Medicare Plan G – The Cost and Coverage

A vital piece of information is that without Original Medicare, you cannot enroll in Plan G. To apply for this plan, you first need to have Medicare Parts A and B. Once that is settled, you need to understand the cost and coverage associated with Plan G to determine if it will fit your healthcare needs and budget well. So, let’s dive in.

How does Plan G work?

First, a Plan G is one of the ten standardized plans known as a Medigap plan and also referred to as a Medicare Supplement. These plans offer secondary coverage to help cover some of the gaps in Medicare. When you have a Plan G, your policy provides coverage for things like the Part A hospital deductible, copays, coinsurance, and the unlimited 20% that Medicare Part B leaves you with after it pays its 80%. It can also cover Plan G charges which come from providers who don’t accept Medicare Assignment.

These plans also follow Medicare’s nationwide network of doctors and healthcare providers. As long as someone accepts Medicare, they must also take your Plan G. With this type of plan, Medicare beneficiaries must first pay the annual Part B deductible ($233 in 2022). After that, Medicare Part B will pay its 80%, and your G plan will pick up that remaining 20%. The only thing you should be responsible for after that is your monthly premium.

Plan G coverage

A simple way to understand what Plan G covers is by knowing whatever Medicare approves and deems medically necessary, your Plan G will follow suit. As long as Medicare pays first, your Plan G will pay second. After the Part B deductible is met, services and treatments like physical therapy, surgery, doctor appointments, and lab work are covered once Medicare provides its seal of approval.

Sounds great. How much?

Medigap plans do not have any set premiums. The cost of a Plan G depends on numerous factors, such as age, tobacco use, gender, and zip code.

Although the cost of a Plan G will be different for everyone, you can rest easy knowing once you pay that annual Part B deductible, you are completely covered for all your Medicare-approved services for the year.

Enrolling in a Plan G

If you think a Plan G is suitable for you, the best time to enroll would be during your Medigap Open Enrollment period. This period is a six-month window based around your Part B effective date, where you can enroll in a Medigap plan like Plan G with no health questions. Once you are outside this period, you are subject to health underwriting in most states and could face a higher premium or be denied based on your pre-existing health conditions.

A few states have exceptions to this rule, but the laws vary depending on the state and insurance carrier.

Another critical thing to note is that increases to your monthly premiums are inevitable, as with all insurance plans. Luckily, you do not have to wait for a specific time of year if you want to switch. You can apply to switch Medigap plans at any time, but again, you will most likely need to answer health questions before getting approved to change.

Start saving with a Plan G

Enrolling in a plan like Plan G can be one of the most beneficial moves you make during retirement. These plans offer peace of mind knowing once you pay your Part B deductible, you won’t have a single bill in your name for the rest of the year for Medicare-approved services.

A Plan G can help cap your out-of-pocket spending when it comes to the unlimited 20% you’re left to pay after Medicare covers its 80%. You can also shop your plan rates annually to ensure you have the most cost-effective plan for your healthcare needs. These plans also offer long-term rate stability, so you don’t see a sudden and sharp increase in your plan every year.

If your healthcare needs grow, you can be sure a Plan G will be there to help save you from potential medical debt and ensure your costs won’t go over a certain amount.