Medicare Supplement (Medigap) Plan G Coverage and Costs
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, watch the video explaining Plan G below or 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)
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 ($240 in 2024), 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 licensed 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 policies)
Below you'll find a range of monthly premium costs for Plan G by state. (Data from Medicare.gov - 2024)
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
Massachusetts: N/A
Michigan: $109-$844
Minnesota: N/A
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
Wisconsin: N/A
Wyoming: $105-$700
Will my Medicare Supplement premium change over time?
There are three ways Medicare Supplement policies 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 ($240 in 2024). There’s no out-of-pocket maximum for Plan G because costs are reduced in a way that it’s not necessary.
Medicare Supplement Plan G Pros and Cons
Medigap Plan G provides the best value based on coverage and costs. Still, every Medicare insurance option available has its pros and cons.
Benefits of a Medigap Plan G
Financial predictability
Medigap Plan G is great for people who want to avoid unexpected healthcare expenses. One of the tricky things about choosing Medicare coverage is that you cannot know what will happen to your health—even within one year. We cannot control how our bodies age, the conditions we’re genetically predisposed to, or the accidents that occur.
With some Medicare coverage options, accidents and unexpected health issues can cost thousands of dollars. With Original Medicare and Medigap Plan G coverage, your costs are highly predictable. You’re responsible for your monthly premium and your Part B deductible. Once you’ve met your Part B deductible, you won’t owe anything else for healthcare services and equipment for the rest of the year.
Access to care
Quick access to quality care is important as we age. With no restrictive networks and no prior authorization requirements, a Medigap Plan G ensures you’ll get the care you need. Knowing you won’t owe anything more than your Part B deductible for the year also ensures that finances don’t keep you from visiting the doctor when you need to.
It’s worth noting that unlike with Medicare Advantage plans, Medicare Supplement plans travel with you within the US. Medicare Advantage networks are restricted to local doctors while your Medigap plan G coverage will be accepted by any doctor in the US who accepts Medicare. For reference, this is ~90% or more of doctors nationwide.
Downsides of a Medigap Plan G
Higher premiums than some Medicare options
Medigap Plan G premiums aren’t free. The average monthly premium for all Medicare Supplement plans is between $150-200. Compared to zero-premium Medicare Advantage plans, this is a lot of money to fork over every month!
It’s important to note that the zero-premium plans come with strings attached. You’re restricted to a network of doctors and you may have to get prior authorization for a number of covered services and equipment. Furthermore, your prior authorization could be denied, leaving you without coverage for a service or device you need.
Still, Medigap Plan G premiums can be too much for some—and the premiums may not seem worth it when you first become eligible for Medicare and don’t need much healthcare coverage. Unfortunately, because you aren’t guaranteed issue into a Medigap Plan G outside of the Medigap Open Enrollment Period and a handful of other guaranteed issue periods, you generally have to choose to invest in your healthcare coverage from the start.
No drug coverage or extra benefits
One of the reasons that 50% or more of Medicare beneficiaries choose to enroll in Medicare Advantage plans is because they offer coverage for services that Original Medicare doesn’t. Remember that with a Medigap Plan G, you won’t receive coverage for additional services—you’ll simply fill the gaps in costs not covered by Original Medicare. A Medigap Plan G won’t cover things like prescription drugs or routine hearing, dental, and vision services.
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!