Medigap Plan G – Around 700,000 people turn 65 and become eligible for Medicare each year. That’s a lot of people making a big life change – and with that comes plenty of questions about what Medicare actually covers, what supplemental plans are available, and how each one works. Today, we’ll focus on Medigap Plan G.
What does Medigap Plan G cover?
To understand what Plan G covers, you need to know what expenses you’ll have after Original Medicare pays. With Part A, which covers your room and board during a hospital stay, you’ll be responsible for a $1,556 deductible and then a set amount for each day of your hospital stay. For example, starting on day 61, your coinsurance amount is $389 per day.
Part B, which is your outpatient insurance, works as an 80/20 coinsurance split. After meeting your Part B deductible of $233, Part B will pay 80% of the cost, and you will pay the other 20%. Neither Part A nor Part B has any out-of-pocket limits on what you could be responsible for.
Let’s talk about how Medicare supplement Plan G can help alleviate some of those costs.
The benefits in Plan G include:
- Part A deductible
- Part A coinsurance and hospital costs, plus an extra 365 days of coverage
- Part B coinsurance / copayment
- Blood (first 3 pints)
- Hospice care coinsurance or copayment
- Part B excess charges
- Foreign emergency services
The only thing not included in Plan G is the Part B deductible. Everything else, assuming Medicare has approved it, will be paid for by Plan G.
One thing you should understand about all Medicare supplement insurance plans is that they do not include extra benefits. If Original Medicare does not cover the service, it will not be covered by your Medicare supplement. Individuals who choose a Medigap plan will also need to enroll in a separate Part D prescription drug plan. They may also want to consider additional policies like those for dental, vision, and hearing care.
Who can enroll in Plan G?
Anyone who meets the eligibility requirements of the federal Medicare program and is enrolled in Medicare Part A and Part B can apply for Plan G. If you are applying outside of your Initial Enrollment Period, you may need to pass medical underwriting before being approved for coverage.
Most states only provide guaranteed issue rights during your Initial Enrollment Period, which is when you first become eligible for Medicare. “Guaranteed issue rights” allow you to apply for any plan with any company without undergoing medical underwriting. Some states have their own rules about guaranteed issue rights. For example, some states allow you to enroll in a new plan every year around your birthday.
How much does Plan G cost?
The cost for Plan G in Missouri will vary depending on a few factors. Personal information such as your gender, age, and tobacco use are key factors in determining your rate. It’s also based on your zip code. Lastly, while the benefits of Plan G remain the same across insurance companies, each carrier has the freedom to set their own rates.
While we can’t tell you exactly what your premium would be without knowing more about you, we can give you an idea of what to expect if you decide to enroll in Plan G. A 65-year-old non-smoking female will pay around $150 per month for Plan G. A male of the same age will pay about $170.
There’s also a high deductible Plan G. This version offers the same coverage but requires much more than the $233 Part B deductible. Enrollees will have to pay $2,490 before coverage begins. The benefit to this is a much lower premium – about $60 for a female and $64 for a male.
What are the best alternatives to Plan G?
There are several alternatives to Plan G, the two closest in benefits are Plan F and Plan N.
Plan F has slightly more coverage than Plan G as it also includes coverage for the Part B deductible. However, you must have turned 65 prior to January of 2020 to be eligible for Plan F or the high deductible Plan F. You’ll also pay a higher premium.
Another great alternative to Plan G is Plan N. There are just a couple of small differences. Plan N does not pay any Part B excess charges. However, since over 96% of providers do not bill for excess charges, you probably won’t notice this difference. Something that you will notice is the office visit copayments. Each time you visit your doctor, you’ll have a copay of (up to) $20. Emergency room visits will cost you as much as $50. In exchange, you’ll enjoy lower monthly premiums.
Still not sure if Medigap Plan G is right for you? Do you want to learn more about your other options, including Medicare Advantage? Our licensed insurance agents can answer all of your questions and help you find a plan that meets your needs. Give us a call today and schedule your complimentary consultation.