Medicare Supplement Plan G

What does Medicare Supplement Plan G Cover?

Medigap Plan G pays for benefits covered under Part A and Part B.

Medigap Plan G does not cover any benefits for Part D (prescription drug coverage).

Part A is hospital insurance, including hospice, skilled nursing facility, and hospital inpatient care.

Part B is medical insurance covering doctor visits, outpatient care, and durable medical equipment.

Medicare Supplement Plan G covers the following Medicare Part A benefits at 100%:

• Medicare Part A deductible for each benefit period
• Coinsurance and hospital charges up to 365 days beyond the point when Medicare benefits are exhausted
• Hospice care coinsurance or copayment
• Skilled nursing facility care coinsurance

Medicare Supplement Plan G covers the following Part B benefits at 100%:

• Part B coinsurance (20% of the Medicare-approved amount) or copayment (generally a fixed amount for the service)
• The first three pints of blood that a provider may have to buy for you
• Excess charges (unless you live in a state where Part B excess charges are prohibited)

Original Medicare does not cover health care services outside the U.S. Within the following parameters, Medigap Plan G pays 80% of the covered cost of foreign travel emergency care:

• Emergency care has to begin during the first 60 days of your trip.
• The emergency services rendered must be medically necessary.
• A deductible ($250 in 2022) is required, separate from your Medicare Part B deductible.
• The plan limits lifetime coverage to $50,000.

What does Medicare Supplement Plan G Cost?

The price, or premium, you pay for a Medigap policy is determined by the insurance company that sells it. Therefore, it’s prudent to ask a licensed insurance agent about the pricing approach adopted by each insurance company offering Medicare Supplement Insurance in your area.

The company can rate (price) the policy based on:

• Community: Age is not factored into the price.
• Issue age: The determining factor is your age when the company issues the policy to you.
• Attained age: The premium is tied to your age when you buy the policy and increases every time a new age is attained. This means your premium gets higher every time you have a birthday.

Here are examples of how you can lower your Medigap Plan G premium:

• Take advantage of discounts the insurer may offer for being a non-smoker, paying the premium yearly, authorizing automatic payments, and bundling multiple insurance policies under one carrier.
• Purchase a high-deductible Plan G. For 2022, the annual deductible is $2,490, in addition to the $250 annual deductible for foreign travel emergency health care.
• Enroll during your Medigap Open Enrollment Period to avoid medical underwriting and the possibility that you will be charged a higher monthly premium based on health issues.

How and When To Enroll in Plan G

The Medigap Open Enrollment Period is a six-month window, which starts on the first day of the month that you have your 65th birthday. Suppose you choose not to enroll in Part B when you become eligible because you already have group health insurance through an employer (you or your spouse’s employer). In that case, your Medigap Open Enrollment Period starts when you register for Part B.

An insurer that sells Medigap policies cannot refuse you a policy, delay coverage, or charge a higher premium based on your health. However, once this window of opportunity ends, there is no guarantee that your application will be approved unless you have guaranteed issue rights, otherwise known as Medigap protection.

Guaranteed issue rights apply if you:

• Are a member of an MA plan no longer offering coverage in your area
• Relocate to a location that your Medicare Advantage plan or Medicare SELECT plan (a specific type of Medigap policy) does not cover
• Have group coverage through an employer or union that is ending
• Are within your one-year trial right to switch back to Medigap after dropping it to try an alternative Medicare plan
• Live in a state where Medigap protection is mandated based on age and/or disability

Why Consider Plan G?

Original Medicare requires coinsurance, copayments, and deductibles that can add up quickly, and there is no out-of-pocket maximum. Medicare Supplement Insurance offers peace of mind that covered costs will not get out of control.

If you were new to Medicare on or after January 1, 2020, Plan G offers the most coverage of all the Medigap plan options. Before 2020, Plan F was the most comprehensive plan available. The difference between the two plans is that Plan F covers the Medicare Part B deductible ($233 in 2022) each calendar year, and Plan G does not. Plan F is no longer available to newly eligible Medicare beneficiaries.