Medigap Plan G

Medigap Plan G Policy Coverage
Basic Benefits included
Part A Deductible included
Part B Deductible excluded
Part B Excess 80%
Skilled Nursing Coinsurance included
Foreign Travel Emergency included

Quick Introduction to Medigap Plans

Medigap is a private health insurance policy that is designed to cover medical costs not covered by Medicare programs. It covers many of the costs that people would otherwise have to pay individually such as copayments, coinsurance, and deductibles. There are ten different Medigap plans offered. Any insurance company offering Medigap plans is required to offer Plan A, other plan availability will vary by insurance company and by state. Medigap policies do not cover long-term care such as nursing homes, vision or dental care, hearing aids, eyeglasses or private-duty nursing. This article will deal exclusively with Medigap Plan G policies covering some of the benefits and other considerations.

More on Medigap Plan G

Medigap Plan G Considerations

Medigap Plan G policies provide Basic coverage in addition to other benefits. Basic coverage of all Medigap plans includes:

  • Medicare Part A Coinsurance, and all costs after hospital benefits are exhausted
  • Part A Hospice Care Coinsurance or Copayment
  • Medicare Part B Coinsurance or Copayment for other than preventative services
  • Blood (first 3 pints). Medicare typically covers all costs associated with blood after the first 3 pints.
  • Medicare Preventative Care Part B Coinsurance

In addition, Medigap Plan G provides the following additional benefits:

Skilled Nursing Facility Care Coinsurance

For each benefit period, with just Medicare, you must pay up to $144.50 per day for days 21--100. Medigap Plan G policies cover these additional costs.

Medicare Part A Deductible

For each benefit period, under Medicare, you must pay for the first $1,156 for days 1--60 of a hospital stay. Medigap Plan G policies cover these additional costs.

Medicare Part B Excess Charges

80% of Excess Charges under Medicare Part B will be covered. For doctors and other providers who don't accept assignment under Medicare, you must pay for the difference between the Medicare-approved amount and either the provider's fee, or the "limiting charge" (no more than 15% above the Medicare-approved amount) that applies for doctor's fees and many other Part B health care services. Medigap Plan G policies cover these additional costs.

Foreign Travel Emergency (Medicare coverage outside the U.S.)

Generally, under Medicare, you must pay for all fees. Medigap Plan G policies cover many of these additional costs, up to plan limits.

Medicare Preventive Care Part B Coinsurance

You must pay all fees under Medicare. Medigap Plan G policies cover these additional costs.

With a Medigap Plan G policy, some or all of the expenses not covered by Medicare outlined above are covered or reimbursed.

What's Not Covered by a Medigap Plan G Policy?

Medicare Part B Deductible

You must pay for the $140 annual deductible.

Source: Centers for Medicare & Medicaid Services, Choosing a Medigap Policy: A Guide to Health Insurance for People With Medicare (2012).

These may or may not be important expenses and limitations, depending on your situation. If a Medigap Plan G policy doesn't meet your needs, consider Medigap Plan K policies.