Medigap Plan G is a Medicare supplement plan that offers eight of the nine benefits available with Medigap coverage. In 2020 and beyond, Plan G will become the most comprehensive Medigap plan offered.
Since it’s a “plan,” it’s optional. However, people concerned about out-of-pocket costs related to their healthcare may find Medicare supplement plans (Medigap) an attractive option.
Keep reading to find out more about Medigap Plan G, what it covers, and what it doesn’t.
Private health insurance companies sell Medicare supplement plans to help reduce out-of-pocket expenses and sometimes pay for services that Medicare doesn’t cover. People also call these Medigap plans. An insurance company will sell these as Medicare supplement insurance.
The federal government requires private insurance companies to standardize Medigap plans. Exceptions exist for Massachusetts, Minnesota, and Wisconsin, who standardize their plans differently.
Most companies name the plans by uppercase letters A, B, C, D, F, G, K, L, M, and N.
Medigap policies are only available to those who have original Medicare, which is Medicare parts A and B. A person with Medicare Advantage can’t have a Medigap plan.
A person with Medigap Plan G will pay a Medicare Part B premium, plus a monthly premium for Plan G. Also, a Medigap policy only covers an individual. Couples can’t buy a policy together.
Pros of Medigap Plan G
- most comprehensive Medigap coverage
- reduces out-of-pocket and unexpected costs for Medicare participants
The following are the healthcare costs that Medicare Plan G covers:
- Medicare Part A coinsurance and hospital costs up to 365 days after a person’s Medicare benefits are used up
- Medicare Part B coinsurance or copayments
- first 3 pints of blood for transfusions
- Medicare Part A hospice care coinsurance or copayments
- skilled nursing care facility coinsurance
- Medicare Part A deductible
- Medicare Part B excess charge (if a doctor charges more than the Medicare-approved amount, this plan will cover the difference)
- foreign travel exchange of up to 80 percent
There are two costs that Medicare Plan G doesn’t cover compared with the former Plan F:
- Part B deductible
- when the out-of-pocket limit and yearly deductible for Medicare Part B are exceeded
On January 1, 2020, changes to Medicare meant that Plan F and Plan C were phased out for people new to Medicare. Formerly, Medicare Plan F was the most comprehensive and popular Medicare supplement plan. Now, Plan G is the most comprehensive plan insurance companies offer.
Because Medicare Plan G offers the same coverage no matter what insurance company offers the plan, the main difference is cost. Insurance companies don’t offer the plans at the same monthly premium, so it (literally) pays to shop around for the lowest-cost policy.
There are lots of factors that go into what an insurance company charges for Plan G. These include:
- your age
- your overall health
- what state you live in
- if the insurance company offers discounts for certain factors, such as being a nonsmoker or paying yearly instead of monthly
Once a person chooses a Medicare supplement plan, the deductibles can increase on a yearly basis. However, some people find it hard to change their coverage because they get older (and premiums are more likely to be higher) and they may find switching plans costs them more.
Because this is the first year Medicare supplement Plan G is the most comprehensive plan, it’s likely that health insurance companies may increase the costs over time. However, competition in the insurance marketplace may help to keep prices down.
You can enroll in a Medicare supplement plan during its open enrollment period. This period — specific to Medicare supplement plans — starts the first day of the month you’re both age 65 and officially enrolled in Medicare Part B. You then have 6 months to enroll in a Medicare supplement plan.
Enrolling during your open enrollment period could save you a lot of money. During this time, insurance companies aren’t allowed to use medical underwriting to price your policy. This means they can’t ask you about your medical conditions or refuse to cover you.
You can enroll in a Medicare supplement plan after your open enrollment plan, but it does get trickier. At that time, you usually need guaranteed issue rights. This means something changed with your Medicare benefits that was out of your control and plans can’t deny you coverage. Examples include:
- You had a Medicare Advantage plan that’s no longer offered in your area, or you moved and can’t get your same Medicare Advantage plan.
- Your previous Medicare supplement plan committed fraud or otherwise mislead you regarding coverage, prices, or other factors.
- Your previous Medicare supplement plan went bankrupt and doesn’t offer coverage anymore.
- You had a Medicare supplement plan, but switched to Medicare Advantage. Less than a year later, you can switch back to traditional Medicare and a Medicare supplement plan.
During these times, a health insurance company can’t refuse to issue you a Medicare supplement policy.
Tips for how to shop for a Medigap plan
- Use Medicare.gov’s tool to find and compare Medigap policies. Consider your current monthly insurance costs, how much you can afford to pay, and if you have medical conditions that may increase your healthcare costs in the future.
- Contact your State Health Insurance Assistance Program (SHIP). Ask for a rate-shopping comparison guide.
- Contact insurance companies recommended by friends or family (or companies you have used in the past). Ask for a quote for Medigap policies. Ask if they offer discounts you may qualify for (such as being a non-smoker).
- Contact your State Insurance Department. Ask for a list of complaint records against insurance companies, if available. This can help you weed out companies that may be problematic to their beneficiaries.
Remember, the coverage for Medigap is standardized. You’ll get the same coverage regardless of insurance company, depending on what state you live in, but you could pay less.
Medicare supplement Plan G, also known as Medigap Plan G, is now the most comprehensive Medicare supplement plan health insurance companies offer.
The plan can help reduce your out-of-pocket costs when you have original Medicare.
If you’re going to purchase a Plan G policy, enrolling during your open enrollment period is likely the most cost effective.