Medicare Supplement Plan G, also known as Medigap Plan G, provides financial help to cover costs left over after Original Medicare pays its share of medical services.
To help pay for additional costs, private insurers offer “Medigap” plans or Medicare Supplement insurance. These plans pay more out-of-pocket costs than Original Medicare.
Medicare Supplement Plan G helps pay for:
You’re eligible for Medicare benefits if you are 65 or older, younger than 65 with disabilities or have end-stage kidney disease. Original Medicare coverage consists of these basic benefits:
· Part A: Inpatient hospital care, skilled nursing, hospice, lab tests, surgery and limited home healthcare
· Part B: Outpatient care, doctor appointments, screenings, chemotherapy, diabetic care, durable medical equipment, immunizations and preventive care
Even after the federal Medicare program reimburses providers for these services, patients are often left with out-of-pocket expenses, which Medicare Supplement Plan G covers.
Those often most interested in Medicare Supplement Plan G are people who:
· Don’t want high out-of-pocket cost for healthcare
· Enjoy the freedom to see any doctor
· Travel often (because of the flexibility of the health insurance plan)
With Medigap Plan G, you can use any doctor in the United States who accepts Original Medicare. Other benefits include:
· Ability to change doctors anytime
· Freedom to allow patients to go to any hospital or facility that takes Original Medicare
· No referrals required
· No need to stay within a network
Please be aware that adding a Medigap plan to your coverage isn’t the same as a Medicare Advantage Plan (Plans C). Medicare Advantage plans, also known as Part C, are also private insurance plans. They take the place of Plan A and Plan B – plus offer extras, such as dental, optical plans and hearing aids.
Medicare Advantage plans often have network restrictions associated with being an HMO or PPO and can be less flexible for some people depending on their circumstances.
What does Medicare Supplement Plan G Cover?
A deductible is an amount you pay for covered healthcare services before your health insurance plan starts to pay. For example, if your deductible is $100, you will have to pay that much first before you get help from your insurer to cover costs.
The 2021 deductible for Medicare Part A for a hospital stay is $1,484 per benefit period. You will also have to pay a deductible for a skilled nursing facility after 20 days.
The annual deductible for all Medicare Part B beneficiaries is $203 in 2021.
Copays and coinsurance
Plan G covers copayments and coinsurance associated with Medicare parts A and B. Copays are your share of medical costs for services like a doctor’s visit or hospital stay. This is usually a set amount rather than a percentage.
Coinsurance is the percentage you pay providers after you’ve reached your deductible. If you have a Plan G policy, you won’t be responsible for these costs.
Medigap plan G does not cover long-term care, dental, vision, eyeglasses, hearing aids and private nursing care.
But here’s what Medigap Plan G will cover:
· Initial pints of blood
· Medicare Part A deductible
· Medicare Part A hospital costs
· Part A expenses
· Part A hospice care coinsurance
· Skilled nursing facility care
Medicare Supplement Insurance plan G benefits also pay these Medicare Part B costs:
· Charges over the amount Medicare allows – “Part B Excess Charges”
· Durable medical equipment
· Foreign travel emergency care (lifetime plan limits apply)
· Medicare Part B coinsurance and copays
What is the monthly premium for Medicare Plan G?
While Medicare Plan G helps bridge the financial gap after Original Medicare pays expenses, it does require a monthly premium for the services. This monthly premium is charged in addition to the premium the federal Medicare program requires for Part A and Part B.
The short answer is that the monthly premium for Medicare Plan G can start around $100. Overall, Medicare Supplement Plan G monthly premiums vary, depending on what part of the country you live in, your age and your gender. They are also set based on whether you’d like a high-deductible plan or a low-deductible plan.
Here’s an explanation of Plan G and Original Medicare costs:
Monthly premiums – This fee to buy the plan is set by the private insurance company and can vary based on many factors.
· Community-rated – Generally, the insurer charges the same monthly premium to everyone who has the Medigap policy, regardless of age. Instead, premiums may go up because of inflation and other factors.
· Issue age – The premium is based on your age when you buy the Medigap policy. Premiums set this way are lower for those who purchase them at a younger age and won’t change as they get older. However, premiums may go up because of inflation and other factors.
· Attained age – The premium is based on your current age and your premium goes up as you get older or due to inflation or other factors.
Medicare itself only charges a premium for Part A if you did not pay into it while working. Most people will pay $148.50 for Part B in 2021.
What is the Medicare Plan G deductible for 2021?
The standard Medicare Plan G has no deductible. However, you are required to pay your Part B deductible. Effective January 1, 2021, the Part B deductible is $203.
What is the difference between Medicare Plan F and Plan G?
Plan F and Plan G are similar, but Plan F is only available to those who became eligible for Medicare before January 1, 2020. Plan F includes the Medicare Part B deductible.
If you don’t qualify for Plan F, you can turn to Plan G for the most comprehensive Medigap plan. The only difference in coverage between Plan F and Plan G is that Plan G doesn’t cover the Medicare Part B deductible amount.
Does Medigap Plan G cover prescription drugs?
No. Medicare Plan G simply fills in the gaps of Original Medicare. Because Original Medicare does not cover prescription drugs, Medicare Supplement Plan G will not either.
Medicare beneficiaries will need to purchase a stand-alone Medicare Part D prescription drug plan from a private insurance company. If a beneficiary chooses to go without Part D coverage while being Medicare eligible, they can be penalized in the future when they decide to enroll in this type of plan.
Does Medicare Plan G cover dental?
No. Medicare and Medigap plans do not cover routine dental care. We can help you locate a stand-alone dental plan.
When can I enroll in Medicare Supplement Plan G?
The best time to buy a Medigap policy, including Medicare Supplement Plan G, is during your six-month Medigap Open Enrollment Period that starts the first day of the month you’re 65 or older and enrolled in Part B. For example, if you turn 65 and are enrolled in Part B in June, the best time for you to buy a Medigap policy is from June to November.
Your Medigap open enrollment period begins when you enroll in Part B and can’t be changed or repeated.
If you purchase a Medigap policy during the open enrollment time-frame, you’ll generally get better prices and a wider range of choices. That’s because even if you have health problems you can buy any policy the insurer sells for the same price as those in good health.
After the open enrollment period, companies may require medical underwriting for approval. This means that the applicant’s medical history will be taken into consideration when determining the cost.
If you have preexisting health conditions, please speak to one of our Policy Guide Medicare supplement insurance agents to assist with the best company, plan and rate for your specific situation.
Companies handle underwriting differently for medical conditions. If you go directly to the carrier, they will not be able to provide you a direct comparison to their competitors.
How often do Medicare Supplement Plan G rates increase?
Rates with all Medicare health insurance companies can change as the cost of care rises. That’s why it’s important to have a relationship with an agent you trust. We can shop your rate year to year to ensure you’re still getting the best deal.
So far, Plan G rate increases seem to be lower than that of Medicare Plan F history. Also, the larger the company, the lower the rate increases. This occurs because the company has more insured people to spread costs.
Plan G by State
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We can help you locate a personalized Medicare Supplement plan G rate from top insurers, and help you apply for a plan over the phone. So contact us today so that we can assist you with your plan options.