What Plan G Medigap Insurance Is
Plan G Medigap insurance is a standardized Medicare Supplement policy sold by private insurers. It fills most of the gaps Original Medicare leaves behind, paying for costs such as hospital coinsurance, skilled nursing facility coinsurance, and the Part B excess charge — the amount some doctors charge above what Medicare approves. Because it is standardized, a Plan G from one company pays the same as a Plan G from another; only premiums and customer service differ.
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The policy covers everything Plan F does, except for the Part B deductible. If you enroll in Medicare before 2020, you may still be able to buy Plan F, but Plan G is the closest option for most people who become eligible now.
What Plan G Covers
- Medicare Part A hospital coinsurance and hospital costs up to an additional 365 days after Medicare benefits end
- Skilled nursing facility coinsurance
- Part A hospice coinsurance or copayment
- Part B coinsurance or copayment
- Blood transfusions (first three pints)
- Part B excess charges, up to the Medicare-approved amount
What Plan G Does Not Cover
Plan G does not cover the Medicare Part B deductible, which is the annual amount you pay before Medicare begins paying for doctor and outpatient services. It also does not cover long-term care, vision or dental care, hearing aids, eyeglasses, or private-duty nursing. These are important gaps to understand before enrolling.
How Premiums Work
Insurers set Plan G premiums independently, so costs vary widely by location, age, and company. Some insurers use community-rated pricing, charging the same premium regardless of age. Others use issue-age or attained-age rating, which can make premiums lower at enrollment and higher as you grow older. When comparing policies, look beyond the monthly premium and examine the insurer's financial strength ratings, complaint history, and how the premium has changed over time.
Plan G vs Plan N
| Feature | Plan G | Plan N |
|---|---|---|
| Part B deductible | Not covered | Not covered |
| Part B excess charge | Covered | Not covered |
| Part B copay for office visits | Covered | Copay up to $20 |
| Emergency room copay | Covered | Copay up to $50 |
| Skilled nursing coinsurance | Covered | Covered |
Plan N may offer a lower premium, but the copays and the lack of excess charge coverage can add up if you see doctors frequently or travel outside your plan's service area.
When Plan G Makes Sense
Plan G tends to work best for people who want predictable out-of-pocket costs and do not want to worry about the Part B excess charge. It is especially useful if you see specialists often, travel outside your home state, or want to avoid surprise bills from providers who do not accept Medicare assignment. Because the Part B deductible is the only remaining gap, your total exposure for Medicare-covered services is limited and manageable.
When Plan G May Not Be the Best Fit
If you are comfortable with the Part B deductible and rarely use medical services, a lower-premium plan like Plan N could save money. If you value the Part B deductible protection above all else and still qualify for Plan F, Plan F may be worth the higher premium. Your choice should reflect how often you see doctors, which providers you use, and how much risk you are willing to absorb.
How to Enroll
You can enroll in Plan G Medigap insurance during your Medigap Open Enrollment Period, which begins on the first day of the month you turn 65 and are enrolled in Medicare Part B. During this window, insurers cannot use medical underwriting, so you cannot be denied coverage or charged more due to health conditions. Outside this period, insurers may ask health questions and decline coverage or charge higher premiums.
Compare policies from multiple insurers, confirm that the plan is standardized as Plan G, and ask about premium increases over the past five years. A stable premium history often matters more than the lowest starting price.