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Medicare Supplement Plan G

What is Medicare Supplement Plan G?

Medicare Supplement insurance: Plan G basic benefits

Medicare Supplement insurance Plan G includes the following basic benefits:

  • Part A hospital coinsurance and hospital costs up to 365 days after Original Medicare benefits are exhausted
  • Part A hospice care coinsurance or copayment
  • Part A deductible
  • Part B preventive care coinsurance
  • Part B coinsurance or copayment
  • Part B excess charges
  • First three pints of blood for a medical procedure
  • Skilled nursing facility (SNF) care coinsurance coverage
  • Limited foreign travel emergency medical care

Medicare Supplement (Medigap) insurance Plan G benefits are the same as those of Medigap Plan F, with one exception. The Medicare Part B deductible, covered under Medigap Plan F, must be paid out-of-pocket in Medigap Plan G.  

Once your out-of-pocket expenses reach the Part B deductible amount, you become responsible for paying 20% of the cost of Medicare-approved Part B services.

The majority of Medicare Supplement insurance plans do not cover Part B excess charges. These are additional charges outside of the Medicare-approved charge. For example, Medicare’s allowed charge for a doctor’s appointment could be $100, but the physician could choose not to accept that amount, and instead charge an additional 15% for the appointment. In this example, Medicare will pay 80% of the allowed charge, sending the physician $80. The beneficiary is responsible for paying not only the remaining $20, but also the excess 15% charge, another $15, making the total out-of-pocket cost $35. Medicare Supplement insurance Plan G covers this excess charge.

As of January 1, 2020, Plan G will offer a high deductible option.

The best time for beneficiaries to enroll in a Medicare Supplement Plan may be during their Medicare Supplement Open Enrollment Period, which is not the same for everyone.

This period begins on the first day of the first month that you are both age 65 or older and enrolled in Medicare Part B, and lasts for six months. During this time, private insurance carriers may not use medical underwriting to assess a beneficiary’s health condition.

This means that if you’re enrolled in Medicare Part A and Part B and live within a Medigap plan’s service area, you can enroll in that Medigap plan without fear of being denied coverage or charged higher premiums based on a pre-existing health condition (although waiting periods may apply).

*Medigap plans do not include prescription drug benefits; if you’re enrolled in Original Medicare and want coverage for your medications, you should enroll in a stand-alone Medicare Prescription Drug Plan.

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