Medicare Part G: What Does It Cover? What Does It Cost?
If you’ve heard of this Medicare Supplement plan but know nothing about it, this article is for you. Here’s everything you need to know about Medicare Supplement Plan G.
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? That’s what you’ll find out here. You’ll also learn what Medicare Part G, or Medicare Supplement Plan G, plans cover, how much they tend to cost, where you can get them, and a whole lot more.
The Many Names of Medicare Part G
Medicare Part G has a few different names. Its commonly called Medicare Part G or Medicare Supplement Plan G. Other names include MedSup Plan G, Medigap Plan G, and even just Plan G or Part G.
This isn’t to confuse you. A quick Google search will show you that people refer to these plans in several different ways. For example, it’s common to shorten Medicare Supplement to MedSup or Medigap.
Want to learn more about MedSup policies? Check out this article of ours: “When Does it Make Sense to Get a Medicare Supplement Plan?”
What Medicare Part G Covers
According to medicare.gov, Medicare Part G fully pays the following 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
Plan G also covers 80 percent of medical care you receive while traveling outside the US – up to your plan’s limits, of course. Want to know more about this type of coverage? See our article, “Do Medicare, Medicare Advantage, or Medigap Plans Pay for Medical Treatments in Foreign Countries?”
What Medicare Part G Doesn’t Cover
Although MedSup Plan G policies help 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, it 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 2018, the Medicare Part B deductible is $183 per year. After your out-of-pocket costs hit that limit, you’ll pay 20 percent of the Medicare-approved amount for most Part B-covered services. 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. To learn more about these Medicare Prescription Drug Coverage plans, read our Medicare Part D article. You may want to check out this article, too: “Is Medicare Enough? What’s Covered and What's Not Covered?”
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
All MedSup Plan G Policies Are the Same--To a Point
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 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.
Differences Between Medicare Supplement Plan G and Plan F
The main difference between MedSup Plan G and Plan F is that Plan F covers your Medicare Part B deductible. Plan G doesn’t cover that cost.
Of course, the Part B deductible is just $183 this year, but a buck is a buck, right?
However, 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 Plan G to be the better deal.
Another Reason to Choose Medicare Supplement Plan G Over Plan F
Thanks to the Medicare Access and CHIP Reauthorization Act of 2015, insurance companies are phasing out MedSup Plan F.
The reason: after Jan. 1, 2020, they’ll no longer be able to sell those plans. They also won’t be able to sell a similar one, Medicare Supplement Plan C. Both policies cover the Medicare Part B deductible mentioned earlier.
Don’t worry, if you’re already enrolled in Plan F, or if you enroll in it between now and that date, you’ll be able to keep it. If you don’t have MedSup coverage and you want to buy Plan F after Jan. 1, 2020, 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 from Jan. 2, 2020, onward.
In either of those cases, Plan G may well be the Medicare Supplement policy for you. Of course, it may be the one for you now, given what’s been said about it so far. Still, if you have any interest in, or any need for, this kind of coverage, don’t drag your feet. Weigh your options now and figure out which plan will treat you and your bank account better in the coming years.
Differences Between MedSup Plan G and Other MedSup Plans
As you’ve learned, 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 MedSup plans available today are only slightly different from F and G while others 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.
More on Medicare Part G and How it Covers Part B Excess Charges
“Excess charge” sounds scary, but it’s not.
Think about it this way: 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 percent 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 Medicare Part G Works
For starters, you need to be enrolled in Original Medicare (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 what happens:
- 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 You Can Buy a Medicare Supplement Plan G Policy
You can buy this and every other MedSup plan from any insurance company that's licensed in your state to sell one.
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 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.
MedSup Plans Sold in Massachusetts, Minnesota, and Wisconsin are Different
We've said that all Medicare Supplement policies of the same letter type provide the same coverage.
These states only offer a few MedSup plans, so you won't have to do much homework before you settle on one of them.
Medicare Supplement Plan G Costs
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 wish. Premiums, deductibles, and copays for one Plan G policy may differ from other insurers.
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 to Get Cheaper Plan G Coverage
Here are a few things you can do to lower your 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 Buy a Medicare Supplement Plan G Policy?
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 You Can Buy a Medicare Supplement Plan G Policy
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 those times 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 this 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 you MedSup open enrollment period.
For more information, check out this article of ours: “When Does it Make Sense to Get a Medicare Supplement Plan?”
MedSup Plan G and Medicare Advantage Plans
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.
To learn more these policies, read our comprehensive “Guide to Medicare Advantage Plans.”
Also, if you don’t know the difference between Medicare Advantage and Medicare Supplement plans, don’t worry. Our article, “Medicare Supplement (Medigap) vs. Medicare Advantage,” will bring you up to speed.
Psst! MedSup Plan G Only Covers One Person
Actually, this is true of all Medicare Supplement insurance policies.
So, if you and your spouse both want this kind of coverage, you each must enroll in your own MedSup policies.
Also, You Can Only Enroll in One MedSup Plan at a Time
That’s right: if you’re already enrolled in a Medicare Supplement plan, you can’t go and enroll in another one.
In fact, insurance companies aren’t allowed to sell more than one of them to you. Or they can’t sell you a second if you’ve already enrolled in one.
If you’d like to switch from your current MedSup or Medigap policy to another, you can try. Most insurance companies will make you pass a medical screening in this kind of 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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