Medicare Supplement Plan G is one of 10 Medigap plans that provides coverage for certain out-of-pocket expenses that are not covered by Original Medicare. Medigap Plan G is one of the more comprehensive Medigap plans, second only to Medigap Plan F in terms of coverage. It covers most of Part A and Part B coinsurances and copayments with the exception of Medicare Part B deductible.

Since insurers no longer offer Medicare Part F to enrollees who became eligible for Medicare after 2020, Plan G is the most comprehensive Medicare Supplement policy for first-time enrollees. Here’s what you need to know about the coverage, how your plan choices are changing, and what your best moves are to protect your finances against crippling healthcare costs now and in the future.

What is Medicare Plan G and who is it available for?

A Medicare Supplement plan is offered by private insurance companies and supplements the federal Medicare program-covered services. You sign up for Original Medicare through the Social Security office, but you purchase a Medicare Supplement plan from a licensed insurance agent. Medigap G Plans vary from insurer to insurer, but they all must follow certain guidelines set by the Centers for Medicare & Medicaid Services (CMS).

Medicare G plans are for those who are already enrolled in Part A and Part B and are looking for additional coverage. If you’re not already enrolled in Part A and Part B, G plans will not be available for you.

How does Medicare Supplement Plan G work? 

First, Original Medicare will pay the costs, and Plan G will pay any remaining costs after you have paid your annual deductible. Plan G is covering the gaps in your coverage with Original Medicare. 

What does Medicare Plan G cover? 

Medicare G Plans typically cover things like copayments, coinsurances, and deductibles. Some plans may also offer coverage for things like foreign travel, emergency care, and excess charges.

Medicare Plan G coverage

Medigap Plan G benefitsIncludesCovered?
Medicare Part A coinsurance and hospital costsCoverage for hospital stays and hospice careYes
Medicare Part B coinsurance or copaymentThe costs of outpatient care and doctor visitsYes
The first three pints of bloodThe cost of the first three pints of blood you may need for a medical procedure.Yes
Skilled nursing facility care coinsuranceCoverage for skilled nursing care in a facility.Yes
Part A hospice care coinsurance or copaymentCoverage for hospice careYes
Part A deductibleThe deductible for Medicare Part AYes
Medicare Part B deductibleThe deductible for Medicare Part BNo
Part B excess chargesCoverage for the charges that exceed the Medicare-approved amount.Yes
Medicare Plan G coverage
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Does Medicare Plan G cover prescriptions? 

No, G plans do not include prescription drug coverage. If you’re interested in getting prescription drug coverage through Medicare, you would need to enroll in Part D

Does Medicare Plan G cover eye exams? 

Some G plans may offer vision coverage as an optional add-on, but this is not required. If you’re interested in getting vision coverage through your G plan, you’ll need to check with your insurer to see if it’s available. 

How does Medicare Supplement Plan G cover hospital costs? 

That small deductible goes a long way toward reducing those hospital costs. Plan G covers all of your hospital expenses, including the hospital deductible which is $1,632 for 2024. When a hospital stay goes for longer than 60 days, there is a daily copay that can be quite expensive. You don’t have to worry about that because Plan G covers all of those as well. 

But it doesn’t stop there. Plan G gives you 365 more days in the hospital once your Medicare benefits are used up, and the costs from your skilled nursing facility co-insurance are covered, too.

Services not included 

Some other services that are not included are: 

  • Cosmetic Procedures: G plans will not cover any cosmetic procedures. 
  • Acupuncture: G plans typically do not cover acupuncture services. 

Medicare Plan G cost 

The cost of a G plan will vary depending on the insurer and the specific benefits that are included in the plan. In general, G plans have premiums (the monthly amount you pay for your insurance) as well as out-of-pocket costs (the amount you pay when you receive care). 

Some of the factors that affect the Medicare Plan G costs are: 

  • The insurer you choose: G plans are offered by private insurance companies, so the cost of a plan will vary depending on which insurer you choose. 
  • The benefits included in your plan: G plans typically cover things like copayments, coinsurances, and deductibles. Some plans may also offer coverage for things like foreign travel, emergency care, and excess charges. 
  • The deductible: The Plan G deductible is the amount you pay out-of-pocket before your G plan begins to pay for covered services. 
  • Your location: G plans are offered nationwide, but the cost of a plan may vary depending on your state or county of residence. 
  • Whether you smoke: As with all insurance plans, Plan G premiums may be higher for smokers than non-smokers. 

Medigap Plan G deductible

Plan G does not have its own deductible. Instead, you pay Medicare Part B deductible.

Does Medicare Supplement Plan G cover Part B deductible? 

No, G plans do not cover the Part B deductible, you will still need to pay for it in addition to your part G premium. The Part B deductible is currently $240 for 2024. 

Medicare Supplement Plan G vs Medicare Supplement Plan F

Of the 10 available Medigap plans, Plans F and G offer the richest coverage.

The main difference between Plan G and Plan F is that Plan G covers the Part B deductible, while Plan F does not. Plan G also has a higher monthly premium than Plan F.

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How Medicare Supplement Plan G curbs excesses

Medicare Supplement Plans F and G offer another valuable benefit: They are the only two plans that provide coverage for Medicare Part B excess charges, which occur when a doctor bills you for more than the Medicare-approved amount for a specific service.

While fairly uncommon, Medicare Part B excess charges can add up quickly. Medicare places no limits on your out-of-pocket spending.

Even if none of your current doctor’s bills for Medicare Part B excess charges, it’s worth considering whether doctors or hospitals that you want to use in the future might.

Why a Medicare Supplement plan is crucial?

Original Medicare pays for only the first 80% of your doctor and hospital bills. A Medicare Supplement plan picks up much of the slack, helping you cover out-of-pocket costs such as copayments, coinsurance, and deductibles.

Currently, there are 10 standardized varieties of Medicare Supplement plans, all going by letters of the alphabet (A, B, and so on). These policies are sold by private insurers. All plans with the same letter offer the same coverage in most states (the exceptions are Massachusetts, Minnesota, and Wisconsin), though premiums vary by insurer. You can use this tool to compare prices.

You can use your Medicare Supplement insurance with any doctor that takes Medicare anywhere in the country.

Medicare Plan G pros and cons 

Medicare is one of the leading health insurance programs in the United States, and Plan G is one of the most popular types of Medicare Supplement plans. G plans are loved by patients because of all the advantages they offer, such as: 

  • The best coverage. G plans cover a wide range of costs, including hospital stays, skilled nursing facility care, and more. They are fairly considered to be the most comprehensive Medigap plans. 
  • Many plans cover foreign travel emergencies. If you travel outside of the US, up to 80% of expenses might be covered.
  • You don’t have to worry about pre-existing conditions. G plans do not have any pre-existing condition exclusions, so you can get coverage even if you have a health condition. 
  • More affordable than Medicare Advantage plans. G plans are often more affordable than Medicare Advantage plans, making them a great option for budget-conscious patients. 
  • No provider networks. You can freely choose any Medicare-approved healthcare provider without any concern about provider networks or geographical restrictions.
  • No referrals. You can see any specialists without a referral from your primary care physician with Medigap G plans.
  • No pre-authorizations. You can receive Medicare-approved services without pre-authorization.

On the other hand, it is worth mentioning that Medigap Plans G have their disadvantages, too:

  • Part B deductible is not covered. You still have to pay it.
  • Your application can be denied. Like with all Medigap plans, there’s no guarantee that you will get a G plan unless you apply during the guaranteed issued rights enrollment window.
  • It is not a cheap plan. Due to such extensive coverage, G Plans are some of the most expensive Medigap plans out there. Moreover, the costs can go up yearly due to inflation or your age (enrollees tend to pay more as they get older). The average cost rate is between 5 and 8% each year.
  • No prescription drug coverage. You would still need to purchase a separate Medicare Plan D to cover prescription drugs.

Medigap Plan G vs Medicare Advantage

It’s important to note that Medicare Advantage plans (also known as Part C plans) are different from Medicare supplement plans like Part G. Medicare Advantage plans are offered by private insurance companies and provide an alternative to Original Medicare.

These plans typically have lower premiums than G plans, but they may also have more limited coverage. Medicare Advantage plans often limit your coverage to a particular network of healthcare providers. Plans that allow you to see out-of-network providers typically charge you more.

You cannot have a Medicare Supplement Plan G with Medicare Advantage.

You must be enrolled in Medicare Parts A & B to be eligible to apply for a Medicare Advantage plan. You may pay a premium for your Medicare Advantage plan in addition to your Part B premium.

How to know whether Plan G Medicare is right for you? 

Healthcare is not something to leave to chance. For many older Americans, there can be many unknowns about their future healthcare needs. So how do you know if Medicare Plan G is right for you? 

It should be clear by now that it is a great option for those who want comprehensive coverage at a reasonable price. If you are looking for an insurance plan that will cover a wide range of healthcare costs, Medicare Supplement Plan G should be at the top of your list. But ultimately, the decision about whether Plan G is right for you depends on your individual needs and circumstances. If you are uncertain about whether it is right for you, be sure to speak with a qualified healthcare professional who can help you make the best decision for your unique situation. For example, you can use our Medicare Personal Shopper, which will help you choose the best plan based on your unique needs.

Questions about Medicare?

Shoot us an email at medicare@hihella.com.

Article updated on January 19, 2024 to reflect the current Medicare costs.