Medicare Supplement Insurance high-deductible Plan G offers the coverage benefits of standard Plan G with lower monthly premiums in exchange for the higher deductible.
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In order to apply for high-deductible Medicare Supplement Plan G, you must be enrolled in both Medicare Part A and Part B and live in an area that is serviced by a high-deductible Plan G option.
High-deductible Medigap Plan G will offer the same benefits as standard Medigap Plan G, except the plan won’t pay its share of covered costs until you meet annual deductible amount.
Once you spend a certain amount in qualified out-of-pocket Medicare expenses, you will meet your deductible and your Plan G benefits will kick in.
The 2024 deductible amount for high deductible Plan G is $2,800. The Plan G deductible is standardized by the federal government and will be consistent no matter where the policy is sold or by whom.
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High-deductible Medigap Plan G will provide all of the same benefits as standard Plan G, which include:
|
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 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 after you meet your deductible.
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.
After you meet your deductible, Plan G pays the 20% coinsurance or copayment costs.
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 after you meet your deductible.
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 once you meet your deductible.
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 $204 per day for days 21-100 of an inpatient skilled nursing facility stay in 2024. After day 100, you are responsible for all costs.
Once you meet your deductible, Plan G fully covers your skilled nursing facility coinsurance.
Medicare Part A comes with a deductible, which is $1,632 per benefit period in 2024. Medigap Plan G will cover your deductible in full for each benefit period you require.
Medigap Plan G will cover your Part A deductible in full for each benefit period you require, once you meet your Plan G deductible.
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 after they meet their deductible.
This benefit provides coverage for medical care provided outside of the United States. Medigap Plan G pays for 80% of the billed charges after you meet your deductible for the year.
For more detailed information, read our page about Medicare Supplement Insurance benefits.
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Explore the key advantages and drawbacks of Medicare Plan G with this concise list of pros and cons. Discover the comprehensive coverage Medicare Plan G pros and cons that you might encounter when considering this plan. Here are 5 pros and 5 cons of the plan.
|
Plan G Pros |
Plan G Cons |
|---|---|
|
Comprehensive coverage for gaps in Medicare |
No Part B deductible coverage |
|
Guaranteed acceptance for new beneficiaries |
Risk of application denial without timely enrollment |
|
Minimal exclusions (except Part B deductible) |
Premium changes could limit carrier options |
|
Choose any Medicare-approved provider |
Affordability varies by location |
|
Direct specialist access |
Extra coverage like drugs and dental not included |
Like any Medigap plan, high-deductible Plan G premium costs will depend on the insurance carrier selling the plan, the pricing model used and where you live.
High-deductible Plan G will likely be among the more affordable Medigap plans because it requires you to meet the deductible before any benefits kick in.
In 2023, the average monthly premium for high-deductible Plan G was around $57 per month.1
Plan G and Plan F are the only two Medigap plans to offer a high-deductible option.
The primary difference in the benefits of these two plans is that high-deductible Plan F covers the Medicare Part B deductible, while high-deductible Plan G will not.
In 2024, the Medicare Part B deductible is $240 for the year. Although the new high-deductible Plan G will not provide coverage of the Part B deductible, the contributions you make toward the Part B deductible will also count toward your Plan G deductible.
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High-deductible Plan G may be a good fit for beneficiaries who want more affordable monthly premiums.
You may also consider high-deductible Plan G if plan to travel outside of the U.S. during retirement and you want some coverage for foreign travel emergency care costs when you are abroad.
The popular Medigap Plan F and Plan C isn't available to anyone who became eligible for Medicare on or after January 1, 2020.
Some recent legislation has made it illegal for Medigap plans to cover the Medicare Part B deductible for newly eligible Medicare beneficiaries. Plan F and Plan C are the only Medigap plans that cover the Part B deductible.
Anyone who was eligible for Medicare before January 1, 2020, may sign up for Plan F (including High-Deductible Plan F) or Plan C, as long as one of these plan options is available where they live.
If you were already enrolled in Plan F or Plan C before January 2020, you will be allowed to keep your coverage.
High-deductible Medigap Plan G may be offered where you live. Call today to speak with a licensed insurance agent who can help you compare the Medigap plan options that are available in your area.
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