October 5, 2017
Medicare Supplement (Medigap) Plan G may help cover the full cost of out-of-pocket Medicare expenses such as copayments, coinsurance, and excess charges.
Medicare Supplement plans (also known as Medigap or MedSupp) provide optional coverage to add to your Original Medicare (Part A and Part B) insurance. Medicare Supplement Plan G covers more of your costs than most other Medicare Supplement plan types, so it might have a higher premium than those that offer less coverage. Health insurers that offer Medicare Supplement plans can set their own premium rates, but the plans are standardized and must offer the same coverage (for example, Plan G in Nebraska must offer the same coverage as Plan G in Vermont). However, some insurance companies may offer additional benefits.
Medicare Supplement Plan G coverage
Medicare Supplement Plan G covers the full cost of the following benefits:
- Medicare Part A hospital coinsurance and all costs up to 365 days after Original Medicare benefits are exhausted
- Part A hospice care coinsurance or copayment
- Part A deductible
- Medicare Part B preventive care coinsurance coverage
- Part B coinsurance or copayment coverage
- Part B excess charges (see below)
- First three pints of blood for a medical procedure, if the hospital has to buy blood
- Skilled Nursing Facility (SNF) care coinsurance coverage
- Foreign travel emergency coverage, up to the plan limit
Plan G is the only Medicare Supplement plan besides Plan F that covers 100% of Part B excess charges. Excess charges occur when doctors and providers do not accept Medicare assignment. When this happens, a doctor may charge more than the Medicare-approved amount. By law, providers can’t charge more than 15% above what Medicare covers. Beneficiaries are then responsible for the difference between the Medicare-approved amount and what the provider charges. Without Medicare Supplement coverage, Medicare patients are responsible paying these excess charges out of pocket; with Medicare Supplement Plan G, these expenses are paid for.
You may also be eligible for foreign travel emergency coverage through Plan G, which covers emergency health costs outside of the United States up to the plan’s limit.
Medicare Supplement Plan G benefits are nearly identical to those Medicare Supplement Plan F offers, except that Plan G doesn’t cover the Medicare Part B deductible. The standard Medicare Part B deductible for 2017 is $183. Once your out-of-pocket expenses get to the deductible amount, you pay 20% of Medicare-approved amount for Part B services and supplies. Medigap Plan G may be a good choice for beneficiaries who want broad coverage, but don’t want or need the Part B deductible benefit.
Medicare Supplement Plan G costs and availability
Although Medicare Supplement Plan G benefits are standardized and will be the same no matter which insurer you buy from, availability and costs for this plan will depend on where you live and how the insurance company prices its Medigap premiums. States are not required to offer this plan, and insurers may charge different premiums for the same benefits.
To see a side-by-side comparison of Medigap plan benefits, use our Medigap plan benefit chart.
Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program.