switch to Plan F.
Long story short: if you want MedSup Plan F but can no longer enroll in it, Plan G may be the best Medicare Supplement policy for you.
How is MedSup Plan G different from other MedSup Plans?
Medicare Supplement Plan G and Plan F are very similar. The main difference between them is Plan F covers your Medicare Part B deductible while Plan G doesn’t.
Some of the other Medicare Supplement plans available today are only slightly different from F and G while a few are quite different. For example:
- MedSup Plan C is like Plan F but doesn’t pay your Medicare Part B excess charges.
- Plan N, on the other hand, doesn’t pay your Part B deductible or excess charges.
Other MedSup plans pay just a portion of costs, like your Part A deductible or your Part B copay or coinsurance fees. Some come with yearly out-of-pocket limits, too.
How does Medigap Plan G cover Part B excess charges?
Here’s what you need to know about the excess charge MedSup Plan G pays for you.
Medicare agrees to pay a certain amount for each treatment. That’s what physicians and other care providers who “accept assignment” charge you for those services.
Physicians and providers who don’t accept assignment, though, charge you more. By law, they can only charge you 15% more than the Medicare-approved amount.
The difference between the two amounts is the excess charge that Medicare Supplement Plan G pays for you.
How does Medicare Part G work?
For starters, you need to be enrolled in Original Medicare, or Medicare Parts A and B. Then you can buy Medicare Part G from a private insurance company that serves your ZIP code.
Once that’s out of the way, here's how Medicare Part G works:
- You pay your monthly Medicare Part B premium. If you receive benefits from Social Security, the Railroad Retirement Board or the Office of Personnel Management, your premium will be automatically deducted from your benefit payment.
- You also pay the monthly premium for your Plan G policy.
- After you visit a healthcare provider, Medicare will pay its share of the Medicare-approved amount for covered treatments.
- Your MedSup policy then pays its share of those costs, if needed.
Where can I buy Medicare Supplement Plan G?
You can buy MedSup Plan G — and every other MedSup plan — from any insurance company that's licensed in your state to sell Medicare Supplement coverage.
Remember, all Plan G policies must provide the same benefits or coverages. Just like all Plan F policies must provide the same benefits or coverages.
Insurers can and do charge different amounts for the MedSup Plan G policies they sell, though. Don’t enroll in the first one you come across while shopping around. Compare the various costs associated with the plans sold in your area before you make your final decision.
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Are MedSup Plans sold in Massachusetts, Minnesota and Wisconsin different?
These states only offer a few MedSup plans, so you won't have to do much homework before you settle on one of them.
How much does Medicare Supplement Plan G cost?
What you pay for Medicare Supplement Plan G coverage is based on several factors, including:
- Where you buy it.
- Where you live.
- Your gender.
- Whether or not you smoke.
Regarding that first bullet point, insurance companies can price MedSup Plan G policies as they please. Premiums, deductibles and copays for one Plan G policy may differ from company to company.
While shopping for these policies, keep in mind that insurance companies price them in three distinct ways. One way bases your Plan G premium on your age when you buy the plan. Another bases your premium on your current age, which means it will go up as you get older. And a third ignores your age and charges everyone the same monthly premium.
Insurance companies usually charge men more than women for MedSup policies. They also charge tobacco users more than people who don’t use tobacco products. And they charge people in certain areas of the U.S. more than they charge people in other areas. Some insurers even base what they charge for a Plan G policy on how long someone’s been enrolled in Medicare Part B.
To figure out how much — or how little — you’ll pay for Plan G coverage, contact a number of insurers that sell the policies in your ZIP code. Compare the prices they quote you and then make your decision based on that information.
How can I lower my MedSup Plan G costs?
Here are a few things you can do to lower your Medicare Supplement Plan G costs:
- Move to an area where this kind of coverage costs less than it does where you live now.
- Shop around and switch to a plan that charges less than your current one does.
- See if the insurance companies that serve your area offer any discounts on these plans. Some give discounts to women, non-smokers, married couples, people who pay yearly and more.
- Quit smoking.
Who can enroll in Medicare Supplement Plan G?
You can buy a MedSup Plan G policy if:
- You’re over 65.
- You’re enrolled in both Medicare Part A and Part B.
- You’re not enrolled in a Medicare Advantage plan.
- You live in the plan’s service area.
Who can’t buy a MedSup Plan G policy? One example is people under 65 with Medicare coverage due to a disability or end-stage renal disease. They may not be able to buy one of these plans. They may not be able to buy any MedSup or Medigap policy, period.
If you’re in this situation and you want Plan G coverage, contact a few of the insurance companies in your area. They can tell you if you’re allowed to buy one or not. If you can’t, ask if you can buy any other MedSup policies.
When can I enroll in Medicare Supplement Plan G?
Although you can buy a MedSup Plan G policy at any time (if you have Original Medicare), some times are better than others.
One of the best times to buy a MedSup plan is during the six-month Medicare Supplement open enrollment period. It begins the month you turn 65 and after you enroll in Medicare Part B. You can buy any MedSup plan sold in your state, even if you have health problems, within this six-month window.
After the six-month MedSup open enrollment period, you’ll likely have to jump through some hoops to get Plan G coverage — if you can get it at all. This is because most insurers will look into your medical and health history. Depending on what they find, they might refuse to sell you coverage. Or they might charge you a lot more for it than they would if you bought it during your MedSup open enrollment period.
Can I enroll in MedSup Plan G if I have a Medicare Advantage plan?
If you’re enrolled in a Medicare Advantage plan, you can’t enroll in a Medicare Supplement plan, too.
What if you’re enrolled in Original Medicare and a MedSup plan and you want to switch to a Medicare Advantage plan with similar coverage? You can do that. Drop the MedSup plan before you buy the Medicare Advantage plan, though. The former won't pay out after you enroll in the latter.
Will MedSup Plan G cover my spouse?
No, your MedSup Plan G won’t cover your spouse, too.
Actually, this is true of all Medicare Supplement insurance policies. MedSup policies cover only one person.
So, if you and your spouse both want MedSup coverage, you each must enroll in your own policies.
Can I enroll in more than one Medicare Supplement plan at a time?
If you’re already enrolled in a Medicare Supplement plan, you can’t enroll in a second one.
In fact, insurance companies aren’t allowed to sell you more than one MedSup plan. Or they can’t sell you a second if you’ve already enrolled in one.
If you want to switch from your current MedSup or Medigap policy to another, you can try. But most insurance companies will make you pass a medical screening in this situation.
Depending on what they find during that screening, they might turn you down for coverage. Or they might charge you a lot more for it than they otherwise would.
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