What Is Medigap Plan G?

Medigap Plan G is one of about ten Medigap plans available to Medicare beneficiaries. You might also hear Medigap plans referred to as Medicare Supplements. Plan G has become increasingly popular since 2020, and we’ll discuss why that is a bit later.

All Medigap plans act as secondary insurance to Original Medicare, which includes Parts A and B. As you might know, Original Medicare doesn’t pay for 100% of your healthcare costs. You’ll have deductibles, copayments, and coinsurance expenses. A Medicare Supplement plan will pick up some (or all) of those costs. Some supplements cover more than others, and Plan G is certainly one good option.

Medicare Supplements Are Standardized Plans

In 1990, the National Association of Insurance Commissioners agreed to standardize Medigap plans to alleviate the confusion surrounding them. Before standardization, there were lots of Medigap options, and you could add riders to your plan. That created many redundancies, so the group decided to simplify all plans.

Each of the Medigap plans remains the same from one year to the next, one state to the next, and one insurance company to the next. Once you enroll in a Medigap plan, your coverage will never change.

What Does Plan G Cover?

Plan G offers great healthcare benefits. It will cover nearly all the leftover costs from Parts A and B. This includes:

  • Part A deductible
  • Part A coinsurance (plus an additional 365 days of hospital costs)
  • Part A hospice coinsurance/copayment
  • Skilled nursing facility care coinsurance
  • Blood (3 pints)
  • Part B coinsurance/copayment
  • Part B excess charge
  • 80% of foreign travel emergencies

The only thing not listed here is the Medicare Part B deductible. So, as long as your service is covered under Medicare, the only out-of-pocket expense you’ll have if you enroll in Plan G is the Part B deductible. In 2023, that deductible is $226.

What Is Not Covered by Plan G?

We already mentioned that Plan G does not include payment for the Medicare Part B deductible. However, there are some other aspects you should be aware of when enrolling in any Medicare Supplement.

Medicare Supplements only provide coverage for things that are also covered by Original Medicare. You won’t find coverage for prescription drugs or routine dental, vision, or hearing services. Instead, you’ll need to enroll in a separate Medicare Part D prescription drug plan to get your medications covered by insurance. (And you absolutely should enroll because you’ll pay a penalty later if you don’t!)

For beneficiaries who would like coverage for the other services listed, many dental, vision, and hearing (DVH) plans are available at very affordable prices.

Why Is Medigap Plan G So Popular?

Plan G has always been a popular choice among beneficiaries. The predictable coverage and freedom to choose your own providers attract many people to this plan. However, it became even more popular in 2020 due to MACRA.

MACRA stands for the Medicare Access and CHIP Reauthorization Act. One goal of MACRA was to increase provider participation in Medicare by providing more reimbursements for services to providers who performed quality care. While the goal benefits both providers and patients, the program had to find a way to increase payments to providers. One way to do that was to eliminate Medicare Supplements that provided 100% cost-sharing benefits.

Plan F, the most popular plan until 2020, provided such benefits. (As did Plan C.) With Plan F, enrollees had no out-of-pocket costs because it also included coverage for the Part B deductible. So, Plan F was put on the chopping block.

However, Plan F was not entirely eliminated. In fact, many people still have Plan F, and others can still enroll. The only requirement is that you must have had both Part A and Part B prior to January 2020. Surprisingly, even individuals eligible for Plan F often switch to Plan G. The reason? The rising premiums associated with Plan F. While the premiums for Plan G are the next highest after Plan F, they often save enrollees more than the $226 they need to pay the Medicare Part B deductible.

Which Providers Accept Plan G?

Any provider who accepts Original Medicare will also accept your Medicare Supplement. There are no provider or facility networks associated with any Medigap plans, which is another reason they are so popular. You won’t be limited on which providers you can see, and you’ll be able to use your Medigap plan if you travel to another part of the country.

How Much Does Plan G Cost?

The cost of Plan G is not the same for everyone. Your monthly premium will depend on various personal factors and from whom you buy the plan. Personal information like your age, gender, tobacco use, and zip code are key factors in determining your premium. 

To give you a general idea of the cost of Plan G, the average 65-year-old female will pay around $110 per month, and a male will pay around $120. This can vary considerably based on your location and which insurance carrier you choose to enroll with.

How do I enroll in Medigap Plan G?

Have you decided Plan G is right for you? Or do you still have a few questions? Either way, our licensed insurance agents are ready to help!

If you are new to Medicare or have been enrolled for years, we can help you shop around for Plan G rates. We are contracted with multiple insurance companies, so we’re able to compare premiums across many carriers to ensure you get a competitive rate. Sunflower Insurance Solutions works only with trusted insurance carriers who have excellent ratings.

Our services come at no cost to you, and we’re happy to answer questions and guide you through your entire Medicare journey. If you have questions or are ready to talk to one of our Medicare advisors, now is the time to call Sunflower Insurance Solutions!

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Dani is a licensed health and life insurance advisor. She is also the creator of everything you see on our social media accounts and runs Blaze Creative, a content-writing and copywriting agency designed specifically for Medicare brokers.

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