Medicare Supplement Plan G or Medigap plan is a top-rated plan on the market, sold by private insurance companies. Medicare Supplement plans are standardized plans whose benefits are related to Medicare which means that if you choose any of the 10 plans from letters A to N you need to have Original Medicare (Parts A and B) first. Your Medicare Supplement insurance is secondary insurance that helps beneficiaries cover out-of-pocket costs left by Original Medicare. If doctors accept Medicare they are obligated to accept Medicare Supplement plans as well.
Plan G covers almost all of the gaps in traditional Medicare at 100% which means that Plan G pays everything that Medicare does not pay aside from Medicare Part B deductible which is 223$ per year in 2022. In other words, your pocket expenses are reduced to a minimum.
Plan G Coverage
As already mentioned, Medicare Supplement Plan G is one of the most comprehensive plans on the market because it provides beneficiaries with almost every benefit of medical service coverage. Therefore, Plan G gives enrollees basic benefits together with these additional benefits:
- Part A coinsurance and hospital benefits
- Part B coinsurance or copayment
- First three blood prints for a medical procedure
- Part A hospital coinsurance or copayment
- Skilled nursing facility care coinsurance
- Part A deductible
- Part B excess charges
- 80% of a foreign travel emergency
The only thing Plan G does not cover is a Part B deductible which means that you have to pay $223 each year before Medicare or your Medicare Supplement plan kicks in. After you met the deductible every other Medicare coverage service is fully covered. For example, you’ll pay nothing for hospital stays or doctor visits because there are zero copayments so there are no out-of-pocket costs.
Plan G also has a high deductible version which is offered in some states. It is called “high deductible Plan G” and this plan has a larger annual deductible you have to meet before your coverage kicks in. In 2022, a deductible is 2490$ per year. After you pay for that, your Part A and B medical services will be covered 100%.
Plan G costs
Maybe the one downside of Medicare Supplement Plan G is the high monthly premium which can range from 100$ to 300$ per month. Also, it is possible that rates increase as time goes on. However, with plan G there are no copayments. After you’ve met your deductible you are fully covered.
Medigap Plan G Enrollment Period
To be able to enroll in supplemental Plan G you have to already be enrolled in Original Medicare – Parts A and B first. But, if you don’t qualify for Guaranteed Issue Rights and do not apply for Supplement plans when you are first eligible for them you may be turned down based on your pre-existing health conditions or have a higher monthly premium rate for it.
If you enroll during the Open Enrollment Period when you are first eligible your carrier cannot deny your application due to any reason (guaranteed issue right). However, if you choose to enroll at any other time you will need to pass medical underwriting to be eligible if you don’t pass it there is a chance that the carrier deny your coverage.
What Is Guaranteed Issue Right?
As of the year 2020, newly eligible Medicare beneficiaries have certain Guaranteed Issue Rights to buy plan G without medical underwriting if they qualify for certain types of life situations. For example, if you turned 65 and enrolled in Original Medicare but not purchased Medicare Supplement Plan during the 6-month open enrollment period when you were first eligible because you were still working and covered under a group health plan you are able to buy this plan without passing medical underwriting.