NerdWallet: Here’s how Medigap Plan G works, and what it covers
Medigap Plan G is one of 10 Medicare Supplement Insurance plans. Medigap assists with fees such as coinsurance, copayments and deductibles that aren’t covered under Medicare Part A and Part B, also known as Original Medicare.
How it works
After Medicare pays its approved portion of medical costs, Medigap Plan G helps supplement remaining out-of-pocket expenses. You must pay a separate monthly premium for Medigap coverage, which is privately insured but standardized across all states except Massachusetts, Minnesota and Wisconsin.
Since Plan F is no longer available to new applicants, Medigap Plan G is one of the more comprehensive Medicare Supplement plans on the market. According to Medicare.gov, here is what Medigap Plan G covers and doesn’t cover.
Medigap Plan G covers:
Part A deductible.
Part A coinsurance and hospital costs up to 365 days after Medicare benefits are exhausted.
Part A hospice care coinsurance or copayment.
Part B coinsurance or copayment.
Skilled nursing facility care coinsurance.
Blood transfusion (first three pints).
Emergency health care service for the first 60 days when traveling outside the U.S.
Medigap Plan G doesn’t cover:
Part B deductible.
Prescription drugs (available only on plans purchased before Jan. 1, 2006. You can receive prescription coverage through a Medicare Part D plan).
Cost of Medigap Plan G
Since Medigap Plan G coverage is privatized and regulated by the state, the price varies by age, location and such factors as tobacco use. In 2021, in one representative California ZIP Code (92589), plan prices for a nonsmoking 65-year-old man range from $120 to $284 monthly.
Some states also offer a high-deductible Plan G, with a 2021 deductible of $2,370. Monthly premiums for the same 65-year-old nonsmoker in ZIP 92589 range from $30 to $68.
The best time to buy your Medigap Plan G policy is during the six-month Medigap Open Enrollment Period, which starts the first month you have Medicare Part B and once you’re 65 years of age or older. Medigap policies can cover only one person, regardless of marital status.
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To find out the cost of Medigap Plan G in your area, visit Medicare.gov.
There are plenty of options and types of coverage when it comes to Medicare benefits. Out of the 64 million people in the U.S. who receive traditional Medicare benefits, 81% use some sort of Medicare supplement insurance, according to Medicare.org, a nongovernment resource for health care information.
If you have questions about Medicare, visit Medicare.gov or call 800-633-4227 (TTY: 877-486-2048).
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Jason Jenkins writes for NerdWallet. Email: firstname.lastname@example.org.