Medigap Plan G is the most popular Medicare Supplement Insurance plan available to any Medicare member
[1]
. Plan G covers certain expenses such as coinsurance, copayments and deductibles that aren't covered under Medicare Part A and Part B, also known as Original Medicare.
Medicare supplement Plan G offers a lot of coverage, but it’s also one of the more expensive options.
Here’s what you need to know to decide whether Plan G is right for you.
» MORE: Best Medicare Supplement Insurance companies
What is Medicare supplement Plan G?
Medigap Plan G covers “gaps” in Medicare coverage: the out-of-pocket costs left over after Medicare pays its portion of the bill. Plan G covers more of these costs than any other Medicare Supplement Insurance plan available to new Medicare members.
There are 10 standardized, letter-named Medigap plans in most states (except Massachusetts, Minnesota and Wisconsin, which have their own standards). The plans differ in terms of what they cover, out-of-pocket limits and premiums.
Plan G is essentially a replacement for Plan F for new Medicare members. Plan F and Plan C aren’t available for sale to people who became eligible for Medicare after 2019.
Medigap insurance is available only to Medicare beneficiaries enrolled in Part A and Part B; it can’t be sold to Medicare Advantage members (unless they’re switching back to Original Medicare)
[2]
.
What Medigap Plan G covers
Here’s what Medigap Plan G covers, according to Medicare.gov
[3]
:
Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up.
Part A deductible.
Part A hospice care coinsurance or copayment.
Part B coinsurance or copayment.
Part B excess charges (if a provider is permitted to charge more than Medicare’s approved amount and does so).
Blood transfusion (first three pints).
Skilled nursing facility care coinsurance.
Medically necessary emergency health care service for the first 60 days when traveling outside the U.S. Deductible and limitations apply.
What Medigap Plan G doesn’t cover
Medigap Plan G offers the most coverage of any plan that new Medicare members can buy. However, there are benefits that even the most comprehensive Medigap plans don’t cover.
All Medigap plans, including Plan G, sold to new Medicare members don’t cover the following:
[4]
Part B deductible (since 2020, new Medicare members can’t buy any plan that covers the Part B deductible, although existing members may own older plans that do).
Prescription drugs.
Long-term care (like non-skilled care you get in a nursing home).
Dental care.
Vision care.
Private-duty nursing.
How much does Medigap Plan G cost?
Premiums for Medigap Plan G are set by the private health insurance companies that sell it, even though the plans are regulated by the government. Prices vary according to age, location, tobacco use and other factors.
Premiums for a 65-year-old nonsmoker range from $101 to $343 per month in Atlanta, which has average costs among major U.S. metro areas for the most popular Medigap plan types
[5]
.
» MORE: How much does a Medicare Supplement Insurance plan cost?
Some states also offer a high-deductible Plan G, which provides the same benefits after a deductible of $2,700 in 2023 is paid. Monthly premiums for the same 65-year-old nonsmoker in Atlanta range from $39 to $61.
» MORE: Are high-deductible Medigap plans worth it?
To find out the cost of Medigap Plan G in your area, visit Medicare.gov.
Buy Medigap Plan G during Medigap open enrollment
The best time to buy your Medigap Plan G policy is during the six-month Medigap open enrollment period.
This period happens only once. It starts once you’re 65 and enrolled in Medicare Part B, and lasts for six months. (If you're still working after 65 and covered by a group employer plan that is deemed creditable coverage, your six-month period starts after you’ve ended active employment or no longer have that insurance.)
Medigap policies are cheapest and easiest to get during this open enrollment period because insurance companies aren’t allowed to factor your health or medical history into your price. After the period ends, the prices may go up or you may be denied coverage due to your health status or medical history.
In some states, insurance companies sell Medigap plans to those under 65 who are living with a disability and are eligible for Medicare. You can find more information through your State Health Insurance Assistance Program, or SHIP.
Is Plan G the best Medicare Supplement Insurance plan?
Plan G vs. Plan N
Medigap Plan G and Plan N are the two most popular Medicare Supplement Insurance plans available for new Medicare members. Plan N covers a little less than Plan G, but it generally has lower premiums.
Plan N also has copays for certain medical office and emergency department visits. If you don’t have a lot of those visits, Plan N might be the better deal for you. If you would have to pay those copays often, however, Plan G might end up less expensive.
» MORE: Medigap Plan G vs. Plan N calculator
Looking for Unbiased Medicare Advice?
Chapter saves people over $1,000/year on their Medicare plans. You can reach them at (855)480-7438
Chapter (mobile image)
Plan G vs. Plan F
For those who are eligible, Plan F covers everything in Plan G, plus the Part B deductible; however, plans covering the Part B deductible can’t be sold to most new Medicare members anymore.
Even for people who can buy Plan F, it might not be the best deal. If the additional cost for Plan F would add up to more than the Part B deductible — $226 in 2023 — over the course of the year, it’s more cost effective to stick with Plan G.