Medicare Supplement Plan G

Medicare beneficiaries have the option of several Medicare Supplement plans to select from that will contribute towards the costs associated with out-of-pocket expenses. A Medigap or Medicare supplement insurance plan is intended to cover the financial “gaps” that are not covered by Original Medicare Part A and Part B. For example, Part B only covers approximately 80% of medically necessary services that are required to diagnose or treat your medical condition. You’d be responsible for paying the remaining 20%, and there is no out-of-pocket maximum for Medicare.

Why Medicare Supplement Plan G is Popular

Due to its coverage and overall cost-effectiveness, Plan G is the second-highest selected of the Medigap plans by Medicare members. This plan offers the most comprehensive benefits as a Medigap plan aside from Plan F which covers 100% of costs not covered by Medicare Part A and Part B but is being phased out to new eligible members turning age 65 after January 2, 2020.

The difference between Plan F and Plan G is that Plan G does not cover the Medicare Part B deductible. The amount of the Part B deductible varies per year, but it is currently $185 for 2019. Once you pay this amount towards your Medicare Part B expenses, Plan G pays 100% of the out-of-pocket costs associated with Medicare Part A and B services. This includes co-payments, your hospital deductible, as well as the 20% of Part B expenses that are not covered.

Plan G is the only plan aside from Plan F of Medicare supplement plans that covers 100% of excess Part B charges. An excess charge is a charge that is outside of the amount approved by Medicare. For example, Medicare may approve an allotted amount for a service and the physician may not approve the amount and charge an extra amount for the service rendered. Medicare pays the set 80% of the allowed charge and you would be responsible for paying the remaining 20% in addition to any excess charges. Plan G would cover the excess charges.

What Does Medicare Supplement Plan G Cover

Plan G covers the following services:

• All inpatient hospital costs and coinsurance for Part A, for up to 365 days afterward once coverage has been used up (Your Medicare benefits are considered to be used up when you run out of lifetime reserve days. This is when your Plan G benefits will begin to pay.)

• Coinsurance associated with Skilled Nursing facility stays (days 21-100 require a daily amount of approximately $170 per day for your benefit period)

• All copayments and co-insurance fees that are associated with Part B services

• Part A deductibles

• Hospice coinsurance and co-payments

• The first three pints of blood received during a hospital procedure

• Up to 80% of emergency medical expenses are received outside of the United States (There’s a lifetime limit of $50,000 to help pay for these emergency costs after you pay a $250 deductible.)

• Any Medicare Part B excess charges, which is the difference between what Medicare pays and what your health care provider charges for a service

How Much is a Medicare Supplement Plan G

Rates for Plan G are competitive but typically begin around $165 per month. Aetna premiums are priced the highest and are approximately $186 per month. Once a company is priced at approximately $168 per month. Cigna is priced at approximately $160 per month for Florida residents. Each of these insurance companies is highly rated for their coverage and customer service.

Plan G premiums may vary by zip code. This means that a neighboring county may be priced higher or lower than the zip code for the city in which you reside. Prices also depend on the premium rates set by the insurance company. Men are typically priced slightly higher than women. Non-smokers will pay less than tobacco users. Setting up automatic premium payments may qualify policyholders with a discount, in addition to buying more than one policy. Medigap plans only cover one person per policy. This means that if you’re married, you and your spouse will need an individual policy.

Plan G premiums are approximately $250 lower per year than Plan F for Medicare beneficiaries. Plan G is a better cost savings option when the only difference between Plan G and F is the Part B deductible. Rates typically increase for Plan G at a lower increase ratio compared to other Medicare supplement plans.

What are the coverage terms for Medicare Supplement Plan G?

Medicare supplement plans are guaranteed to be renewed. Only the policyholder can cancel the plan. Rates do not increase based on your health and your policy is not canceled based on your overall health status that may have changed since you enrolled in the plan.

What costs doesn’t Medicare Supplement Plan G cover?

Plan G does not cover the Medicare Part B deductible, which is currently $185 in 2019. If you’re switching over to this plan from Plan F, you won’t have to pay the Part B deductible until next year since it is already covered for this current year. You’ll still be required to pay any premiums that may be associated with Part A and Part B, as well as your monthly premium for this plan and any others.

What services doesn’t Medicare Supplement Plan G cover?

Plan G is a Medigap plan. This means that the plan does not add additional benefits, but will cover the costs that may be associated with health care services being rendered under original Medicare Part A and Part B. Enroll in Medicare Part D for prescription drug coverage, or a Medicare Advantage plan, which may offer hearing, dental, and vision coverage. Please note that you will not be able to have a Medicare Advantage plan and a Medigap plan at the same time.

Do I need to use a specific provider network with Medicare Supplement Plan G?

You’ll be able to receive services from any provider or visit any facility that accepts Medicare and will not be limited to accessing a specific provider network with Medicare supplement Plan G. You’ll also be able to see specialists without referrals.

When can I enroll in Medicare Supplement Plan G?

You’ll need to be enrolled in Medicare Part A and Part B in order to qualify for Medicare supplement Plan G enrollment. You can enroll in Part A and Part B during your initial enrollment period. This is a seven-month period that begins three months before you turn age 65, the actual month of your birthday, and ends three months after your birthday. You can enroll in Medicare supplement Plan G during the Medigap open enrollment period. This begins on the first day of the month that you turn age 65, on the first of the month that your Part B coverage begins, and lasts for six months. Medical underwriting is not used during this enrollment period. This means that you are guaranteed to be enrolled into a Medigap plan and will not be charged more if you have a chronic health condition. There are certain annual periods outside of the open enrollment and initial enrollment period where you can enroll in original Medicare and Medicare Supplement plans. Those periods are outlined on the Medicare.gov website, or you can ask your Medicare insurance company. You may be subject to meeting medical underwriting requirements when enrolling outside of your open enrollment periods and may be denied a policy or charged a higher premium.

What is the future of Medicare Supplement Plan G?

Plan G is not impacted by the congressional ruling to eliminate Medicare Supplement plans that pay the Part B deductible, such as Plan F, from being offered to new beneficiaries in 2020. There will be a high deductible Medicare supplement Plan G option available in 2020. The plan details are still under development, but it is expected that this will entail a lower monthly premium, with an increased deductible for the policyholder to meet before Plan G begins to pay.

Which Medicare Supplement Plan is right for me?

Medigap Plan G is the best of the Medicare supplement plans for individuals who do not want to be worried about the potentially overwhelming out-of-pocket expenses billed for health care services. Aside from the Medicare Part B deductible, which is currently $185 for 2019, this plan pays 100% of Medicare costs including coinsurance, hospital deductibles, and co-payments. This may be an ideal option if you are suffering from a chronic illness and visit the doctor regularly. Medicare supplement Plan G is an overall money-saving value option for Medicare beneficiaries when you consider the premium amount vs. the coverage. Contact your Medicare insurance agent today for additional information about Medicare supplement plans.

Additional Resources:
https://www.medicare.gov/medigap-supplemental-insurance-plans/
https://www.medicare.gov/supplements-other-insurance/whats-medicare-supplement-insurance-medigap