Medicare Supplement (Medigap) Insurance Plan G
When it comes to covered benefits, Medicare Supplement insurance Plan G is nearly identical to Medicare Supplement insurance Plan F. These two plans offer the most comprehensive coverage of the 10 Medigap plan types available in most states. The main difference between the two plans is that Plan G doesn’t cover the Medicare Part B deductible. If you have this plan, you’ll need to pay this cost out of pocket.
The Medicare Part B deductible may vary from year to year; you’ll need to pay for all medical costs until your out-of-pocket costs reach this amount. After you reach the yearly Medicare Part B deductible, you’ll generally pay 20% of the Medicare-approved cost for Part B-covered services (such as doctor visits and durable medical equipment).
Like other Medigap plans, Medicare Supplement insurance Plan G helps Original Medicare beneficiaries with certain out-of-pocket costs (such as cost sharing). Plan G also includes the following benefits:
- Medicare Part A inpatient hospital coinsurance and hospital costs up to 365 days after Original Medicare benefits are exhausted
- Medicare Part A hospice care coinsurance or copayment
- Medicare Part A deductible
- Medicare Part B coinsurance or copayment
- Medicare Part B excess charges
- First three pints of blood for a medical procedure used in a year
- Skilled nursing facility care coinsurance coverage
- Foreign travel emergency coverage (80%, up to plan limits)
Medicare Supplement insurance Plan G and Medicare Part B excess charges
It’s worth noting that Medigap Plan G covers Part B excess charges, which the majority of Medicare Supplement insurance plans do not cover. Medigap Plan F is the only other Medicare Supplement insurance plan that covers this benefit. Excess charges are additional expenses you may have to pay for health care beyond what Original Medicare covers; it’s the difference between what Medicare pays for a particular medical service and what your doctor or provider charges for it. Normally, the Medicare program has set up approved payment rates (known as the Medicare fee schedule) for covered medical services; this regulates what doctors and providers are allowed to charge you for Medicare-covered services.
You may have to pay excess charges if you use a doctor or provider that doesn’t accept assignment, meaning the provider does not accept the Medicare-approved amount as the full payment. Excess charges occur when the doctor charges you above this amount. By law, providers who don’t accept assignment can only charge up to 15% in excess charges above the Medicare-approved amount (state law may impose further limitations).
For example, if Medicare’s allowed charge for a doctor appointment is $100, a non-participating physician may choose not to accept that amount as the full cost and charge an additional 15% for the appointment. In this instance, Medicare would pay 80% of the allowed charge, sending the physician $80. The beneficiary would then be responsible for paying not only the remaining $20 but also the excess 15% charge, another $15, making the total out-of-pocket cost $35. Because Plan G covers 100% of Medicare Part B excess charges, all of the out-of-pocket costs in this example would be covered by this policy.
Finding Medicare Supplement insurance Plan G
Remember, like other Medicare Supplement insurance plans, basic benefits are standardized across each letter category. So Plan G basic benefits are exactly the same, no matter which insurance company you purchase the policy from. However, keep in mind that costs and availability will vary by insurance company and location, so it’s important to shop around to find the best value for the Medigap plan you’re considering.
One easy way to research plan options is to use our plan finder tool to view Medigap plans in your service area and compare plan benefits side-by-side. Simply enter your zip code into the tool on this page to see how Plan G’s basic benefits stack up against the other nine Medicare Supplement insurance plans. Need assistance more quickly? You can always pick up the phone to call eHealth and get your Medicare questions answered from a licensed insurance agent.
This website and its contents are for informational purposes only. Nothing on the website should ever be used as a substitute for professional medical advice. You should always consult with your medical provider regarding diagnosis or treatment for a health condition, including decisions about the correct medication for your condition, as well as prior to undertaking any specific exercise or dietary routine.
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