If you are looking for supplemental coverage your original Medicare doesn’t cover, you have options. In fact, most states offer 10 different standardized Medicare Supplement, or Medigap, insurance plans. Those looking for a broad level of coverage may find that Medicare Part G is an excellent choice for having access to the medical coverage you need for the lifestyle you lead.
Medicare supplement plans are designed to fill in the gaps that Medicare leaves behind. There are several different plans to choose from, each of which is named by a letter. These Medigap plans range from Plan A all the way to Plan N.
Ultimate Guide to Medicare Supplement Plan G in 2020
If you are already familiar with Medicare Plan F, you’ll notice that Plan G has many similarities to the former plan. It offers substantial value for beneficiaries who are able and willing to pay a relatively small annual deductible. Medicare Part G provides full coverage for gaps in Medicare. It will pay for coinsurance, copays and hospital deductibles.
If you aren’t familiar with Plan F, we can share some information about it for you. Keep in mind that Medicare is the federal health insurance program for “people who are 65 or older, certain younger people with disabilities, and people with end-stage renal disease.”(1)
Part A is what covers some home health care, inpatient hospital stays, hospice care, and skilled nursing facility care. Part B is used to cover certain services from doctors, outpatient care, preventive services and medical supplies. Part D adds on prescription drug coverage to several Medicare plans.
Medicare Plan F is a comprehensive supplement plan that covers Medicare copays, coinsurance and deductibles without any out-of-pocket costs. Unlike Plan F, Plan G has a deductible on a calendar year basis that will need to be paid. It’s also important to be aware that the amount of the deductible increases each year. As an example, it may be $183 for 2018, $185 for 2019, and increase from that point.
Below, we’ll go into more depth about what Plan G Supplemental Medicare can offer you when it comes to healthcare.
Benefits of Medigap Plan G
The following benefits are provided by Plan G. Many are also available through Plan F, which also covers the Part B deductible of $198 each year. It’s essential to consider your own priorities and lifestyle when deciding which supplement to Medicare is right for your needs:
- Blood up to the first three pints
- Foreign travel emergencies up to the plan limits (80%)
- Part A coinsurance and hospital costs
- Part A deductible
- Part A hospice care copayment or coinsurance
- Part B coinsurance or copayment
- Skilled nursing facility coinsurance
When comparing Plan G with Plan F, the only thing Part G does not offer is the Medicare Part B deductible. The foreign emergency benefit is available using Plan F, Plan G, or Plan N if you are expecting to do a lot of travel overseas.
You may already know that original Medicare has no out-of-pocket limit. Plan G has an out-of-pocket maximum that includes the monthly premiums as well as a Part B deductible of $198 a year for 2020. Other plans like Plan L and Play K are not options for most people as insurance carriers know they don’t offer the same level of coverage as Plan G and may choose not to offer them.
Plan G is now the most popular plan available because it offers comprehensive coverage. While Plan F also provides a high level of coverage, it is no longer available to newly eligible seniors to Medicare if born after the year 1954. Plan G is popular because responsibility consists only of premium payments and a deductible payment without other out-of-pocket costs.
Real-World Example of How Plan G Works
When you have access to Medicare Supplement Plan G, it covers all the same things as traditional Medicare except for the outpatient deductible. Anything covered by a Medicare plan is also covered by Medigap insurance.
This plan offers help paying for surgeries, blood transfusions, ambulance rides, skilled nursing, x-rays, hospice care, durable medical equipment, doctor’s visit, diabetes supplies and lab work.
How it works is that Medicare pays first and then Plan G kicks in. It will pay the rest as long as you have paid your annual deductible. This plan also offers up to $50,000 in supplements for foreign travel emergency benefits if you are traveling abroad.
The monthly cost and the $198 Part B deductible are the only expenses you pay for the plan itself. While the rates will vary by the insurance company you choose, you can be sure that there will be no extra payments required as you seek medical care throughout the year.
When you have Plan G, you deal with Medicare directly for approval of claims rather than leaving that responsibility to an insurance company. This means physicians accept Medicare claims and the insurance claim that makes up the difference automatically. Many insurance carriers also offer automatic claims filing where the 20% (or other amount required by the hospital) is paid to the doctor on an automatic basis without the doctor needing to reach out to the carrier for the payment.
An individual with Medicare and Medigap can visit a hospital or a doctor and show them their Medicare card. The senior can ask them to bill Medicare, and the insurance company will pay whatever is leftover in terms of coverage. This is known as the gap in coverage and explains the term “Medigap.”
Who is Plan G For?
Plan G Medicare is increasingly popular because it works well for all sorts of people. It covers the Medicare gaps other than the Part B deductible, which is $198 in 2020. Only needing to worry about paying your premiums and a small deductible can help you plan around a fixed budget instead of worrying about unforeseen out-of-pocket expenses. There’s no need to worry about co-payments and out-of-pocket costs that can add up and put seniors in a bind.
Those who are well-suited for Plan G are those who want excellent coverage. The plan covers hospital expenses. It also pays the entire hospital deductible, which is $1,408 a year for 2020. Every time you enter a hospital after a 60-day period, you would also have to satisfy this deductible cost again. The deductible is required as part of using Part A Medicare and can be alleviated through having Supplement G.
When it comes to outpatient care, Medigap G covers everything except the first $198 of expenses. This is something that needs to be paid the first time you seek outpatient care for the year. Once it has been paid, Supplement G takes care of other expenses.
Plan G can work well for those who want total coverage of their medical needs. Medicare pays 80% of your outpatient costs, while Supplement G pays the additional 20%, so you don’t need to spend anything extra out-of-pocket.
In places where Medicare Supplement G is much cheaper than Plan F, it makes sense to choose Plan G. You will need to pay the Part B deductible once each year, but you can save hundreds in premiums to make up for that.
Plan G is made for people who are interested in simplicity and convenience. It is ideal for anyone who wants the flexibility to see any doctor they wish without paying extra. Additionally, Plan G is a fantastic choice if you are someone who frequently travels to foreign countries.
How to Enroll in Medicare Supplement Plan G
You cannot sign up for Plan G unless you are already enrolled in Part A and Part B. The ideal time to enroll is 6 months before you turn 65 or enroll in Part B. However, if you are healthy, it is ideal to change at any time. The reason is that you may be eligible to be placed with a healthier group of seniors. The group you are placed with is a major factor in determining price and it’s always best if you can pay less for the same coverage.
You can both enroll in and switch supplement plans at other times, but insurance companies can choose to charge you more or deny you based on your health. While Medigap plans are typically standardized across the United States, there are exceptions if you live in Minnesota, Massachusetts, or Wisconsin.
Learn what your options are from the experienced team at Medicare Nationwide.
Does Medicare G Cover Prescriptions?
Based on information from Medicare.org, “Unfortunately, Medigap plans, including Plan G, do not cover the cost of prescription medications.”(2) This plan helps reduce out-of-pocket costs for certain medical expenses and includes coverage for expenses, including coinsurance, hospital deductibles, and copayments. The Medicare Advantage Plan (Part C) and Medicare Prescription Drug Plan (Part D) cover outpatient prescriptions but cannot be combined with Plan G coverage.
How Much Does Medicare Plan G Cost?
Many wonder how much does Medicare Plan G cost. The answer varies based on where you are located and which insurance company you go through for coverage. As Medicare.gov explains, “Insurance companies may charge different premiums for the same exact policy. As you shop for a policy, be sure you’re comparing the same policy.”(3) It can be challenging to determine on your own what the price will be. A nationwide, independent Medicare broker will be able to provide better information about price options available to you.
What is the Difference Between Medicare Plan F and G?
The primary difference between Medicare Plan F and G is that Plan F will cover the Medicare Part B deductible, but Plan G does not. Medicare Part A will only begin to pay a share of the healthcare costs after beneficiaries meet a $1,408 deductible for the 2020 benefit period. Medicare.gov explains that all Medigap policies are required to follow federal and state laws for your protection and must be identified as “Medicare Supplement Insurance.”(4)
What Does Medicare Part A Cover?
Medicare Part A covers an assortment of items, including home health care, inpatient care in a hospital, hospice care, skilled nursing facility care, and inpatient care in a skilled nursing facility. Medicare.gov notes that there are two ways to find out if Medicare covers what you need. This includes talking to your doctor or using an online tool to find the answer.(5)
Medicare Plan G is for People Who Want Peace of Mind
Medicare Supplement Plan G Benefits are standardized so you can expect the same options regardless of the insurer you use. However, the cost of the plan varies based on your insurance company and where you live. In addition, states are not required to offer Plan G, and some insurers will charge different amounts for premiums to receive the same benefits.