Coverage, Benefits, and Eligibility
Medicare Supplement Plan G is the 2nd most popular Supplement plan. Since Medicare Part A and Medicare Part B do not pay for all healthcare costs, you are responsible for additional co-pays, coinsurance, and deductibles. With a Medicare Supplement Plan G, almost all these costs will be paid. Plan G is one of 10 different Medicare Supplement “Medigap” plans you can choose from.
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Medicare Supplement Plan G Coverage
- After Original Medicare benefits run out, you can have up to 365 days in the hospital
- Coinsurance and copayments when visiting your doctor and additional Medicare Part B services
- Coinsurance use in skilled nursing care and or hospice care
- First 3 pints of blood used for different medical procedures
- Deductible of $1,340 for your Medicare Part A
- Deductible of $183 for your Medicare Part B
- Foreign travel emergencies based on your plan’s limits
Plan G is one of two Medicare Supplement plans which pays for Medicare Part B excess charges some doctors can charge in some states. For example, many states allow the provider to charge an extra 15% for doctor visits. These Excess Charges will not be covered by your Medicare Part B. However, they are covered by Medicare Supplement Plan G and Plan F.
Eligibility for Medigap if You are 65 and Older
Anyone enrolled in Medicare Part B will then be eligible to enroll in one of the Medicare Supplemental plans or Medigap plans like Plan G. The most straightforward way for you to qualify for this coverage will be during your 6-month open enrollment period (OEP). This will begin for you on (the 1st day of the 1st month) when you have turned 65; or older, plus you are enrolled in Part B.
Enrolling during the Open Enrollment Period will automatically qualify you for a policy and guarantees you won’t be rejected or charged higher premiums for any pre-existing health conditions. Conversely, waiting to enroll after the OEP will cause the policy to be “medically underwritten,” resulting in higher premiums or problems in finding coverage.
Plan G and Eligibility for those Disabled People Under 65
When disabled and under the age of 65, Medigap eligibility depends on which state you live in. Unfortunately, some of the states have very few Medigap plans or no options for any plans for those who are disabled, and for most under the age of 65, you will have to pay a higher premium as opposed to those over the age of 65.
Plan G versus Plan F
Of all the Medigap plans, Plan F will offer you the most complete coverage. It has the same coverage as Plan G with the addition of paying your annual Medicare Part B deductible. As a result, Plan F allows you to have the least amount of out-of-pocket costs, but you will have a higher monthly premium and rate increases over Plan G.
- After Original Medicare benefits run out, you can have up to 365 days in the hospital
- Coinsurance and copayments when visiting your doctor and additional Medicare Part B services.
- Coinsurance use in skilled nursing care and or hospice care
- First 3 pints of blood used for different medical procedures
- Deductible for your Medicare Part A
- Deductible for your Medicare Part B
- Foreign travel emergencies based on your plan’s limits
- Eligibility Medicare Supplement Plan C
*For people who are new to Medicare, Plan F is no longer available unless you turned 65 before January 1, 2020. If you already have Plan F, you can still hold on to it.
Plan G Benefits
- Medicare Part A coinsurance and hospital costs up to 365 days after your Medicare benefits are used up
- Medicare Part B coinsurance or copayments
- First 3 pints of blood(transfusions)
- Medicare Part A hospice care coinsurance or copayments
- Skilled nursing care facility coinsurance
- Medicare Part A deductible
- Medicare Part B excess charges
- Foreign travel exchange of up to 80 percent
Plan C versus Plan G
Plan G is like Plan C in that it will cover your excess charges. Plan G differs from Plan C in that it will not pay for your annual deductible for Medicare Part B. If you have concerns about any excess charges but also want to save money on your monthly premiums, then Plan G might be the better option for you rather than using Plan F or Plan C.
Which plan is better, Medicare Plan F or Medicare Plan G?
While Plan F will offer you slightly better benefits than Plan G, Plan G is a lower cost. The only difference between the two plans is Plan F will pay your annual deductible for Original Medicare Part B.
Are Medicare Supplement Plans G and F going to be discontinued?
In 2020 Plan F and Plan C are to be discontinued for anyone eligible after 2020. Therefore, by purchasing the plan before 2020, you will not lose your plan. However, if you turn 65 during 2025, you will not be able to buy Plan F. Currently, there are no plans to discontinue Medicare Supplemental Plan G. Use the chart below to compare Medigap Plan G to the other options available.
| Medigap Benefits | Medigap Plans | |||||||||
| A | B | C | D | F* | G* | K | L | M | N | |
| Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes |
| Part B coinsurance or copayment | Yes | Yes | Yes | Yes | Yes | Yes | 50% | 75% | Yes | Yes*** |
| Blood (first 3 pints) | Yes | Yes | Yes | Yes | Yes | Yes | 50% | 75% | Yes | Yes |
| Part A hospice care coinsurance or copayment | Yes | Yes | Yes | Yes | Yes | Yes | 50% | 75% | Yes | Yes |
| Skilled nursing facility care coinsurance | No | No | Yes | Yes | Yes | Yes | 50% | 75% | Yes | Yes |
| Part A deductible | No | Yes | Yes | Yes | Yes | Yes | 50% | 75% | 50% | Yes |
| Part B deductible | No | No | Yes | No | Yes | No | No | No | No | No |
| Part B excess charge | No | No | No | No | Yes | Yes | No | No | No | No |
| Foreign travel exchange (up to plan limits) | No | No | 80% | 80% | 80% | 80% | No | No | 80% | 80% |
| Out-of-pocket limit** | N/A | N/A | N/A | N/A | N/A | N/A | $7,060 in 2024 ($7,220 in 2025) | $3,530 in 2024 ($3,610 in 2025) | N/A | N/A |
(source)
*Plans F & G offer a high deductible plan in some states.
**Plans K & L show how much they’ll pay for approved services before you meet your out-of-pocket yearly limit and Part B deductible. After you meet them, the plan will pay 100% of your costs for approved services.
***Plan N pays 100% of the costs of Part B services, except for copayments for some office visits and some emergency room visits.
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