Medigap Plan G
For Those Who Want the Most Coverage After Paying the Medicare Part B Deductible
When Original Medicare doesn’t cover what you need, Medicare Supplement (Medigap) insurance can help. All Medigap policies must adhere to federal and state laws that are meant to protect the policyholder. The basic benefits of each plan letter have to be the same — no matter where you purchase the plan. Generally, the only difference between Medicare Supplement policies of the same letter is cost.
There are many plans available in Texas, and one of the most popular is Plan G. We’ll tell you why.
What’s Covered Under Plan G?
You’ll see that the Medigap Plan G benefits are the same as the Plan F benefits, with one exception. Plan G includes these basic benefits:
- Medicare Part A hospital coinsurance and hospital costs — up to one year after Original Medicare benefits run out
- Part A hospice care coinsurance or copayment
- Part A deductible
- Skilled nursing facility care coinsurance
- Part B prevenative care coinsurance
- Part B coinsurance or copayment
- Part B excess charges
- First 3 pints of blood for a medical procedure
- Foreign travel emergency care — up to plan limits
What’s Not Covered?
The only thing not covered is the Medicare Part B annual deductible, which is $203 in 2021. Once your out-of-pocket expenses hit this amount, you must pay 20% of the cost of Part B services approved by Medicare.
Get the right coverage at the right price.
Plan G Premium
You’ll pay a monthly premium for Plan G, which is set by the private insurance carrier, based on any of these three price rating systems: Community-rated, Issue-age-rated, and Attained-age-rated.
Sometimes insurance carriers charge different rates for the same plan. This will depend on many factors such as your location, age, gender, and health status.
Should You Choose Medigap Plan G?
If you’re looking for the most coverage after paying the Medicare Part B yearly deductible, Plan G is a great fit. Many of our clients pick Plan G because they want a lower premium and are able to pay the Part B deductible.
Most Medicare Supplement plans don’t cover the Part B excess charges, but Plan G covers them. These are additional charges above the Medicare-approved charge. For example, Medicare’s allowed charge for a doctor’s appointment may be $200, but the doctor could decide not to accept that $200, and charge an additional 15% for the appointment instead.
In this example, Medicare will pay 80% of that allowed charge, sending the physician $160. The Medicare beneficiary is responsible for paying the remaining $40, AND the excess charge of 15% — another $30 — bringing the total out-of-pocket costs to $70. However, Medigap Plan G pays these excess charges for you.
When to Enroll in Medigap Plan G
The ideal time to enroll in a Plan G policy is during your six-month Medigap Open Enrollment Period. This period begins on the first day of the month that you’re 65+, AND enrolled in Medicare Part B. During this six-month window, you normally have the guaranteed issue right to enroll in the plan that interests you — despite any pre-existing health conditions you may have — as long as you live within the plan’s coverage area and are enrolled in Medicare Parts A and B.
If you miss your Medigap Open Enrollment Period and choose to apply later on, you may be subject to medical underwriting. The carrier may also deny your application.
Compare Rates with Oak Haven Insurance
Medigap Plan G also offers a high deductible option. To compare rates for Plan G among the top carriers in Texas, contact us at Oak Haven Insurance. We can also help you explore other Medicare Supplement plans like F and N.
