Medicare Supplement Plan G is one of 10 Medigap options available in most states. Medigap can be used to supplement your original Medicare benefits. It helps pay for some of the healthcare costs not covered by original Medicare.
Unlike original Medicare, which is government sponsored, Medigap supplement plans are purchased through private insurance providers. To qualify for Medigap Plan G (or any Medigap plan), you must have original Medicare. Original Medicare is made up of parts A (hospital insurance) and B (medical insurance).
When you receive medical treatment, original Medicare will first pay a share of the costs, known as the Medicare-approved amount. If you have purchased Medicare Supplement Plan G, you can then use it to cover some of the costs that original Medicare doesn’t pay for.
Coverage with Medicare Supplement Plan G includes:
|Part A coinsurance and hospital costs up to an extra 365 days after Medicare benefits are used||100%|
|Part A deductible||100%|
|Part A hospice care coinsurance or copayment||100%|
|blood (first 3 pints)||100%|
|skilled nursing facility care coinsurance||100%|
|Part B coinsurance or copayment||100%|
|Part B excess charge||100%|
|Part B deductible||not covered|
|foreign travel exchange||80%|
Medicare Supplement Plan G covers your share of any medical benefit that original Medicare covers, except for the Part B (outpatient) deductible.
Are there plans that cover the Part B deductible?
The only plans that cover the Medicare Part B deductible are Medigap Plan C and Medigap Plan F. As of January 2020, Medigap Plan C and Plan F are available only to those who were enrolled in Medicare before 2020. If you are signing up for Medicare for the first time, you will not be able to purchase Plan C or Plan F.
One of the reasons that people choose Medigap Plan G is because it’s one of only two Medigap plans that covers Part B excess charges. The other is Medigap Plan F.
What are Part B excess charges?
Medicare Part B excess charges result from the difference between what Medicare will pay for medical services and what your doctor may charge for that same service.
Medicare sets approved payment amounts for covered medical services. Some doctors accept this rate for full payment, whereas others don’t.
If your doctor doesn’t accept the rate in the Medicare fee schedule as full payment, they are allowed under federal law to charge up to 15 percent more than the approved rate. The amount above the Medicare-approved rate is the excess charge. You are responsible for paying any excess charges.
Medicare Plan G does not cover outpatient retail prescriptions. It does, however, cover the coinsurance on all Part B medications. These prescriptions are typically for medications used for treatment within a clinical setting, such as for chemotherapy.
If you want coverage for outpatient retail prescriptions, you’ll need Medicare Part D.
Generally, Medigap policies don’t cover:
Plus, Medigap policies cover only one person. You will have to buy a separate policy for you and your spouse.
There are 10 different Medicare Supplement plans (Medigap policies) that are offered by private companies to help pay for some of the healthcare costs not covered by original Medicare (parts A and B).
One of those is Medicare Supplement Plan G. Medigap Plan G covers your share for most medical benefits that original Medicare covers, with the exception of the Part B deductible.