Medicare Supplement Plan G Coverage and Costs

Written by Jordan McElwainUpdated: Thursday, September 21, 2023

Medicare Supplement Plan G, also known as Medigap Plan G, is a type of Medicare Supplement plan that helps cover certain out-of-pocket costs that Original Medicare (Medicare Part A and Part B) doesn't fully cover. Medigap plans are offered by private insurance companies and are designed to work alongside Original Medicare to provide additional coverage and help reduce your healthcare expenses.

We’ll first go over what Medicare Supplement plans are. If you’re already familiar, skip to the second half of this article to learn more about Plan G!

What are Medicare Supplement plans?

Medicare Supplement (also called Medigap) plans exist to help fill the gaps in Medicare coverage. Specifically, they help cover the 20% of costs that Original Medicare (Part A & Part B) don’t cover. These plans are provided by private insurance companies and pair with your Original Medicare coverage (whereas Medicare Advantage plans replace your Original Medicare).

There are ten different types of Medicare Supplement plans, each labeled by letters A-N. Each plan of the same letter is identical in coverage, although pricing and insurance carriers may vary based on your location. 

Benefits of Medicare Supplement plans

Many Medicare beneficiaries choose to pair a Medicare Supplement plan with Original Medicare to significantly reduce their out-of-pocket costs and gain financial predictability. There are other important benefits to consider, especially when comparing Original Medicare + Medigap to a Medicare Advantage plan. 

Standardization

We mentioned before that all Medicare Supplement insurance plans are standardized. This means that one Plan G from Humana vs. another Plan G from United Healthcare will provide the same exact coverage. The only differences will be cost and insurance carriers. As a result, you don’t need to compare specific summaries of benefits from plans to make sure your coverage meets your expectations.

Lower out-of-pocket costs

We’ve explained that Medigap plans significantly lower your out-of-pocket costs, but we haven’t yet shared how. Depending on which Medigap plan you choose, you may receive coverage for:

  • Part A coinsurance and hospital costs

  • Part B coinsurance and copayments

  • Blood you receive

  • Part A hospice care coinsurance and copayments

  • Skilled nursing facility coinsurance

  • Your Part A deductible

  • Your Part B deductible (only applicable for Plans C & F which are unavailable to individuals who turn 65 after January 1, 2020)

  • Part B excess charge

  • Foreign travel exchange

We’ll explain more details about Medigap Plan G later on, but Plan G covers everything but your Part B deductible. This means that, after meeting your Part B annual deductible ($226 in 2023), you’ll owe nothing else for the year for covered services. This is why many people consider Plan G the best.

No restrictive provider networks

One of the big downsides of Medicare Advantage plans is that they limit planholders to provider networks. With a Medicare Supplement plan, you can see any doctor who accepts Medicare, which is about 90% of doctors nationwide! This is particularly important for frequent travelers and snowbirds who are more likely to need to see doctors in more than one state. Of course, it’s also important for individuals who value their choice in their doctors. 

No need for prior authorization

One of the other big disadvantages of Medicare Advantage plans is that they often require prior authorization, even for covered services. Original Medicare, with or without a Medigap plan, never requires prior authorization for covered services. This makes access to healthcare services faster and easier for those on Medigap vs. Medicare Advantage. 

Eligibility for Medicare Supplement plans

Medicare beneficiaries who are enrolled in Medicare Part A and Medicare Part B and are not enrolled in a Medicare Advantage plan are eligible to enroll in Medigap plans. When you enroll in a Medigap plan matters though. Even if you’re eligible, if you enroll outside of a handful of guaranteed issue periods, insurance companies can ask you questions about your health history and your application may be denied. 

Comparing Medicare Supplement plans

There are ten types of Medicare Supplement plans (as well as high-deductible versions of both Plan F and Plan G). Each covers a different selection of out-of-pocket costs, and you can consult this chart to understand the differences. 

Medigap Plan G has the most comprehensive coverage and is generally considered the best Medigap plan available. Learn more about why in the next section!

If you want help understanding the differences and the value of coverage, our expert Medicare Advisors are here to help! Schedule a free consultation to ask questions about Medicare and Medigap or give us a call at (855) 900-2427 to get personalized advice. 

Medicare Supplement Plan G coverage

About 32% of Medicare Supplement enrollees are enrolled in Plan G. This number will quickly increase as a larger percentage of Medicare beneficiaries cannot enroll in the, previously popular, Plan F. (Plan F isn’t available to those who turn 65 after January 1, 2020.)

Important note: Massachusetts, Minnesota, and Wisconsin offer a different set of Medigap plans and therefore do not offer a Medigap Plan G. 

What’s covered?

Plan G eliminates out-of-pocket costs for:

  • Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up

  • Part B coinsurance and copayments

  • Blood you receive (up to 3 pints)

  • Part A hospice care coinsurance and copayments

  • Skilled nursing facility coinsurance

  • Your Part A deductible

  • Part B excess charges

Plan G also covers 80% of foreign travel exchange.

What’s not covered?

Plan G, like all Medigap plans, provides coverage for out-of-pocket costs leftover by Original Medicare. It does not provide coverage for additional healthcare services.

Medicare Supplement Plan G costs

One of the reasons to enroll in a Medicare Supplement plan, and specifically Medicare Plan G, is to have a better sense of what your healthcare expenses will be each month. With plan G, you’ll pay a monthly premium and your Part B deductible. 

Medicare Plan G premiums

There are a handful of factors that may impact your Plan G premium:

  • Where you live

  • Your smoking status

  • Your age 

  • Your gender

  • The insurance carrier

  • Household discounts (offered by some Medigap plans)

Below you'll find a range of monthly premium costs for Plan G by state. (Data from Medicare.gov - 2023)

Alabama: $0-$692

Alaska: $111-$674

Arizona: $100-$684

Arkansas: $129-$552

California: $137-$1,096

Colorado: $0-$889

Connecticut: $220-$429

DC: $112-$703

Delaware: $0-$3,909

Florida: $167-$1,261

Georgia: $0-$3,551

Hawaii: $110-$919

Idaho: $164-$446

Illinois: $96-$713

Indiana: $96-$663

Iowa: $92-$702

Kansas: $104-$787

Kentucky: $97-$1,500

Louisiana: $0-$1,157

Maine: $208-$537

Maryland: $128-$855

Michigan: $109-$844

Mississippi: $0-$1,427

Missouri: $0-$799

Montana: $0-$932

Nebraska: $96-$880

Nevada: $123-$846

New Hampshire: $0-$892

New Jersey: $134-$717

New Mexico: $92-$661

New York: $282-$705

North Carolina: $96-$1,519

North Dakota: $0-$665

Ohio: $105-$647

Oklahoma: $101-$664

Oregon: $139-$789

Pennsylvania: $105-$783

Rhode Island: $128-$716

South Carolina: $87-$671

South Dakota: $97-$1,591

Tennessee: $97-$1,649

Texas: $94-$714

Utah: $101-$630

Vermont: $157-$697

Virginia: $93-$678

Washington: $99-$329

West Virginia: $93-$678

Wyoming: $105-$700

Will my Medicare Supplement premium change over time?

There are three ways Medicare Supplement plans may be priced or “rated.”

Community-rated (also called no-age-rated)

With community-rated policies, premiums are the same for enrollees of all ages. This means your premium isn’t determined by your age, and won’t increase due to age. Premiums may increase due to inflation and other factors.

Issue-age-rated (also called entry age-rated)

If your Plan G policy is issue-age-rated, your premium is based on your age when you first enrolled in the plan. With issue-age-rated policies, premiums are lower for individuals who enrolled at a younger age. Premiums may increase due to inflation and other factors, but not because of your age. 

Attained-age-rated 

Medigap premiums for policies with an attained-age-rating are based on your current age (the age you’ve attained). With these policies, premiums are low for younger enrollees, but will increase with their age. They seem attractive at first because they have the lowest premiums, but they may become more expensive than policies with different rating structures. Premiums may also increase due to inflation and other factors. 

Medicare Plan G deductibles

There is no Plan G deductible. With Plan G, your Part A deductible is taken care of, so you are only responsible for your Part B deductible. 

Note: Some states also offer a high-deductible plan G, which has a lower premium, but won’t start paying for your 30% of costs until you meet the higher deductible. 

Medicare Plan G out-of-pocket costs and maximums

With a Plan G, your out-of-pocket costs for covered services are reduced to just your annual Part B deductible ($226 in 2023). There’s no out-of-pocket maximum for Plan G because costs are reduced in a way that it’s not necessary. 

How to enroll in a Medicare Supplement Plan G

Our Medicare Supplement Advisors are here to help you submit your Medicare Supplement application. The best time to enroll is during the six months following your Part B effective date. This period of time is called your Medigap Open Enrollment Period. During it, you are guaranteed acceptance into any Medicare Supplement plan, regardless of your health status. 

Outside of this period and a handful of other guaranteed issue periods, insurance companies can ask you questions about your health history and your application may be denied. 

How to choose the right Plan G

Because all Plan Gs provide the same coverage, you can focus your decision on premiums and insurance carriers. Chapter Medicare Advisors will get you the best value from your Plan G. We’ll help you sort through each option, provide insight on customer service reputations, and compare premiums (both for today and future estimates). 

Get started: schedule a free consultation or call us at (855) 900-2427!

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