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MEDICARE SUPPLEMENT or (MEDIGAP) PLAN G

medigap plan gMedicare Part G is one of the most popular supplement plans available. It helps to cover what Medicare does not. Medicare is a federal health insurance program that is available to seniors and those who are disabled and helps them manage their healthcare costs.  It also can be confusing, with multiple parts and plans available that all cover different things.  Medigap Plan G is just one example of a Medicare Supplement (or Medigap plan), but it is one of the more comprehensive plans.  To understand what it does, it’s important to understand how Medicare in general works.

A, B, D, F, G…? What Do All These Different Letters Mean?

Basic Medicare is made up of Part A, which covers the costs of inpatient hospital stays, Part B, which covers the costs of doctor visits and outpatient hospital treatments, and Part D, which covers prescription costs.  Each of these plans leaves patients with a certain amount of copay and coinsurance to pay on their own.  There are also deductibles, coverage gaps, and donut holes during which costs go up; sometimes patients must pay 100% of the bill on their own. This can quickly become overwhelming and a burden financially.

Why a Medigap Coverage Plan is a Smart Choice

Medigap plans help to pay for some of those costs that Medicare does not cover. This can help relieve some of the overall financial burden that may come with your medical needs. Medicare Plan G, one of these Medigap or Medicare Supplement programs, is one of the more comprehensive supplement plans available, although its coverage is not as complete as Plan F. Plan F, however, has higher premiums and higher rate increases from year to year. For this reason, Plan G is becoming more and more popular. It offers great coverage at what many consider a more comfortable overall price. For example, Medigap Part G covers:
  • Hospitalization benefits, including the Part A coinsurance. Medicare Part G also pays for an additional 365 days of hospitalization after Part A no longer pays.
  • Medical expenses, such as the Part B coinsurance and co-pays for doctor visits and outpatient hospital treatments.
  • Part A deductibles, Part B excess charges (the difference between what your doctor charges and what Medicare pays) and skilled facility nursing care.
  • $50,000 in foreign travel emergency benefits
Essentially, Medigap Plan G covers all of the medical benefits that Plan F does. One of the key differences, however, is that Plan F also pays for the Medicare Part B premium. Not sure you understand? Let’s take a look at an example of Plan G coverage in the section below.

Medicare Supplement Plan G Coverage Example

medicare supplement plan gDarren has a chronic condition and he also has Medicare Part G. Once a year, he visits his primary care doctor. However, he also visits a specialist several times a year to renew his prescriptions. His first visit for the year is in January. After his visit, the specialist’s office sends the bill to Medicare, which covers 80% of the bill, with the exception of the $226 deductible that Darren pays himself. At that point, Darren’s Medicare Supplement Plan G kicks in and covers the rest of the bill. His coverage will also provide medical equipment he may need. For example, if Darren is diabetic, his coverage will pay for lancets, test strips and a new glucose meter. This is all at no charge to Darren. For the remainder of the year, Darren will not owe anything out of pocket for services that are covered by Part A and Part B. His Medicare Part G coverage pays for the rest. Darren will only pay for the copays under his Part D prescription card. Under Medigap Plan G, Darren will no longer need to cover doctor office copays.  Furthermore, he doesn’t have to pay for lab work or imaging.  And if Darren is scheduled for surgery, Medicare will cover 80% and his Medicare Supplement Plan G will cover the remaining 20%. In this sense, Plan G is truly a superb Medigap option.
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