Medicare Suplement Plans(Medigap)

Plan G is one of the standardized Medicare Supplement Plan (Medigap) plans available to Medicare beneficiaries. It’s designed to fill in many of the “gaps” in Original Medicare coverage, helping with out-of-pocket costs that Medicare doesn’t pay.

Here’s a breakdown of what the Plan G Medigap policy typically covers:

  • Part A Deductible and Coinsurance: Medigap Plan G covers the Medicare Part A deductible, which is the amount beneficiaries pay for hospital stays before Medicare starts paying. It also covers the coinsurance for hospitalization, essentially providing coverage for an additional 365 days after Medicare hospital benefits are exhausted.
  • Part B Coinsurance or Copayment: Plan G covers the coinsurance or copayments for Medicare Part B, which generally means covering 20% of the Medicare-approved amount for most doctor services, outpatient therapy, and durable medical equipment.
  • Blood: The first three pints of blood required for a medical procedure are covered by Plan G.
  • Part A Hospice Care Coinsurance or Copayment: Plan G covers the coinsurance or copayments for hospice care under Medicare Part A.
  • Skilled Nursing Facility Care Coinsurance: If a beneficiary requires skilled nursing care after a hospital stay, Plan G will cover the coinsurance amount.
  • Foreign Travel Emergency: If a health emergency occurs while traveling outside the U.S., Plan G will cover 80% of billed charges (after you meet a yearly deductible) up to plan limits.
  • Part B Excess Charges: If a doctor or healthcare provider doesn’t accept Medicare assignment (meaning they don’t accept Medicare’s approved amount as full payment), they may charge up to 15% more than the Medicare-approved amount. Plan G will cover these “excess charges.”

What Plan G Doesn’t Cover:

  • Part B Deductible: One significant difference between Plan G and Plan F (another popular Medigap plan) is that Plan G does not cover the Medicare Part B deductible.

Medigap Plan G has become a popular choice for many Medicare beneficiaries, especially after the discontinuation of Plan F for new Medicare enrollees starting January 1, 2020. Plan G offers comprehensive coverage, similar to Plan F, but usually at a lower premium because beneficiaries pay the Part B deductible themselves.

As with all Medigap policies, it’s essential to compare the premiums, benefits, and customer service of various insurance companies offering Plan G in your area. Rates can vary between insurance providers for the same set of benefits.

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