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 byoriginal 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 (parts A and B).
Let’s learn more about what Medigap Plan G covers and doesn’t cover, if it might be a good option to fit your needs, and more.
Medigap Plan G can help pay for costs not covered byMedicare Part AorMedicare Part B. Here’s how it works.
When you receive medical treatment, 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 use it to cover some of the costs that original Medicare doesn’t pay for or fees that come with original Medicare coverage.
Coverage with Medicare Supplement Plan G includes:
| Benefit | Coverage |
|---|---|
| Part A coinsurance and hospital costs up to an extra 365 days after Medicare benefits are used | Yes |
| Part A deductible | yes |
| Part A hospice care coinsurance or copayment | yes |
| blood (first 3 pints) | yes |
| skilled nursing facility care coinsurance | yes |
| Part B coinsurance or copayment | yes |
| Part B excess charges | yes |
| Part B deductible | no |
| foreign travel exchange | 80% |
| out-of-pocket limit | no |
Are there plans that cover the Part B deductible?
The only plans that cover theMedicare Part B deductibleare MedigapPlan Cand MedigapPlan F. As of January 1, 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 reason 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 chargeshappen when there’s a difference between what Medicare will pay for medical services and what your doctor decides to 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 to15 percentmore than the approved rate. The amount above the Medicare-approved rate is the excess charge.
With Medicare, you are responsible for paying any excess charges. Some people choose Medigap Plan G to assure that these fees are covered and avoid any unexpected costs after receiving medical care.
Generally, Medigap policies don’t cover items or services not covered under original Medicare. Some of these items include:
- eye exams, vision care, oreyeglasses
- dental care
- hearing aids
- private-duty nursing
- long-term care
Plus, Medigap policies cover only one person. You will have to buy a separate policy for your spouse or any other family member.
Are prescription drugs covered under Medicare Supplement Plan G?
Medicare Plan G does not cover outpatient retail prescriptions that are typically covered byMedicare Part D.
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 forchemotherapy.
If you want coverage for outpatient retail prescriptions, you’ll need to buy a separate Part D plan.
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 annual deductible.
Medicare plan options and costs are subject to change each year.