Key takeaways
• Medigap Plan G is the most popular Medicare supplement plan among those who are new to Medicare.
• When added to Original Medicare, all inpatient and outpatient Medicare bills except the Medicare Part B deductible are paid.
With Plan G, a Medicare beneficiary’s maximum annual out of pocket for Medicare bills is equal to the Part B deductible.
• Healthcare providers, including doctors, are required to accept Medigap Plan G if they accept Original Medicare, and there are no network restrictions, allowing its use throughout the United States.
• Among the 12 standardized Medicare supplement insurance plans, Plan G offers the most comprehensive benefits for those new to Medicare, with the only responsibility being the annual Medicare Part B deductible ($226 per year).
Original Medicare Benefits
Original Medicare coverage (federal Medicare program) consists of two Parts: Medicare Part A and Medicare Part B.
Medicare Part A
Medicare Part A is premium-free for most people. This coverage includes hospital insurance and helps cover inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care services. Part A is your inpatient Medicare benefits insurance.
Most people qualify for premium-free Part A if they or their spouse paid Medicare taxes for at least 10-years while working.
Medicare Part B
Part B provides medical insurance and helps cover services from doctors and other health care providers, outpatient care, durable medical equipment, home health care, and some preventive services. The monthly Part B premium is set annually by Medicare and can vary based on income. It is typically deducted from the beneficiary’s Social Security or Railroad Retirement Board benefits.
What Is Medicare Supplement Insurance?
Medicare Supplement Insurance, also known as Medigap or Medigap policy, is a type of health insurance offered by private companies and designed to work alongside Original Medicare (Part A and Part B). It helps pay for the “gaps” or out-of-pocket costs that Original Medicare doesn’t fully pay for, such as deductibles, coinsurance, and copayments.
Medicare supplement plans have a separate monthly premium requirement.
Medicare Supplement plans are standardized and regulated by the federal government (more on that below). There are several standardized Medigap plans available, labeled with letters A, B, C, D, F, G, K, L, M, and N. However, as of January 1, 2020, Medigap Plans C and Plan F are no longer available to new Medicare enrollees.
Medigap Plan Benefits are Standardized
Medigap policies are standardized plans. This means that the coverage provided by each specific Medigap plan is the same, regardless of the insurance company offering the plan. The federal government sets certain coverage standards for each Medigap policy, ensuring consistency and transparency for beneficiaries.
Medicare supplement insurance benefits are written into Social Security Law and cannot be changed without an act of Congress. Your Medigap coverage is guaranteed renewable so no one can change or take away your Medicare supplement insurance plans once you have one.
Medicare Supplement Plan G
Medigap Plan G is the most popular choice among beneficiaries seeking comprehensive coverage for the gaps in Original Medicare.
Here’s what you should know about Medigap Plan G:
Medigap Plan G Inpatient Coverage
With Medigap Plan G, your coinsurance and hospital costs for inpatient care are covered at 100%. You can spend a year in the hospital as an inpatient without it costing you a dime.
Medigap Plan G Outpatient Coverage
With Plan G, your only expense for Medicare outpatient services will be the annual Medicare Part B deductible, which is less than $250.
No Network Limitations for Medigap Coverage
With any Medicare supplement, you can see any doctor or visit any medical facility in the U.S. or its territories who accepts Medicare patients. If Medicare accepts your services or procedures, the supplement will pay its portion of the covered health care costs.
Medigap Plan G Annual Maximum Out of Pocket Costs
Medigap Plan G has the lowest annual maximum out-of-pocket (MOOP) limit available for those new to Medicare. Plan F has a lower MOOP, but is not available for everyone. The MOOP refers to the maximum amount that a beneficiary would have to pay for covered services within a given year, beyond which the insurance plan would cover all additional costs.
The Plan G annual maximum out of pocket limit is the Part B deductible. Between Medicare and Medigap Plan G, all other inpatient and outpatient Medicare bills are covered at 100%.
How Much Does Medicare Plan G Cost?
Medicare Plan G costs can vary by as much as 400%, depending on factors like location, age, tobacco use, and the insurance company chosen. Insurance companies set the premiums, which can increase over time. To find the insurance company that may offer the lowest lifetime premium for any supplement plan, reach out to us. As an independent Medicare insurance broker we represent your best interest in finding the right policy for you.
The only way to get an accurate price is through our quote request form or calling us at 800-847-9680. Our services are free and have no obligation on your part. We will shop the Medigap plans in your area, to find the right Medigap plans and insurance company for your needs and budget.
Medigap Plan G vs Plan F
Both Medigap Plan G and Medigap Plan F provide robust coverage for out-of-pocket costs not covered by Medicare Parts A and B. Plan F covers the Medicare Part B deductible, while Plan G does not, hence, the higher premiums for Plan F. Plan F is the most comprehensive Medigap plan because it covers 100% of the gaps in Medicare coverage.
Plan G covers all other benefits that Plan F covers, including the Medicare Part A deductible, copayments, coinsurance for Medicare approved services and procedures, plus the 20% coinsurance for Medicare Part B services.
As of January 1, 2020, Plan F is no longer available to new Medicare beneficiaries. Only those who became eligible for Medicare before that date can enroll in Plan F. Plan G, on the other hand, is available to both new and existing beneficiaries.
With Plan F, beneficiaries have no out-of-pocket costs for Medicare-covered services. On the other hand, Plan G requires beneficiaries to pay the Medicare Part B deductible each year. Once the deductible is met, Plan G covers the remaining costs for covered services.
Although Plan F may have higher premiums, you need to consider the long-term cost and cover implications. Plan G’s lower premiums and similar coverage can often make it a more cost-effective choice, especially if the difference in premiums is greater than the Part B deductible.
Ultimately, it all depends on your needs, preferences, and budget.
Medigap Plan G vs Plan N
Both Plan G and Plan N offer comprehensive coverage, but there are some
differences. Plan N, for example, requires beneficiaries to pay an office visit copay.
Generally, Plan G tends to have higher premiums compared to Plan N, which is the least expensive plan of these three plans. However, premium costs can vary depending on factors such as location, age, and the insurance company. Your lifetime cost depends more on the insurance company you choose than on your choice of Medigap Plans.
Both Plan G and Plan N are available to new and existing Medicare beneficiaries.
Are Medigap Policy Premiums Tax deductible?
Medicare premiums can be tax deductible, but certain limitations apply. Medicare beneficiaries may deduct their Medicare health insurance premiums from their federal taxes if their total medical and dental expenses exceed 7.5% of their adjusted gross income. This is known as the medical expense deduction. If eligible, deducting these premiums reduces adjusted gross income, leading to a lower taxable income for calculating taxes.
My article on tax deductions for Medicare premiums goes into detail on the subject. Business owners have special rules making such a tax deduction much more favorable.
Medigap Plan G vs. Medicare Advantage Plan
Medigap Plan G supplements Original Medicare and helps cover out-of-pocket costs, providing flexibility in choosing healthcare providers. Medicare Advantage plans replace Original Medicare and often include additional benefits but have network restrictions.
Medicare supplement insurance Plan G generally has a higher monthly premium but more predictable costs, while Medicare Advantage plans may have lower premiums but much higher out-of-pocket expenses.
Medicare Advantage plans may also require prior authorization for non-urgent medical services or procedures, which can cause unnecessary delays and complications.
Medicare Advantage plans can change their benefits, provider networks, and formularies (covered drugs) on an annual basis which will affect your coverage, while Medigap plan benefits are standardized and never change.
Also, if you travel frequently or spend time in different regions, Medicare Advantage plans may have limited coverage or higher costs for services received outside their designated service area.
How To Shop for and Enroll in Medicare Supplement Plan G
Reach out to us to speak to a Medicare expert. We research multiple insurance companies and compare the quotes on Plan G before you buy a Medigap policy.
Consider your expected healthcare needs and determine if the plan’s coverage and health care costs align with your budget and goals.
To secure guaranteed acceptance without medical underwriting, enroll in Medicare Supplement Plan G during the Medigap Open Enrollment Period. This period begins when you enroll in Medicare Part B, and it lasts for six months.
The Medigap Seminars Independent Agent Near Me
Fill out the form below to get a quote on Plan G or talk to an Independent Medicare Agent by calling 800-847-9680. We’re happy to answer any Medicare benefits questions you may have and help you make an informed decision! We can help you buy a Medigap plan that is right for you.
Matthew Claassen
Matthew Claassen, CMT and CEO of Medigap Seminars Insurance Agency. Medigap Seminars is an award winning premier national Medicare Insurance Brokerage, ranked among the top in the U.S.A. Matthew is considered a leading national expert on Medicare and Social Security. Mr. Claassen is a distinguished member of the Forbes Business council, an invitation only organization of business leaders and entrepreneurs. He and his team have received awards from many of the countries largest insurance companies including Mutual of Omaha, Aetna, Humana, Cigna, United American, United Healthcare and others. His videos have become the most popular Medicare educational videos on YouTube with millions of views. As a financial analyst Matthew lead a team of researchers to win the 2009 Best Equity Research & Strategy Award from The Technical analysis magazine.
