Medicare Supplement Plan G covers your portion of medical benefits (with the exception of the outpatient deductible) covered by original Medicare. It’s also referred to as Medigap Plan G.
Medigap Plan G is one of the most popular of 10 available plans because of its broad coverage, including coverage for Part B excess charges.
Keep reading to learn more about Medicare Part G and what it covers.
Medicare Part B excess charges
Medicare Part B only covers healthcare providers that participate with Medicare. If you choose a provider that doesn’t participate with Medicare, that provider can charge up to 15 percent more than the standard Medicare rate.
This additional charge is considered a Part B excess charge. If your Medigap plan does not cover Part B excess charges, you will pay out-of-pocket.
Once you’ve paid your deductible, most Medigap policies cover coinsurance. Some Medigap policies also pay the deductible.
Coverage with Medicare Supplement Plan G includes:
- Part A coinsurance and hospital costs after Medicare benefits are used up (up to an additional 365 days): 100 percent
- Part A deductible: 100 percent
- Part A hospice care coinsurance or copayment: 100 percent
- Part B coinsurance or copayment: 100 percent
- Part B deductible: not covered
- Part B excess charge: 100 percent
- skilled nursing facility care coinsurance: 100 percent
- blood (first 3 pints): 100 percent
- foreign travel exchange: 80 percent
- out-of-pocket limit: not applicable
Medigap policies, such as Medicare Supplement Plan G, help cover healthcare costs that aren’t covered by original Medicare. These policies are:
- sold by private insurance companies
- standardized and follow federal and state laws
- identified in most states by the same letter, in this case, “G”
A Medigap policy is for only one person. You and your spouse each need an individual policy.
If you want a Medigap policy, you:
- must have original Medicare Part A and Part B
- cannot have a Medicare Advantage plan
- will incur a monthly premium (in addition to your Medicare premiums)
One method of finding a Medicare supplement insurance plan that fits your needs is through the “Find a Medigap policy that works for you” Internet search application. These online search tools are set up by the U.S. Centers for Medicare & Medicaid Services (CMS).
If you live in Massachusetts, Minnesota, or Wisconsin, Medigap policies are standardized differently than in other states. The policies are different, but you have guaranteed issue rights to buy a Medigap policy.
- In Massachusetts, Medigap plans have a Core Plan and a Supplement 1 Plan.
- In Minnesota, Medigap plans have Basic and Extended Basic benefit plans.
- In Wisconsin, Medigap plans have a Basic plan and 50 percent and 25 percent Cost-sharing plans.
For detailed information, you can use the “Find a Medigap policy that works for you” search tool or call your state insurance department.
What are guaranteed issue rights?
Guaranteed issue rights (also called Medigap protections) require insurance companies to sell you a Medigap policy that:
- covers preexisting health conditions
- doesn’t cost more on account of past or present health conditions
Guaranteed issue rights typically come into play when your healthcare coverage changes, such as if you’re enrolled in a Medicare Advantage Plan and it stops providing care in your area, or if you retire and your employee’s healthcare coverage is ending.
Visit this page for more information on guaranteed issue rights.
Medicare Supplement Plan G is a Medigap policy that helps cover healthcare costs not covered by original Medicare. It’s one of the most comprehensive Medigap plans, including coverage for Medicare Part B excess charges.
Medigap policies are standardized differently in Massachusetts, Minnesota, and Wisconsin. If you live in one of those states, you’ll have to review their Medigap offerings to get a policy similar to Medicare Supplement Plan G.