Medicare Supplement Plan G

Also known as Medigap Plan G, Medicare Supplement Plan G has been available for several years now. Another plan, Medigap Plan F, was very popular and was phased out in 2022. In its absence, Medigap Plan G has taken its place.

Medigap Plan G is one of the ten standardized Medicare Supplement Policies.  Plans are named in chronological order of the alphabet (A, B, C, etc.). Original Medicare does not cover all the treatments and services that many people need.  These policies are available to fill in the gaps. Any hospital, facility, or doctor that accepts Medicare will accept the Medigap Plan G. The vast majority of hospitals and doctors in the United States do accept Original Medicare.   Additionally,  Plan G is one of the plans that cover foreign travel.

What Does Plan G Cover?

Plan F, which is now unavailable, was considered the gold standard of Medigap Plans because it covered 100% of the gaps in Medicare. However, when it was phased out last year, Plan G soon became one of the most popular plans because it is almost as much coverage as Plan F. Medigap Plan G is nearly as much coverage, with one distinct difference. Plan G does not cover the Original Medicare Part B deductible, which was $233 in 2022. Even with the difference in coverage, beneficiaries of Medigap Plan G find it more cost-effective than Plan F when considering their respective premiums. Plan G covers everything that Original Medicare (Parts A and B) cover at 100% except for the Part B premium. This means that beneficiaries will pay nothing out of pocket for covered services and treatments after the deductible is met.

Medigap Plan G, much like Plan F, also covers “excess charges.” An excess charge is what happens when a doctor does not accept the full Medicare-approved amount for the payment, which can mean that they charge beneficiaries up to 15% more than the Medicare-approved amount for services or procedures. Since the year 2016, the following states have made excess charges illegal: Connecticut, Massachusetts, Minnesota, New York, Ohio, Pennsylvania, Rhode Island, and Vermont.

Some beneficiaries may prefer the High Deductible Plan G.   Click here to learn what a High Deductible Plan G offers. 

Click here to watch our training video about Plan G.

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How Do Medicare Supplement Plans Work?

Original Medicare consists of Part A and Part B, which are Hospital Insurance and Medical Insurance, respectively. Together, Medicare Parts A and B cover and pay for many, but not all, of the healthcare services and supplies that seniors will need. A Medicare Supplement plan will help pay for the beneficiary’s share of some things that Medicare does not cover.

Here are some important things to know:

• Medicare supplement plans are not the same as Medicare Advantage plans.

• Beneficiaries must pay a monthly premium for their Medicare Supplement plan in addition to the Part B premium from original Medicare.

• Private insurance companies that provide Medicare supplement policies cannot cancel the beneficiary’s coverage even if they have persistent health problems.

What Do Medicare Supplement Plans Cover?

Medicare Supplements help to cover costs not covered by Original Medicare. Each plan provides a range of benefits. Basic benefits can include the following:

• Part A coinsurance and hospital costs up to an additional 365 extra days after Medicare benefits are used

• Part B coinsurance or copayment

• Blood (first 3 pints)

• Part A hospice care coinsurance or copayment

Certain Medicare Supplement plans may include additional benefits such as:

• Skilled nursing facility care coinsurance

• Part A deductible

• Part B deductible

• Part B excess charge

• Foreign travel exchange (up to plan limits)

• Out-of-pocket limit

What Do Medicare Supplement Plans Not Cover?

While Medicare Supplement plans cover many things, there is a general list of procedures and services that they do not cover. This list includes the following:

• Long-term care (like non-skilled care you get in a nursing home)

• Vision or dental services

• Hearing aids

• Eyeglasses

• Private‑duty nursing

• Prescription drug coverage

Beneficiaries who need prescription drug coverage can find it under Medicare Part D. To get coverage for the previously mentioned products, and other goods and services, a Medicare Part C, a Medicare Advantage Plan, can be a good option.

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Plan G High Deductible

A Medicare plan G high deductible plan (HDG) offers beneficiaries the comprehensive benefits of standard plan G at a much lower premium.   The premise is simple.   Like all supplemental (Medigap) plans, Medicare pays first.   The balance is submitted to the Medigap plan for payment.  The 2023 deductible amount is $2,700.  Therefore, enrollees  in a High deductible plan pay the first $2,700, after Medicare has made payment.  Once the $2,700 deductible has been met, the (HDG) covers the balance.   The Part B deductible applies toward the $2,700 deductible.

Both plans F and G have a high deductible option.  Plan F is only available to individuals eligible for Medicare prior to 1/1/2020.

The average cost of HDG is around $40-$90 per month. Medigap Plan G High Deductible cost varies based on several factors and will vary from company to company. Some of the most common factors private carriers assess include your age, location, tobacco usage, and gender.

Plan is ideal for those who:

• Are comfortable paying a higher deductible in exchange for lower monthly premiums
• Don’t often see the doctor or need to visit the hospital
• Live in a state that allows excess charges
• Enjoy traveling outside the U.S.

Click here for a summary of what Medicare HDG covers.

How to compare Medicare advantage plans:   Agent contracting

Agents can use our online link to request contracting with all the carriers they need. All contracts  pay agents directly at full allowable CMS max commission.  Because of this, the agent owns the cases they write (the book of business).

CLICK HERE FOR AGENT CONTRACTING

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Cigna Medicare (Loyal American) Plan G

Cigna Medicare plans allow participants to use any healthcare provider that accepts Medicare; no referrals required. That is one of the reasons Cigna Medicare (Loyal American) Plan G may be the right fit for your insurance needs.  Please read the plan details below and decide if this is the plan you need to get the coverage you want.

Medicare plan G allows for basic benefits, covers the Part A deductible, includes emergency foreign travel coverage and some Part B excess coverage for a moderate monthly premium (Connecticut Monthly premium for 2015 is $219.54). Read more