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Medicare Supplement Insurance Plan G

Medigap Plan G is one of 10 standardized Medicare Supplement Insurance plan options available in most states. (Massachusetts, Minnesota, and Wisconsin have different options). Find out how this plan could help with your health care and health insurance needs.

Medigap Plan G: An Overview

Medigap Plan G covers all of the standardized Medigap benefits aside from the Medicare Part B deductible.

The average premiums for Plan G were low compared to other options in 2010, according to the Kaiser Family Foundation.1 About 6% of Medigap policyholders chose this plan in 2014, according to America’s Health Insurance Plans.2

Please keep reading for details on Plan G’s benefits and enrollment rates, in addition to how the benefits compare to other plan options.

Plan G Benefits

Medigap Plan G changed in June 2010. It has different benefits than the same letter plans bought before that date.

The updated Plan G provides 8 out of 9 available Medigap benefits.

Plan G benefits

Standard Medicare Supplement Insurance benefits

Plan G

Medicare Part A co-insurance and hospital costs

Medicare Part B co-insurance or co-payment

First 3 pints of blood

Part A hospice care co-insurance or co-payment

Co-insurance for skilled nursing facility

Medicare Part A deductible

Medicare Part B deductible

 

Medicare Part B excess charges

Foreign travel emergency

80%

Medicare Part A co-insurance: Medicare Part A is known as hospital insurance and it includes cost-sharing measures like co-insurance. Inpatient hospital stays covered by Medicare Part A require co-insurance fees if they exceed 60 days. Medigap Plan G pays for all of these co-insurance fees.

Medicare Part B co-insurance and co-payment: Medicare Part B usually charges a coinsurance and copayments for doctor visits and other outpatient care. Medicare Part B typically pays for 80% of the Medicare-approved amount for covered services, leaving a 20% coinsurance in most cases. Plan G pays the 20% coinsurance or copayment costs.

First 3 pints of blood: Original Medicare only covers the fourth pint of blood and beyond. If you need blood while in the hospital, Medigap plans cover the cost of the first 3 pints.

Part A hospice care co-insurance or co-payment: Hospice care provides medical treatment and care during a terminal illness. Medicare covers these services, but it requires co-payments. These co-payments include $5 for each symptom and pain relief prescription drugs and 5% of the Medicare-approved amount for inpatient respite care. Plan G covers these costs completely.

Co-insurance for skilled nursing facility: Co-insurance for medical care provided at skilled nursing care facilities is fully covered by Plan G.

Medicare Part A deductible: Medicare Part A comes with a deductible, which is $1,364 per benefit period in 2019. Medigap Plan G will cover your deductible in full for each benefit period you require.3

With Plan G, you still have to pay the Medicare Part B deductible, which is $185 in 2019.

Medicare Part B excess charges: Doctors can bill a procedure for up to 15% higher than what Medicare pays for it. The extra expenses are called “excess charges.” If there are any excess charges for an approved visit, a person insured under Plan G would be covered.

Foreign travel emergency: This benefit provides coverage for medical care provided outside of the United States. This insurance benefit pays for 80% of the billed charges. Coverage is provided after a $250 deductible has been met for the year.

For more detailed information, read our page about Medicare Supplement Insurance benefits.

Plan option comparison

This Medigap plan option may be ideal for you if you’re worried about potentially expensive health care costs. Although the premiums are higher than other Medigap plans, Plan G provides a wide range of benefits.

To see the difference between Plan G and the other standardized Medigap plan options, please review the chart below.

Plan G vs. other Medigap plan options

Medicare Supplement Benefits A B C D F1 G K2 L3 M N4
Part A co-insurance and hospital costs
Part B co-insurance or co-payment 50% 75%
First 3 pints of blood 50% 75%
Part A hospice care co-insurance or co-payment 50% 75%
Co-insurance for skilled nursing facility 50% 75%
Medicare Part A deductible 50% 75% 50%
MedicarePart B deductible
Medicare Part B excess charges
Foreign travel emergency 80% 80% 80% 80% 80% 80%
1. Plan F offers a high-deductible plan. This plan requires you to pay a $2,300 deductible in 2019 before it covers anything. 2. Plan K has an out-of-pocket yearly limit of $5,560 in 2019. After you pay the out-of-pocket yearly limit and yearly Part B deductible, it pays 100% of covered services for the rest of the calendar year. 3. Plan L has an out-of-pocket yearly limit of $2,780 in 2019. After you pay the out-of-pocket yearly limit and yearly Part B deductible, it pays 100% of covered services for the rest of the calendar year. 4. Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don’t result in an inpatient admission.

Plan G Enrollment Statistics

Plan G is rapidly growing, according to America’s Health Insurance Plans (AHIP). From 2013 to 2014, enrollment increased 25%.

Despite the recent growth and availability, Plan G only represents 6% of the Medigap market share, according to AHIP.


https://kaiserfamilyfoundation.files.wordpress.com/2013/04/8412-2.pdf

https://www.ahip.org/wp-content/uploads/2016/04/MedigapEnrollmentReport_Linked.pdf

https://www.medicare.gov/your-medicare-costs/costs-at-a-glance/costs-at-glance.html

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