Medicare Supplement Plan G - Understanding Your Options - MHP

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Medicare Supplement Plan G Explained

Of the 10 major Medicare Supplement plans, commonly known as Medigap, Plan G is one of the most comprehensive. It is also growing more popular among Medicare beneficiaries. This could be because Plan G covers more than most Supplement plans but is cheaper than more traditionally popular plans—like C and F.

According to a 2018 study, Plan G enrollment grew by 41% from 2015 to 2016, with a total of 1,263,744 enrollees by the end of 2016.1

Understanding what Plan G covers

Like all Supplement plans, Plan G helps pay for some of your out-of-pocket costs if you need care and have Original Medicare. You can purchase Plan G from a private insurance company, and the coverage is standardized by federal and state laws.

Here’s what Plan G covers:

  • Part A coinsurance for inpatient hospital stays
  • Hospital costs for up to 365 inpatient days after your Original Medicare benefits end
  • Part A coinsurance and copayments for hospice care
  • Part A deductible
  • Part B coinsurance and copayments
  • Skilled nursing facility care coinsurance
  • Blood you receive in the hospital (first three pints)
  • Part B excess charges
  • 80% of costs for emergency care during foreign travel (up to plan limits)

Next to Plan F, Plan G is the most comprehensive. Other than the Part B deductible, Plan G covers most Original Medicare costs like coinsurance, copayments, and the Part A deductible. These two Medigap plans are the only ones you can buy that cover the Part B excess charges.

What are excess charges? An excess charge is the difference between what your doctor can legally charge you for a service and the amount Medicare approves for the service. This could affect you if you visit a doctor who doesn’t accept Medicare assignment for services, which means they haven’t agreed to Medicare’s payment rules. If you think you may run into this situation, you may want a plan that covers excess charges—like Plan G.

Due to a recent federal law, Plan F (and Plan C) are set to be phased out by 2020.2 If this occurs, Plan G will become the Medigap plan that covers the most Original Medicare costs, and we expect to see a strong increase in Plan G enrollment.

The only cost Plan F covers that Plan G doesn’t is the yearly Part B deductible. If you buy Plan G, you’ll still be responsible for this deductible each year, which is $185 in 2019.

Comparing Plan G rates

In 2018, for example, you might pay between $116 – $134 in Fort Worth, Texas; $142-$172 in Los Angeles, California; or $255-$300 in Miami, Florida for a monthly Part G premium.3 The exact amount that you’ll pay for the plan may vary based on several factors, including your age, your state, when you purchase, and other variables.

Learn more about Medigap plan cost changes here.

What else you should know about Plan G

If you’re thinking about enrolling in Medigap Plan G, here are a few things to remember:

  • Like all Supplement plans, you must be enrolled in both Medicare Part A and Part B to buy Plan G.
  • Your first chance to get Plan G is during Medigap Open Enrollment, which is the six-month period that starts once you turn age 65 and enroll in Part B.
  • If you live in Massachusetts, Minnesota, or Wisconsin, your state standardizes Medigap plans differently. Check with a licensed insurance agent to learn exactly what plans are available in your area.
  • To learn more information about other Medigap plans, check out our Supplement Plans page or visit medicare.gov.

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