Medicare Supplement Plan G Benefits
Medigap Plan G insurance basic benefits include:
- Medicare Part A hospital coinsurance and hospital costs . Part A coinsurance amounts can range from $0 to up to $778 per day in 2022, depending on the length of your hospital stay.
- Medicare Part B coinsurance or copayment
- First three pints of blood
- Medicare Part A hospice care coinsurance or copayment. Copayment amounts for prescription drugs and other products related to pain relief or symptom control are generally no more than $5. Respite care typically requires a coinsurance payment of 5 percent.
- Medicare Part A deductible. In 2022, the Part A deductible is $1,556 for each benefit period.
- Medicare Part B excess charges. Health care providers that do not accept Medicare assignment may charge up to 15 percent more for products and services.
- Skilled nursing facility care coinsurance coverage. Part A coinsurance may cost up to $194.50 per day during each benefit period in 2022.
- Foreign travel emergency coverage
What Is Medicare Supplement Plan G
Medicare Supplement Plan G is one of eight standardized insurance plans that are available for Original Medicare beneficiaries who became eligible for Medicare after January 1, 2020. There is a high-deductible version of Plan G as well.
Plan G offers the most comprehensive coverage of all the standardized plans and includes coverage for excess charges and foreign travel emergencies.
|Plan structure||Supplemental insurance plan that covers most of the out of pocket costs associated with Medicare Parts A and B. Plan pays after Medicare pays.|
|Benefits available||Coinsurance and copayments for Part A inpatient and Part B outpatient services. Part A deductible, Part A hospice copays, Part B excess charges, and 80% of foreign travel emergency expenses.|
|Cost sharing||You pay a monthly premium which may increase each year depending on your age or inflation. You are responsible for the Part B annual deductible and the plans deductible if you choose the high-deductible version.|
Medicare Supplement Insurance Plan G
by Christian Worstell | Published January 14, 2022 | Reviewed by John Krahnert
Medicare Supplement Insurance Plan G is among the most comprehensive Medigap plans available in most states. Medicare Supplement Insurance works alongside Original Medicare to cover some of the program’s out-of-pocket costs such as deductibles, coinsurance and copayments.
Medicare Supplement Insurance Plan G coverage includes eight of the nine available Medigap benefits.
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Best Overall Medicare Supplement Plan Pre
If you qualified for Medicare before Jan. 1, 2020, Plan F is the best Medigap plan. Plans will cover all the items that you would usually need to pay for out of pocket, including deductibles and coinsurance.
Plan F is a good option if you want a comprehensive policy that will give you peace of mind about day-to-day expenses, such as paying a copay for a doctor’s office visit. The monthly premium for Plan F averages $231, which makes this plan even more expensive than Plan G. Unfortunately, Plan F is not available to new Medicare enrollees who become eligible after Jan. 1, 2020. Anyone who currently has Plan F will be able to keep their coverage.
What Are The Eligibility Requirements For Aarp Medicare Supplement Plan G
You must be enrolled in Medicare Part A and Part B before you can apply for Medicare Supplement Insurance Plan G. And you must be at least 65 years old to purchase Medigap in some but not all states. Lastly, you must live in the area that is serviced by the plan. While Medigap can be used anywhere that Original Medicare is accepted, it can only be purchased in the county or zip code in which you reside.
To apply for AARP Medicare Supplement Plan G or any other Medigap plan from AARP, you must be an AARP member. Memberships are $16 per year in 2021 and include a number of savings and discounts on travel, dining, shopping and more.
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What Are Guaranteed Issue Rights
Guaranteed issue rights require insurance companies to sell you a Medigap policy that:
- covers preexisting health conditions
- doesnt cost more on account of past or present health conditions
Guaranteed issue rights typically come into play when your healthcare coverage changes, such as if youre enrolled in a Medicare Advantage Plan and it stops providing care in your area, or if you retire and your employees healthcare coverage is ending.
Visit this page for more information on guaranteed issue rights.
Does It Matter Which Company I Select
Medicare Supplement plans are completely standardized, so the benefits will be the same from company to company. All Medicare Supplement plans, including Plan G, are standardized in the following ways:
- Benefits You dont have to worry about which company offers the best or most benefits. The benefits of a Plan G will be the same regardless of the company you select.
- Doctors Network Medicare Supplement insurance companies dont have their own doctors networks. Their plans are only supplements to your primary Medicare Parts A & B coverage. Your network is the nationwide Medicare network, so, you dont have to worry about whether one company has a better doctors network than another.
- Claims-Paying Process The Medicare Supplement claims process is highly automated. It is easy for you to use the coverage, and most people never see any paperwork. Once Medicare approves your claim, they will pay their portion and notify your provider of what they owe. The company must then pay the amount due per Medicares instructions. Due to the automation and standardization in this area, every company is equal in its claims-paying history.
To make it simple, Medicare is your primary coverage. The plans that each Medicare Supplement insurance carrier offers are identical from company to company, because they are standardized by the government.
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Enrolling In Medicare Supplement Plan G
To enroll in Medigap Plan G, you must have Medicare Part A and Part B.
Pre-existing conditions may play a role in your Medicare Supplement Plan G enrollment, depending on when you apply for coverage. Pre-existing conditions do not affect enrollment if you apply for Medigap Plan G during your Medicare Supplement Open Enrollment Period or qualify for Guaranteed Issue Rights. During these times, a carrier may not deny you coverage for any reason.
If you enroll at any other time, you may be subject to underwriting health questions. However, specific state rules may also allow you to enroll without needing to answer these questions, so knowing what your state permits is vital.
If you live in a state that does not have exceptions and decide to apply outside of these enrollment periods, you will need to answer underwriting health questions to determine your insurability. By providing answers to underwriting health questions, carriers may deny you coverage based on any findings.
Lastly, if you currently have a Medicare Advantage plan and are interested in enrolling in Medicare Supplement Plan G, you will need to switch back to Original Medicare first. You can make this change by using the Annual Enrollment Period in the fall or the Medicare Advantage Open Enrollment Period in the first quarter of each year.
Medicare Part B Excess Charges
This is potentially one of the most valuable areas of this Medigap plan. Medicare Supplement Plan G covers 100% of the excess charges that Original Medicare Part B leaves to the beneficiary after the yearly deductible has been met. Original Medicare provides for 80% of these expenses leaving the 20% to the beneficiary. In addition to the 20%, copays for appointments are also covered. Ultimately, these costs can add up to a substantial amount of money left to the beneficiary to pay.
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Best For Easy Application: Mutual Of Omaha
Mutual of Omahas application process couldnt be simpler. The front page details each different Medicare Supplemental Plan it has available, and it never navigates away from that page during the comparison process.
Easy, clean website with reviews available on the same page
Simple comparison process that only requires gender, date of birth, and ZIP code
Household discount available
Multi-step process to pay online
Limited extra benefits other than the household discount
Mutual of Omaha prides itself on simplicity. It offers an easy-to-read chart for services covered under Medicare Supplement Plan G. It also allows you to create an account or apply as a guest, allowing faster comparisons. Applying with either type of account requires information from your Medicare card, your social security number, and your medications to allow for an accurate estimate. You also can save your application and return to it later, but you will have to create an account to do so.
What Is Covered By Aetna Medicare Supplement Plan G
This plan provides the most comprehensive coverage.
Plan G Covers:
- Coinsurance for Medicare Part A hospital coverage
- after Medicare benefits have been exhausted for a maximum of 365 days
- the copay or coinsurance for Part A hospice care
- Part A deductible
- Coinsurance for Part B preventive office visits
- Copays for Part B
- for the first three pints of blood needed for medical procedures
- Coinsurance for skilled nursing care
- Toreign travel coverage
Plan G does not cover:
- Part B deductible of $233 per year
- Dental, hearing, or vision
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A Hospice Care Coinsurance Or Copayment
Hospice care provides medical treatment and care during a terminal illness. Medicare covers these services, but it requires copayments. These copayments include $5 for each symptom and pain relief prescription drugs and 5% of the Medicare-approved amount for inpatient respite care.
Plan G covers these costs completely.
Check Plan Pricing And Coverage
Cost is often a determining factor in many purchases. Different providers may have different costs for the same care, while some may go above and beyond the basic level of care required by law.
The federal government mandates all Medicare Supplement Plan G coverage. All plans will cover the same basics: nursing home care, extended hospital care, blood transfusions, etc. Some providers may offer more, but the cost may be higher with those plans.
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Open Enrollment For People Age 65 And Older
The open enrollment period for Medicare supplement plans is a six-month period during which you may buy any Medicare supplement plan offered in Texas. During this period, companies must sell you a policy, even if you have health problems. The open enrollment period begins when you enroll in Medicare Part B. You must have both Medicare parts A and B to buy a Medicare supplement policy.
You can use your open enrollment rights more than once during this six-month period. For instance, you may change your mind about a policy you bought, cancel it, and buy any other Medicare supplement policy.
Although a company must sell you a policy during your open enrollment period, it may require a waiting period of up to six months before it starts covering your preexisting conditions.
Preexisting conditions are conditions for which you received treatment or medical advice from a doctor within the previous six months.
Find Out What Medicare Supplement Plan G Plans Are Available In Your Area
Not every provider offers every Supplement plan, and not every provider has plans available in every location. Most Supplementary Medical Insuranceproviders will ask for your ZIP code when you’re preparing your personalized estimate, which will let you know immediately if the provider covers your area.
Just because a plan covers your state doesnt mean it covers your area, so make sure you enter your ZIP code correctly to see the plans available in your county.
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What Is The Difference Between Plan G And Plan G With A High Deductible
The difference between a regular Plan G plan and a High Deductible Plan G plan is the deductible amount and coverage timing. With a standard Supplement Plan G, youre covered immediately and are responsible only for the $233 Part B deductible, plus your monthly premium. With a high-deductible Plan G, your coverage begins once you pay your $2,490 deductible, which then covers all future out-of-pocket costs.
Determining which one is best for you depends on your situation and if you need the coverage Plan G provides immediately or if it makes more sense to pay the lower premiums until that higher deductible is met.
Switching From Medicare Advantage
If you currently have a Medicare Advantage plan and want to go with a Medigap policy, when can you switch to Plan G? You can switch to Original Medicare during the Annual Election Period from October 15 to December 7, or the Medicare Advantage OEP from January 1 to March 31. Then you can apply for a Medicare Supplement plan.
In most states you will not have guaranteed-issue rights when you switch, meaning you might face medical underwriting and higher premiums. Some states do allow it. To see what the Medigap rules are where you live, check with your state insurance department.
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How Medicare Supplement Plan G Curbs Excesses
Medicare Supplement Plans F and G offer another valuable benefit: They are the only two plans that provide coverage for Medicare Part B excess charges, which occur when a doctor bills you for more than the Medicare approved amount for a specific service.
While fairly uncommon, Medicare Part B excess charges can add up quickly. Medicare places no limits on your out-of-pocket spending.
Even if none of your current doctors bills for Medicare Part B excess charges, its worth considering whether doctors or hospitals that you want to use in the future might.
What Does Plan G Include
Plan G covers everything that Medicare Part A and B cover at 100% except for the Part B deductible. Premium costs vary widely, depending on where you live. In many states, costs also vary based on your gender and whether you smoke or vape. If you qualify for Original Medicare, you may be able to enroll in Plan G.
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What Are The Characteristics Of Medicare Beneficiaries With Different Sources Of Coverage
Among Medicare beneficiaries in traditional Medicare, most have supplemental coverage, either through Medigap , employer-sponsored retiree health coverage , or Medicaid . But nearly 1 in 5 Medicare beneficiaries in traditional Medicare have no supplemental coverage .
Figure 2: Nearly One in Five Traditional Medicare Beneficiaries Had No Source of Supplemental Coverage in 2018
Medicare supplement insurance, also known as Medigap, provided supplemental coverage to 2 in 10 Medicare beneficiaries overall, or 34% of those in traditional Medicare in 2018. As with other forms of supplemental insurance, the share of beneficiaries with Medigap varies by state. Medigap policies, sold by private insurance companies, fully or partially cover Part A and Part B cost-sharing requirements, including deductibles, copayments, and coinsurance. As of January 1, 2020, Medigap policies are prohibited from covering the full Medicare Part B deductible for newly-eligible enrollees however, older beneficiaries who are already enrolled are permitted to keep this coverage. While Medigap limits the financial exposure of Medicare beneficiaries and provides protection against catastrophic expenses for services covered under Parts A and B, Medigap premiums can be costly and can rise with age, depending on the state in which they are regulated. Estimated average monthly premiums for Medigap policies range from $150 to around$200.
Employer-sponsored Retiree Health Coverage
Cobra Coverage From An Employer Plan
Federal and state law allows people who leave their jobs to continue their employer-sponsored health coverage for a period of time. Be aware of the following:
- You have an eight-month period after your employment ends to enroll in Medicare. If you dont enroll during that eight-month window, you might have to pay a penalty when you enroll.
- If youre in your Medicare initial enrollment period, you must enroll in Medicare during that time to avoid a possible penalty.
- If you dont buy a Medicare supplement policy during your open enrollment period, youll be able to buy some Medicare supplement plans within 63 days of losing your COBRA coverage.
Talk to your employer about COBRA and Medicare eligibility.
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Best Cheap Medicare Supplement Plan: Plan K
If you are interested in the cheapest Medigap policy that still provides some coverage on top of Original Medicare, you may want to look into Plan K.
Plan K is significantly different from many other Medigap policies since it provides only 50% coverage for Medicare Part B coinsurance, blood, Part A hospice, skilled nursing and the Part A deductible. Many other Medigap plans, such as Plan G, provide full reimbursements for these types of health care.
This is crucial to consider if you need health insurance coverage for skilled nursing. In this case, if you were to get Plan K, only 50% of such costs would be covered.
On the other hand, your monthly premiums with Plan K will be much cheaper. Policyholders can expect to pay about $77 per month, making it the best Medicare Supplement plan for low-income seniors.
Who Should Get A Medicare Supplement Plan G
A Medicare Supplement Plan G may be a good choice for you if you:
- Have Original Medicare and want comprehensive coverage for most out of pocket expenses you incur when you receive your Part A and Part B benefits.
- Want to see any Medicare provider in the U.S.
- Travel abroad or choose to receive care from providers who charge more for Medicare-covered services than what Medicare allows.
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What’s The Least Expensive Medicare Supplement Plan
Plan K is the cheapest Medigap plan, with an average cost of $77 per month for 2022. For those who are only interested in protecting themselves against major medical expenses, a high-deductible plan is another way to have low-cost coverage. Only a few providers offer these plans, and a high-deductible Plan G from Mutual of Omaha costs about $54 per month.