Medicare Supplement Plan G [2022 Review + Cheat Sheet!]
When I’m buying a winter coat for our puppy, I go to Amazon, look at the list of best-selling dog jackets, and pick from those. I’m willing to trust that the masses got it right.
But I’m not that trusting when it comes to health and financial decisions.
Yes, Plan G is the clear crowd favorite when it comes to Medicare Supplement Insurance. Still, we’re glad you’re here to make your own judgment, and we can promise you a thorough look at Plan G below.
Let’s dive in.
Supplemental Insurance: 3 Crucial Things To Know
If you are early in your journey towards understanding Medicare (or in need of a refresher), this section is for you.
It’ll help you understand whether you need Medicare Supplement Insurance, and if so, how to determine whether Medigap Plan G is the right plan for you.
1. Original Medicare Is NOT Health Insurance…
This is not a knock against the Medicare program. It provides excellent coverage in the areas it chooses to cover. It’s just not comprehensive enough to be regarded as health insurance.
After all, that was never the point.
Medicare’s goal is to make sure that Americans on a fixed income (e.g., those retired or disabled) do not have to turn down critical medical services for financial reasons.
There is no underwriting and no price differentiation. If you are 65 or older, regardless of how many pre-existing conditions you have, you can get coverage through Medicare.
Prior to enrollment, be sure to understand your coverage gaps and how you plan to fill them so you can fill them ASAP post-enrollment.
Action Item: Mind Your Gaps!
Original Medicare (Parts A & B) alone will NOT meet your health insurance needs. It has significant “gaps” in coverage, which come in two forms:
- Services Covered: Original Medicare may not cover the full range of healthcare services you need (e.g., vision care, hearing aids, prescription drugs, etc.).
- Share of Costs Covered: You may be left with coinsurance requirements and deductibles that you find unaffordable.
2. Medigap Plans: More Coverage (Not Wider Coverage)
I wish the industry made this second point clearer to consumers.
By law, Medicare Supplement Insurance must cover the same services as Original Medicare.
All Medigap plans do NOT cover any new services. Their purpose is simply to reduce the financial burden that Original Medicare leaves you with.
In other words, Medicare Supplement Insurance does two things:
- Lowers your Medicare coinsurance (or copayment)
- Lowers your Medicare deductibles
3. Medigap Plans Have Standardized Benefits
Since 1992, Medicare Supplement Insurance has been standardized across companies and states.
In other words, Medigap Plans (A – N) sold nationwide by any company must cover the same set of services.
A Plan G policy from Aetna in Alaska will offer the same coverage as a Plan G policy from Humana in Hawaii.
This was done so that consumers would (1) find it easier to compare plans and (ii) not see benefit structures change after buying a plan.
How This Impacts The Purchase Process
Standardization makes choosing the right policy a straightforward, two-decision process (one of which is a gimme):
(1) Determine the Plan (A-N) that best matches your coverage needs.
Table: Coverage Comparison Across Medigap Plans (A-N)
(2) Choose the least expensive plan among those available in your state, and you’re golden.
(You should choose a carrier with a B+ or higher financial stability rating from A.M. Best, but I doubt you’ll find any below that.)
To see which plans are available in your area, be sure to visit the Medigap policy finder on the official Medicare.gov website.
Medicare Supplement Plan G Vs. Plan F
Medicare Supplement Insurance Plan G is the most popular Plan among new enrollees (likely because it offers the most comprehensive Coverage).
Plan F held both of those titles for many years, as the best selling and most comprehensive Medicare Plan. It still holds a vast lead over any other plan in terms of total market share. Plan F currently has 49% of the Medigap market, with Plan G (22%) and Plan N (10%) lagging far behind.
However, as of 2020, Plan F (and Plan C) are closed to newly-eligible Medicare recipients.
Only those eligible for Medicare Part A prior to January 1, 2020 can enroll in (or switch into) Plan F.
Comparing Medicare Supplement Plan G vs. Plan F
Plan G Is Better Than Plan F (And I’ll Prove It To You)
This is an excellent example of how the masses can lead you astray. Let’s walk through the logic of it.
As the table above shows, Plans G and F are almost identical. There’s only one meaningful difference. Plan F pays your Part B deductible ($203) while Plan G does not. This makes Plan F more comprehensive than Plan G, but can you recommend it on this basis alone?
Comprehensive Coverage = Red Herring
Insurance companies who offer Plan F do not pay your $203 Part B deductible out of their pockets. For them, it’s simply another cost. To which they add fees and a profit margin.
What do they do with this final amount (let’s say $300)? They pass it on to the consumer via higher premiums.
If you buy Plan F, you are paying your insurer $300 to make a $203 payment for you. And this is your best-case scenario. If you happen not to use part B services at all (which is unlikely), you would have paid your insurer $300 for nothing.
While Plan G does not pay your $203 Part B deductible, your premium savings with Plan G will easily make up for this.
The Takeaway on Plan G
If you are skeptical, I don’t blame you. Feel free to check out the excellent “find a Medigap policy” tool at Medicare.gov to see the Plans available in your area.
Calculate the difference between Plan F and Plan G’s annual premiums. Then subtract $203. This is the amount of money you would be paying your health insurer to make a single payment for you.
I priced out policies in CA and CT for 66-year-old and 76-year-old men and women. At a minimum, these hypothetical individuals would waste $113 by purchasing Plan F (over G), and at most, $1,609.
I’ll put a table together over the weekend with more data and will update this page.
Medigap Plan G Benefits (Printable Cheat Sheet)
If you’re like me and understand things better on paper, we’ve put together a printable, one-page cheat sheet to help you get your head around Plan G.
In the sections below, we’ll go through each of these benefits in more detail.
Covered Services and
What You Owe
|Part A Inpatient Hospital Deductible||$0|
|Annual Part B Deductible||$203 (100%)|
|Out of Pocket Maximum||$203|
|Part B Excess Charges||Covered|
No matter which Medicare supplement plan you have, you will always have to pay your Medicare Part B premiums ($148.50 per month or $1,782 per year).
As of 2020, all new Medicare enrollees have to pay their Part B deductible, so you will also be responsible for this $203 annual expense.
Plan G covers 100% of your Plan A deductible ($1,484) and covers all Part B excess charges.
|Primary Care Visits||$0|
|Referral To Specialist Required?||No|
|Provider Network Required?||No|
|Preventive Services||$0 for Medicare-covered services|
As far as doctor visits are concerned, Plan G makes it very simple.
You pay nothing. For primary care visits, specialist visits, and preventative services. Also, unlike Medicare Advantage plans, Medicare supplemental insurance plans (like Plan G) do not restrict you to a provider network and do not require referrals for specialists.
|Ground Ambulance Services||$0|
|Air Ambulance Services||$0|
|Foreign Travel Emergency||$250 Annual Deductible |
Then 20% ($50,000 Lifetime Max)
Same goes for urgent emergency care, and ambulance services (whether by ground or air): you pay nothig.
For emergency care in foreign countries, you have a $250 annual deductible, after which you’ll pay 20% coinsurance (up to a $50,000 lifetime max).
Many Medigap policies do not cover foreign travel healthcare costs at all, so if you are planning to travel abroad, be sure to consider the potential value of this coverage.
|Inpatient Hospital Care||For Days 1-60: $0; |
For Days 61-90: $0;
For Days 91+: Varies**
|Skilled Nursing Facility||For Days 1-100: $0 |
For Days 101+: All Costs
This is where it gets somewhat confusing. For inpatient care at a hospital or a skilled nursing facility, you will have a certain number of days at no cost, after which you will pay all expenses.
For inpatient hospital care, you will pay nothing for days 0-90. Then, you will begin using your 60 lifetime reserve days under Medicare Part B. After this, your Plan G coverage will pay for the next 365 days.
Up to this point, which would be 515 days, you will pay nothing for inpatient care. After these 515 lifetime days, you will be responsible for all costs.
|Ambulatory Surgical Center||$0|
|Outpatient Hospital Services||$0|
|Mental Health - Outpatient||$0|
Under Medigap Plan G, you will pay nothing for services at ambulatory surgical centers, outpatient hospital services, and outpatient mental health care.
Lab & X-Ray
|Diagnostic Radiology Services||$0|
|Durable Medical Equipment||$0|
Once again, for lab & x-ray services, you pay nothing.
$0, whether it be lab services, diagnostic radiology services, outpatient x-rays, or durable equipment.
Frequently Asked Questions
Medicare Supplement Plan G is one of the most popular Medigap plans on the market. Next to Plan F (not available to new Medicare enrollees), Plan G covers the most comprehensive range of benefits. Additionally, Plan G premiums tend to be lower than premiums for Plan F.
People who are 65 years of age or older are eligible for Medicare coverage. Anyone in this group is also eligible for Medicare Plan G.
The answer is yes, but ONLY during your FIRST Medigap Open Enrollment Period (when you are first eligible for Medicare). After that open enrollment period, an insurer may charge you a higher rate, or at worst, deny you, depending on your health.
We hope you found this overview helpful! If you have a question we did not cover, however, don’t hesitate to leave a comment or send us an email at email@example.com. We’ll be sure to get back to you within 24 hours.
The GetSure Team