While Medicare Parts A and B cover hospital and
medical services respectively, they don't cover everything. This is
where Medicare Supplement Plans, also known as Medigap plans, come
into play. Though there's no official "Medicare Part G," it is often
referenced in discussions about these supplemental covers.
Therefore, it is crucial to understand what people mean when they
refer to Medicare Part G and how it fits within the broader scope of
Medicare supplement plans.
What is Medicare Part G?
Medicare Part G, often confused as a separate
part of Medicare, is actually Medigap Plan G. Medigap Plan G is one
of the ten standardized Medigap policies that help cover some of the
healthcare costs that Original Medicare (Part A and Part B) doesn't
cover, such as copayments, coinsurance, and deductibles. These plans
are sold by private insurance companies and offer additional
coverage to help manage out-of-pocket expenses.
Coverage of Medigap Plan G
Medigap Plan G is one of the most comprehensive Medigap plans available. It covers the following:
- Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up.
- Part B coinsurance or copayment.
- Blood (first three pints).
- Part A hospice care coinsurance or copayment.
- Skilled nursing facility care coinsurance.
- Part A deductible.
- Part B excess charges.
- Foreign travel emergency (up to plan limits).
One notable exclusion in Plan G is the Medicare
Part B deductible. This means that beneficiaries must pay this
deductible out-of-pocket before their Medigap Plan G benefits kick
in.
Benefits of Choosing Medigap Plan G
Comprehensive Coverage
Medigap Plan G offers extensive coverage,
making it a popular choice among beneficiaries who want to minimize
their out-of-pocket expenses. It covers nearly all gaps left by
Original Medicare, making it similar to Medigap Plan F, which is no
longer available to new enrollees as of January 1, 2020.
Predictable Healthcare Costs
With Plan G, beneficiaries can more easily
predict their healthcare costs since it covers most of the
significant out-of-pocket expenses. This predictability can be
particularly beneficial for those on a fixed income.
Access to Any Doctor that Accepts Medicare
Medigap Plan G, like all Medigap plans, offers
the flexibility to visit any doctor or healthcare provider that
accepts Medicare. There are no network restrictions, allowing
beneficiaries to seek care from specialists and facilities
nationwide.
Comparing Medigap Plan G with Other Plans
Medigap Plan F
Medigap Plan F provides the same coverage as
Plan G, with the addition of the Medicare Part B deductible.
However, Plan F is no longer available to new Medicare beneficiaries
who became eligible after January 1, 2020.
Medigap Plan N
Medigap Plan N offers similar coverage to Plan
G but with some differences. Plan N requires copayments for certain
office visits and emergency room visits, which can result in lower
monthly premiums but higher out-of-pocket costs when needing care.
Enrollment and Eligibility
When to Enroll
The best time to enroll in Medigap Plan G is
during the six-month Medigap Open Enrollment Period, which starts
the month you turn 65 and are enrolled in Medicare Part B. During
this period, you can buy any Medigap policy sold in your state
without medical underwriting, meaning you cannot be denied coverage
based on pre-existing conditions.
How to Enroll
To enroll in Medigap Plan G, follow these
steps:
- Confirm your eligibility for Medicare Part A and Part B coverage.
- Identify insurance companies that offer Medigap Plan G in your area.
- Compare premiums and benefits from various insurers to find the best plan for your needs.
- Contact the chosen insurance company and complete the enrollment process.
Costs Associated with Medigap Plan G
Premiums and Pricing
The cost of Medigap Plan G varies depending on
several factors, including your age, gender, location, and tobacco
use. Insurance companies may use one of three pricing methods to
determine premiums:
Community-rated: The same monthly
premium is charged to everyone, regardless of age.
Issue-age-rated: Premiums are based on
your age at the time of purchase and do not increase with age.
Attained-age-rated: Premiums are based
on your current age and increase as you get older.
Page Last Updated: 20 March 2025