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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).

Medicare Supplement Plan G is the fastest growing Medigap plan.1 Learn more about what Plan G covers, its cost and why it might be the right Medigap plan for you.

 

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What Does Medigap Plan G Cover?

Plan G currently provides coverage for each of the standardized Medigap benefits except for the Medicare Part B deductible.

In 2020, changes to Medigap coverage requirements will make Plan G the most comprehensive of any Medigap plan that will still be available to newly eligible Medicare beneficiaries (see below for more information).

Plan G Benefits

Standard Medicare Supplement Insurance benefits

Plan G

Medicare Part A coinsurance and hospital costs

Medicare Part B coinsurance or copayment

First 3 pints of blood

Part A hospice care coinsurance or copayment

Coinsurance for skilled nursing facility

Medicare Part A deductible

Medicare Part B deductible

 

Medicare Part B excess charges

Foreign travel emergency

80%

Medicare Part A Coinsurance

Medicare Part A is known as hospital insurance, and it includes cost-sharing measures like coinsurance. Inpatient hospital stays covered by Medicare Part A require coinsurance fees if they exceed 60 days.

Medigap Plan G pays for all of these coinsurance fees.

Medicare Part B Coinsurance and Copayment

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 Plan G covers the cost of the first 3 pints.

Part A Hospice Care Coinsurance or Copayment

Hospice care provides medical treatment and care during a terminal illness. Medicare covers these services, but it requires copayments. These copayments 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.

Coinsurance for Skilled Nursing Facility

You have to pay coinsurance after you are admitted to a skilled nursing facility as an inpatient for more than 20 days.

The coinsurance charge is $170.50 per day for days 21-100 of an inpatient skilled nursing facility stay in 2019. After day 100, you are responsible for all costs.

Plan G fully covers your skilled nursing facility coinsurance.

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.

Medigap Plan G will cover your deductible in full for each benefit period you require.

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 fully covered.

Foreign Travel Emergency

This benefit provides coverage for medical care provided outside of the United States. Medigap Plan G pays for 80% of the billed charges after a $250 deductible has been met for the year.

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

 

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How Does Medigap Plan G Compare to Other Plans?

You can use this Medigap plans comparison chart to compare Medigap Plan G vs. Plan F vs. Plan C and the other standardized Medigap plans.

2019 Medigap plans comparison chart

Plan G Enrollment Statistics

The popularity of Plan G is on the rise among Medicare beneficiaries. Plan G was the fastest-growing Medigap plan from 2014 – 2017, including a 31% year-over-year growth in enrollment from 2016 to 2017.1

Plan G was the second-most popular plan in 2017, encompassing 13 percent of all Medigap enrollees. Only Plan F (55 percent) had a higher enrollment rate in 2017.1 

How Much Does Medigap Plan G Cost?

The average premium paid for a Medigap Plan G in 2018 was $122.78 per month. That was just the eighth-most expensive plan, despite offering a more comprehensive set of benefits than most other standardized plans.2 

The only benefit not covered by Plan G — the annual Medicare Part B deductible — costs just $185 per year in 2019 (around $15 per month).

Beneficiaries who have a choice between Plan G and Plan F may benefit from choosing Plan G if the cost of the plan is at least $15 lower per month than Plan F. 

Here’s an example:

  • A Plan G that costs $122 per month will cost $1,464 for the year, plus $185 for the Medicare Part B deductible in 2019 (if you meet the deductible) for a total of $1,649.
  • Meanwhile, a Plan F that costs $138 per month ($16 more per month than Plan G) will cost $1,656 for the year ($7 more than Plan G).
  • There’s no guarantee that you will meet the Part B deductible in a year. And even if you do, you could still potentially pay less in Plan G premiums plus the Part B deductible than you would by paying Plan F premiums all year.

How Are Medigap Plans Changing in 2020?

The popularity of Plan G may increase even more beginning in 2020.

  • Starting in 2020, the highly-popular Plan F and Plan C will no longer be made available to new Medicare beneficiaries who become eligible for Medicare on or after January 1, 2020.
  • If you are eligible for Medicare before January 1, 2020, you may be able to enroll in Medigap Plan C or Plan F after this date (if the plans are available where you live). If you currently have Plan C or Plan F, you will be allowed to stay with either plan coverage going forward. 

With Plan F and Plan C no longer being eligible to new Medicare beneficiaries after 2020, Plan G will become the Medigap plan that offers coverage for more standardized benefits than any other Medigap plan available for sale. 

When Is the Best Time to Sign Up for Plan G?

A great time to enroll in Medigap is during your Medigap Open Enrollment Period (OEP).

Your Medigap Open Enrollment Period lasts for 6 months, and it starts as soon as you are at least 65 years old AND enrolled in Medicare Part B.

If you sign up for a Medigap plan during your Medigap Open Enrollment Period, Medicare Supplement Insurance companies can’t use your health status to determine your eligibility for a plan. They also can’t charge you more for a Medigap plan based on your health.

You may be able to enroll in a Medigap plan anytime outside of your Medigap Open Enrollment Period. You may face medical underwriting if you do so, unless you qualify for a guaranteed issue right.

If you have a guaranteed issue right, Medigap insurance companies can’t use your health to determine your eligibility or plan rates.

A licensed insurance agent can help you determine whether or not you qualify for a guaranteed issue right. Not all plan types may be available for purchase if you have a guaranteed issue right.

How Do I Sign up for Plan G?

You may have Plan G options available in your area. A licensed insurance agent can help you compare Medigap plans available near you and help you find a plan that fits your coverage and budget needs.

 

Find Medigap Plan G in your area.

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Or call --ms-tfn-- to speak with a licensed insurance agent.


1 AHIP. The State of Medigap 2019. (May, 2019). Retrieved from www.ahip.org/wp-content/uploads/IB_StateofMedigap2019.pdf.

2 TZ Insurance Solutions LLC internal sales data, 2019. This data is based on the Medicare Supplement Insurance policies TZ Insurance Solutions LLC has sold. It is not a comprehensive national average of all available Medicare Supplement Insurance plan premiums.

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