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HomeHealthHow Does Medicare Plan G Work?

How Does Medicare Plan G Work?

Medicare health insurance is available to America’s seniors 65 years and older and others who qualify earlier due to receiving disability benefits. Medicare covers inpatient (Part A) and outpatient (Part B) services. However, these two parts do not cover all healthcare services, and you will have out-of-pocket costs for many services. Due to these out-of-pocket costs, many beneficiaries purchase a Medicare Supplement, also known as a Medigap plan, for cost-sharing help.

Private insurance carriers and Medicare brokers sell Medigap plans. There are ten standardized Medigap plans, but Medigap Plan G is one of the most popular. Whether you purchase Plan G from an insurance carrier directly or through Boomer Benefits – Medicare Plan G will have the same benefits. Let’s first discuss how Medigap plans work.

How does a Medigap plan work?

The purpose of a Medigap plan is to help cover the “gaps” in Medicare, such as deductibles, copays, and coinsurance. Medigap plans are secondary coverage to Original Medicare. If Medicare Parts A or B cover a medical service, so will a Medigap plan. But, if Medicare denies a service, the Medigap plan will not pay out.

Since Original Medicare does not have network restrictions, you can visit any doctor in the U.S. and use your Medigap plan. If the doctor or hospital accepts Original Medicare as insurance, they must accept your Medigap plan for secondary coverage. Senior citizens who often travel typically look into a Medigap plan for flexible coverage.

What does Plan G cover?

Medicare Plan G is popular among beneficiaries due to its predictable healthcare costs and comprehensive coverage. Here is what Medigap Plan G covers:

  • Part A deductible
  • Part A coinsurance and hospital costs
  • Part A hospice care coinsurance or copayment
  • First 3 pints of blood
  • Skilled nursing facility coinsurance
  • Medicare Part B coinsurance or copayment
  • Medicare Part B excess charges
  • Foreign travel emergency

When you have Medigap Plan G, the only cost you are responsible for is the annual Part B deductible ($233 in 2022). After you pay the Part B deductible, Plan G will pick up all remaining Medicare-approved costs for the rest of the year.

So, let’s say you paid the Part B deductible and now need to have outpatient surgery. In this case, you will pay $0 for your outpatient services as long as the doctor accepts Original Medicare and all services are approved by Medicare.

How Does Medicare Plan G Work?
How Does Medicare Plan G Work?

Foreign travel coverage

Medigap Plan G offers a foreign travel emergency benefit. Plan G will cover you outside the United States for up to 60 days. After day 60, you will no longer have coverage from your plan outside the country. If a medical emergency occurs, you will first pay a deductible of $250. After you spend $250, Plan G will cover 80% of your approved services. Therefore, you will be responsible for a 20% coinsurance. The benefit amount is set to $50,000, and it’s a lifetime benefit. So, if your plan pays out $50,000, you have used up this benefit entirely.

How much does Medicare Plan G cost?

The cost of a Medigap plan is not the same across the board for everyone. Medigap premiums vary from person to person since they are based on multiple factors. For example, a Plan G premium is calculated by your age, gender, tobacco use, zip code, and carrier. Therefore, not everyone will have the same premium.

For instance, let’s say you are a 65-year-old female, smoke tobacco, live in upper state New York, and purchase Plan G from XYZ carrier. You will have a different premium than an 80-year-old male, a non-smoker in south Texas, who bought Plan G from the same carrier.

Since Medigap premiums vary from person to person and carrier, it’s best to shop Medigap Plan G among multiple carriers. When you shop plans among numerous carriers in your zip code, it will help you find the most cost-effective Plan G. Remember, a Plan G has the same benefits no matter who you purchase the plan from. The only difference between carriers is the monthly premium.

Summary

With Medigap Plan G, you can visit any hospital or doctor in the United States that accepts Original Medicare and have secondary insurance. Your only out-of-pocket cost for Medicare-approved services with Plan G is the Part B deductible. So, if you like the flexibility to seek care across the U.S. and have predictable healthcare costs for the year, consider Medicare Plan G! You can read Medicare Supplement plan reviews online to see how other beneficiaries benefit from Medigap coverage.

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