Medicare Supplement Plan G has emerged as one of the most popular Medigap options for seniors seeking comprehensive coverage beyond Original Medicare. This detailed guide explores everything you need to know about Plan G, including its benefits, costs, eligibility requirements, and how it compares to other Medicare Supplement plans.
What is Medicare Supplement Plan G?
Medicare Supplement Plan G is a standardized Medigap insurance policy that helps cover healthcare costs not paid by Original Medicare (Parts A and B). Often referred to as the "second-best" Medicare supplement plan after the now largely unavailable Plan F, Plan G provides extensive coverage with predictable out-of-pocket expenses.
Unlike Medicare Advantage plans, which replace Original Medicare, Plan G works alongside your existing Medicare coverage to fill gaps in benefits. This means you keep your Original Medicare while gaining additional protection against high medical bills.
Medicare Supplement Plan G Benefits: What's Covered
Plan G covers almost all the gaps in Original Medicare, providing comprehensive protection against unexpected medical expenses. Here's what Plan G covers:
Complete Coverage Benefits:
- Medicare Part A coinsurance and hospital costs for up to 365 days after Medicare benefits end
- Medicare Part B coinsurance or copayment (after you meet the Part B deductible)
- Skilled nursing facility coinsurance (days 21-100)
- Medicare Part A deductible ($1,632 in 2024)
- Blood costs (first three pints)
- Part A hospice coinsurance or copayment
- Part B excess charges (when doctors charge more than Medicare-approved amounts)
- Foreign travel emergencies (80% of costs after $250 deductible, up to $50,000 lifetime)
What Plan G Doesn't Cover:
- Medicare Part B deductible ($257 in 2025) - This is the main difference between Plan G and Plan F
- Prescription drugs - You'll need a separate Part D plan
- Dental, vision, or hearing aids - These require separate insurance
- Long-term care
How Much Does Medicare Supplement Plan G Cost?
Plan G premiums vary significantly based on several factors:
Factors Affecting Plan G Costs:
- Your location - Premiums differ by state and zip code
- Your age - Most insurers use attained-age pricing
- Insurance company - Different insurers charge different rates for identical coverage
- Tobacco use - Smokers typically pay 15-20% more
- Gender - Where permitted, women may pay slightly more due to longer life expectancy
- Household discounts - Many insurers offer 5-12% discounts for multiple policies
Does Medicare Plan G Cover Prescriptions?
No, Medicare Supplement Plan G does not provide coverage for prescription drugs. As of January 1st, 2006, no new Medigap plans sold offer coverage for prescription drugs.
If you have a Medigap plan and are interested in prescription drug coverage, you should look into a standalone Medicare Part D plan. Medicare Part D plans are offered by private insurers and are designed to specifically cover the costs of outpatient prescription drugs.
Plan G vs. Other Medicare Supplement Plans
Understanding how Plan G compares to other Medigap options helps you make an informed decision:
Plan G vs. Plan F
- Similarities: Both offer comprehensive coverage
- Key Difference: Plan F covers the Part B deductible, Plan G doesn't
- Availability: Plan F only available to those eligible for Medicare before January 1, 2020
- Cost: Plan G typically costs $200-400 less annually
Plan G vs. Plan N
- Plan G Advantages:
- No copayments for office visits or emergency rooms
- Covers Part B excess charges
- More predictable costs
- Plan N Advantages:
- Lower premiums (typically 15-25% less than Plan G)
- Still provides substantial coverage
- Plan N Requirements:
- $20 copayment for office visits
- $50 copayment for emergency room visits (waived if admitted)
- No coverage for Part B excess charges
Plan G vs. High-Deductible Plan G
- Standard Plan G: Higher premiums, lower out-of-pocket costs
- High-Deductible Plan G:
- Lower premiums (often 40-60% less)
- Must pay the full Medicare deductible ($2,800 in 2024) before benefits begin
- Same coverage after deductible is met
Who Should Consider Medicare Supplement Plan G?
Plan G may be ideal for:
Good Candidates for Plan G:
- Budget-conscious seniors who want comprehensive coverage without Plan F's higher cost
- Frequent healthcare users who want predictable expenses
- Those who travel frequently (domestic and international)
- Individuals with chronic conditions requiring regular care
- People who prefer Original Medicare over Medicare Advantage restrictions
When to Consider Other Options:
- If you're very healthy and rarely need medical care, Plan N may be more cost-effective
- If you want the lowest possible premium, High-Deductible Plan G may work
- If you need prescription drug coverage, ensure you enroll in Part D separately
Medicare Supplement Plan G Enrollment: When and How
Best Time to Enroll in Plan G:
Medigap Open Enrollment Period (OEP):
- Begins the first month you're both 65 or older and enrolled in Medicare Part B
- Lasts six months
- Guaranteed issue rights - cannot be denied coverage or charged more for health conditions
- No waiting periods for pre-existing conditions
Special Enrollment Situations:
- Losing employer health coverage
- Moving to a new state
- Being dropped from a Medicare Advantage plan
- Certain other qualifying life events
Choosing the Right Plan G Insurance Company
All Plan G policies offer identical benefits, but insurers differ in:
Key Comparison Factors:
- Premium costs - Can vary significantly
- Rate increase history - Some companies increase rates more aggressively
- Financial strength - Look for A or higher ratings
- Customer service - Check complaint ratios and reviews
- Claims processing - Efficient payment systems matter
- Household discounts - Potential savings for couples
Questions to Ask Before Enrolling:
- What type of pricing method do you use? (attained-age, issue-age, community-rated)
- What has been your average annual rate increase over the past five years?
- Do you offer household or loyalty discounts?
- What is your A.M. Best rating?
- How do you handle claims processing?
Common Medicare Supplement Plan G Questions
Can I switch from Plan G to another Medigap plan?
Yes, but you may face medical underwriting unless you qualify for guaranteed issue rights. Some states have additional protections for switching plans.
Does Plan G cover my spouse?
No, Medicare Supplement plans only cover the named policyholder. Your spouse needs a separate policy.
Can I use Plan G with any doctor?
Yes, Plan G works with any healthcare provider that accepts Medicare. There are no network restrictions.
When do Plan G benefits begin?
If you have no pre-existing conditions or enroll during a guaranteed issue period, benefits begin immediately. Otherwise, there may be a six-month waiting period for pre-existing conditions.
The Bottom Line on Medicare Supplement Plan G
Medicare Supplement Plan G offers excellent value for most Medicare beneficiaries, providing comprehensive coverage at a lower cost than Plan F. With its extensive benefits and protection against high medical expenses, Plan G has become the go-to choice for many seniors seeking peace of mind in their healthcare coverage.
The key to maximizing Plan G's benefits is choosing the right insurance company and timing your enrollment appropriately. By understanding what Plan G covers, what it costs, and how it compares to other options, you can make an informed decision that supports your health and financial well-being throughout retirement.
Other Medigap Plans: