Medigap Plan G Details

Find out how Medigap Plan G works and what it covers

by Senior 65+ on Oct 28, 2015 | 16 Comments

Medigap Plan G Overview

Medigap Plan G one of the federally regulated Medicare Supplement Insurance plans (aka Medigap). Medigap plan G has a wide coverage and is currently the most popular Medigap plan.

Remember Medigap plans are designed to complement Original Medicare Part A and Part B.  Below is a list of what you would pay under Original Medicare alone, and then what you would pay if you purchased Medigap Plan G. 



Medigap Plan G Benefit Details

Benefits Original Medicare Alone Original Medicare With Medigap Plan G
Doctor Network All Doctors that accept Medicare All Doctors that accept Medicare
Part A Hospital Benefit Period Deductible You pay $1,408* You pay $0
Hospital days 61-90 You pay $352 per day per day You pay $0
Hospital Days 91-150 You pay $704 per day per day (lifetime reserve days) You pay $0
Beyond Lifetime Reserve Days You pay 100% You pay $0 up to an additional 365 hospitalization days.
Skilled Nursing Facility Care Days 1-20 You pay $0 (Part A deductible applies)** You pay $0
Skilled Nursing Facility Care Days 21-100 You pay $176 per day You pay $0
Hospice Respite Care You pay 5% You pay $0
First 3 Pints of Blood You pay 100% You pay $0
Additional Blood You pay $0 You pay $0
Part B Annual Deductible You pay $198 You pay $198
Ambulance You pay 20% (Part B deductible applies) You pay $0, after Part B deductible
Doctor’s Office Copays/Coinsurance You pay 20% (Part B deductible applies) You pay $0, after Part B deductible
Durable Medical Equipment You pay 20% (Part B deductible applies) You pay $0, after Part B deductible
Part B Excess Charges You pay 100% (Part B deductible applies) You pay $0
Foreign Travel Emergency You pay 100% You pay 20%***
Out-Patient Surgery You pay 20% (Part B deductible applies) You pay $0, after Part B deductible
Urgent Care You pay 20% (Part B deductible applies) You pay $0, after Part B deductible


Next Steps for Medigap Plan G

Get quote: Click here to see prices for Plan G
Check out Medigap Plan Detail Overview where you can find every Medigap plan available.

The fine print of the Medigap Plan G Chart Above

*Medicare Part A deductible is broken down into 60 day benefit periods. You have to pay the deductible if you reenter the hospital after 60 days from discharge. Example: If you enter the hospital March 1st you’ll pay the Part A deductible. If you leave the hospital 5 days later and return to the hospital on July 6th, you will be charged the Part A hospitalization benefit again.
**For Skilled Nursing you must have a 3-day qualifying stay in the hospital to qualify for Skilled Nursing Facility care AND you’ll still pay the benefit period Part A deductible ($1,408).
***Foreign Travel Emergency requires a deductible of $250. You will have to have your emergency within the first 60 days of travel, and the plan has a lifetime coverage amount of $50,000.
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Reader Comments and Questions

By Lloyd on October 08, 2019

I will be retiring dec.31st of 2019,.and loosing coverage through work ,I plan on enrolling in part B in early January 2020. I currently have part A , effective May 2017. I hope I am elegible for Part G with guarantee issue? which i hope my open enrollment will last for 63 Days. Am i eligible for Part G since this would be my open enrollment period, from Jan.-Feb of 2020. If not I assume i would be eligible for Part F., and do i need to get it prior to 2020. Thanks Lloyd

Lloyd,
Based on the information you shared, we believe you will be able to enroll in Medigap Plan G guarenteed issued. Please call us and we can ask a few more questions to confirm this. We can also help you enroll in a plan at no cost which is a win/win. We receive a direct commission from the insurance company and we continue to serve as your agent for as long as you have the plan.
-Michelle from Senior65.com


By Daniel on August 05, 2019

Would it be wise to apply for Plan G even if I have a possible Auto Immune issue 30% probability and 70% nothing wrong.. I have type 2 Diabetes. Pre cancer issues on skin all removed.

Daniel,
If you are in your Initial Enrollment Period (3 months before you turn 65 until 3 months after), then you are guaranteed to be approved by Medigap. If that is not the case, give us a call and we can discuss how medical underwriting would work in your case and your chances of approval based on some additional questions we have.
-Michelle from Senior65.com


By Helene on November 13, 2018

I have AARP Medicare Complete plan 3 with United Health. How do I change to AARP medicare supplement plan g?

Give us a call at 800-930-7956 and we can help you switch plans. The best time to make this move is during open enrollment from Oct 15 - Dec 7th.
-Eric from Senior65.com.


By Diana on June 14, 2018

Any data on the increases in Plan F or Plan G over the years and the increases in Part B? Plan G could get hit with 2 increases every year- any increase in Part B and any increase in Plan G premiums. Plan F would only be affected by increases in F premiums. Have heard that since Plan F will no longer be accepting new applicants after 2020, that.
1. Plan F average age will increase (no new members) and
2.the number of members will decrease (again no new members) and that the increasing/higher average age coupled with a decreasing number of members will make them a higher risk group and drive up the premium price. Thoughts?

Diana,
You have hit on great points when considering F vs G. Rates are different for each insurance carrier and often set by county so there isn't a great general answer for your first question about rate increases.

You second question speculates that plan F will go up after 2020 when those new to medicare cannot join. While we don't know for sure exactly what will happen, this is a serious concern that we share. We have seen rates increase dramatically on other plans that have "sunsetted" in the past.

Generally speaking, in most areas, G is so much cheaper than F that it makes for a good decision now and moving forward. Give us a call and we can look at the plans in your area. There is no fee for our service.
-Michelle from Senior65.com


By Mary on May 29, 2018

I plan on trying to shop my options for my supplemental coverage, Plan G. I know I am responsible for my Part B deductible which is $183. My question is that if I am able to switch for a cheaper rate, do I have to repay my $183 since I have already paid it down this year? Will it start over for this calendar year?

Great Question Mary!
If you switch from one plan G to another mid year, it is our understanding that you DO NOT have to pay the part B deductible a second time. If you need help shopping for a new plan, please give us a call. We would love to earn your business.
-Michelle from Senior65.com


By BernBomb on October 27, 2017

Does plan G $183 deductible coincide with Medicare (new deductible after 60 days release from hospital) or is it an annual deductible?

The Part B deductible is an annual deductible. Hope that helps.
-Eric from Senior65.com


By Jackie on August 24, 2017

My husband and I are turning 65 in December. I was speaking with our United Health Care representative last week about options and recommendations. I mailed in the paperwork for more information about Plan F. I spoke to someone today who opted for Plan G because they said Plan F is being discontinued. I also say on the internet in my researching that it is ending in 2020. Why would we opt for F when it will be gone in 3 years? I am confused why they would recommend it. It there any chance that if we opted for F now we would have a hard time getting G later, or should we just choose G?

Jackie,
Plan F will still be available beyond 2020 for those who have already purchased it. Plan F will not be available for those NEW to MEDICARE in 2020 and beyond. If you need help selecting between F and G, please give us a call at 800-930-7956.
-Chris from Senior65.com


By Pat on June 03, 2017

If I have a medigap plan and move out of state, will I have to go through underwriting and answer health questions, possibly increasing my medigap premium by a lot?

Pat,
Most Medigap plans are portable, therefore, you will not need to change plans when you move to the majority of states. If you happen to move to a state that requires you to leave your old plan, you will not have to go through medical underwriting. For further help on Medigap and moving rules, call one of our Senior65 licensed independent insurance agents at 800-930-7956.
-Eric from https://www.senior65.com/


By Diane on April 04, 2017

Currently I am enrolled with Plan F in GA. When I move to Alabama later this year will I be required to drop my Georgia Plan F and reapply for a Alabama Plan F or will my GA Plan F carrier over to Alabama? If I should be allowed to keep my GA Plan F will there be an increase in premium for Alabama? Thank you in advance for your help.

Diane,
You should be able to keep your Medigap plan if you move, but your premium may change based on your new zip code (rate could decrease or increase). If you are interested in comparing Medigap rates for your new zip code, call one of our Senior65 licensed independent insurance agents at 800-930-7956.
-Michelle from https://www.senior65.com/


By P. MASSA on February 24, 2017

DOES MEDI GAP PLAN G OFFER ANY COVERAGE FOR EYE SURGERY I.E. CATARACTS ??

P. Massa,
Medigap fills in the gaps of cataract surgery costs. Remember with Plan G, you still have to pay your Part B deductible, but other than that, if Original Medicare covers the type of procedure you're having, then Medigap covers the rest. If you need help finding Med Supp Plan G call one of our Senior65 licensed independent insurance agents at 800-930-7956.
-Amy from https://www.senior65.com/


By Gypsy Hartman on October 22, 2016

Hello, I'm too early for this, but would you please tell me: If I have original Medicare Part A and B, does it matter which provider I pick for Part F and D - meaning: are these my personal choice or does the hospital/doctor have a say? Thanks.

Gypsy,
I'm not clear if you're asking if you need to choose your provider, as in physician or insurance carrier, so I will answer both for you.

  • You can choose any physician that accepts Medicare assignment, and you will be covered with any Medigap plan.
  • Part D plan will have specific pharmacies that are covered, sometimes with lower rates than others, (preferred or standard pharmacy). You can see any doctor you want.
  • You choose your Medigap insurance provider that has the best price now, as well as, how it has historically raised rates.
  • With Part D, you want to choose your insurance provider by seeing which plan offers you the lowest annual cost for your current drugs.
Our Senior65 licensed independent insurance agents can help find and enroll you in the best plans for your needs. For help, call 800-930-7956.
-Amy from https://www.senior65.com/


By Robert Miller on October 14, 2016

I read that under original medicare I can get my diabetic supplies free. If I enrolled in an Advantage plan I would not. Where would I be on the those supplies with a medigap plan?

Robert,
Unfortunately, your information isn't true. According to Medicare, you will usually pay 20% for diabetic supplies, and the Part B deductible applies. To answer your question about Medigap plans, most plans cover 100% of your coinsurance, but only Medigap Plans C and F cover your Part B deductible. To learn more about Medigap plans in your area, call one of our Senior65 licensed independent insurance agents at 800-930-7956.
-Chris from https://www.senior65.com/


By R Manen on June 29, 2016

Are endless pools covered under DME for supplemental G if prescribed by a physician?

R Manen,
If durable medical equipment is covered by Original Medicare, it will be covered by your Medicare Supplement Plan G. If you are not already in enrolled in Plan G, call one of of our licensed independent insurance agents at 800-930-7956.
-Amy from https://www.senior65.com/


By Lee on February 12, 2016

Thank you. "Plan G is not protected under the Medigap Guaranteed Issue rights provision. The only plans protected under Guaranteed Issue are A,B,C, F, K and L, plans G and N are not." If I have plan G that doesn't include this, how important is it?

Lee,
Guaranteed issuance only comes into play after your Medigap initial enrollment period (when all plans are guaranteed), if you have a very specific qualifying event like you lose your previous insurance by no fault of your own, you move out of your Medicare Advantage area, or are enrolled in Plan B and had job-based insurance, and quit.

Since you have Plan G, as long as you pay your premium on time, you will have coverage. This does not apply to you.
-Amy from https://www.senior65.com/


By Lee on February 11, 2016

My concern about having Plan G is the 'no guaranteed issue' aspect, if I ever decide to move out of state. I read the following that someone posted online: "If one has Plan G and then moves to another state --- there is no longer any guaranteed issue for Plan G application in the new state. If you choose the premium structure of the new state, (even with the same insurance company) that is technically a new application. If you choose to keep the pricing structure of your initial state, your insurance company will likely charge a premium surcharge for "out of state residence." So is that correct, that if I get plan G with the 'no guarantee issue' clause, and eventually moved out of state, I would have to reapply and go through underwriting? Then the premium could go sky high. Thanks

Lee,
With ANY Medigap plan (except in the state of Massachusetts) you keep your plan no matter which state you move to. Moving states is NOT a qualifying event for Medigap guaranteed issuance. However, you are not charged an out of state residence charge, but with that said, your plan, again any Medigap lettered plan, will be adjusted to the appropriate premium within that state, and in some cases it can be less than what you are charged in your initial enrollment state.
-Amy from https://www.senior65.com/


By /donna on November 25, 2015

I am in my initial enrollment period at age 65 and I'm looking at Medigap Plan G and Plan F. Right now the premium difference between the 2 is more than the Part B deductible offset of $166 for 2016. However, my concern is that if I go with Plan G, will the Medicare deductible increases over time eliminate the $$$ cost savings if I had taken Pan F. In Oregon I can switch on my birthday but cannot go to F from G. Are there any studies of whether Plan G premiums are set so they always offset the Part B deductible when compared to the Plan F premiums. I have quotes for Plan G for $124 and Plan F for $141. So Plan G even paying the deductible is cheaper. At some point in the future would it have been better just to take Plan F because the increasing deductible will eliminate any savings on Plan G.

Donna,
Unfortunately, there are no details on this particular situation. However, the difference of the quotes you are giving is $38 a year (Premium difference minus the Part B deductible). So, if that is your main concern, you may want to start with Medigap Plan F, and then go to Plan G in the future. Hope this helps!
-Chris from https://www.senior65.com/



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