High Deductible Plan G versus Medigap Plan G

It’s common knowledge that individuals who became eligible for Medicare after January 1, 2020, can no longer enroll in Medigap Plan F or High Deductible Plan F. This has left many people who were considering a high-deductible Medigap plan uncertain about their options since these plans are no longer available to any Medicare beneficiaries. Given this information, you might be wondering which Medicare Supplement plan is the most suitable for you. The good news is that there are numerous options available. Insurance companies have introduced High Deductible Plan G after phasing out Plan F and High Deductible Plan F. But how does this new plan compare to the ever-popular Medigap Plan G or Plan N? We’ll be comparing the standard Plan G with the high-deductible version to help you decide if either of these plans is the best choice for you.

How Do Medigap Policies Work?

To start with, let’s explore the functioning of Medigap plans. Original Medicare Parts A and B fall short of covering all medical services, leaving certain gaps in the coverage. For instance, if you obtain a Part B service, like chemotherapy, you are accountable for paying the Part B deductible and a 20% coinsurance after that.

The 20% coinsurance can prove to be a substantial amount that you may have to shell out, and there is no cap on the out-of-pocket expenses. Hence, numerous beneficiaries opt for a Medigap plan to assist them with the out-of-pocket costs.

Unlike Medicare Advantage plans, Medigap plans work in tandem with Original Medicare, providing supplementary coverage as secondary coverage. As long as a healthcare provider accepts Medicare, they will also take your Medigap plan, irrespective of the plan type or carrier. Since Medicare lacks any network restrictions, so does a Medigap plan. You can consult any doctor in the United States who accepts Original Medicare and make use of your Medigap plan.

There are ten standardized Medigap plans, with Supplement Plan G being a popular choice among Medicare beneficiaries. 

Plan G vs. High Deductible Plan G

Under Plan G, you can enjoy coverage for a wide range of healthcare expenses, including your hospital deductible, Part A coinsurance, skilled nursing facility care, hospice, Part B excess charges, Part B coinsurance, and much more. This means that you are only responsible for paying the annual deductible for Part B, which is set at $226 for 2023, as your out-of-pocket expense for all Medicare-approved services for the entire year.

The High Deductible Plan G provides the same benefits as the regular Plan G. However, to access the coverage, you need to first fulfill the plan’s deductible.

Unlike the regular Plan G, where you only pay the Part B deductible, the High Deductible Plan G requires you to pay its own deductible, which stands at $2,700 for the year 2023.

Here’s how it works:

You are accountable for the Part A and Part B deductibles and the coinsurance.

After meeting the Part B annual deductible, Medicare pays 80% of the approved Part B service costs, leaving you with 20% to pay until you fulfill the $2,700 high deductible. Any amount you pay towards the Part A and Part B deductibles counts towards the high deductible.

Once you meet the high deductible, the plan will cover all approved services for the remainder of the year. It’s worth noting that the deductible amount can rise annually.

For budget-conscious consumers who cannot afford a traditional Medigap G policy or are in good health and do not require frequent medical attention, High Deductible plans are often a popular option.

To determine whether a High Deductible Plan G is suitable for you, it is essential to do the math. Although the premiums for this type of plan are usually low, there is a catch – you may be required to pay an additional $2,700 out-of-pocket.

You must consider whether a lower monthly premium would be better suited to your budget, even if it means incurring higher healthcare costs. Alternatively, a higher premium could result in fewer and more predictable healthcare expenses over the year.

Enrolling in a High Deductible Plan G requires monitoring your claims and the amount you pay out-of-pocket throughout the year. 

Final Thoughts

Medicare supplement G plan covers a wide range of healthcare expenses, with beneficiaries only responsible for paying the Part B deductible each year. The High Deductible option has the same coverage as Plan G but requires beneficiaries to pay a higher deductible before accessing the benefits.  It is often a popular option for budget-conscious consumers who are in good health and do not require frequent medical attention. However, it is essential to consider the out-of-pocket costs and determine whether a lower monthly premium or a higher premium with fewer healthcare expenses is more suitable for your budget. Enrolling in a High Deductible Plan G requires monitoring your claims and out-of-pocket expenses throughout the year. Have in mind that you can switch your Medigap plans whenever you want, so if you picked the wrong one for your needs, there is no problem.

If you have any additional questions about Medigap policies and coverage contact Temmen Insurance. Our experienced Medicare agents can help you find the best plan options that are suitable for your specific budget and needs!

Need Assistance?

Get a free quote

Get Live Support

Talk to An Expert

We represent all major companies and organizations that serve the senior market..