How does Medicare Supplement Plan G work and what does it cover?

This post was most recently updated on July 25th, 2023

Medicare Supplement Plan G

Original Medicare Parts A and B are important when you turn 65. They are health insurance plans designed to endure you get quality medical attention when you need it the most and without costing you much. With the Original plans, you qualify for Medicare supplement plans which are put in place to cover the medical care gaps left by Original Medicare. 

Medicare supplement Plan F has been the most popular because of the numerous benefits. However, the offer is no longer enrolling new members, and insurers are no longer offering it. Those already enrolled in Plan F get to retain their policies, but there is a likelihood the premiums could rise. 

The next better option, after Plan F, is supplement Plan G. This plan is offered privately by insurance companies to complement the federal Medicare program services. The premiums for Plan G vary from one insurer to another, but the medical benefits remain the same across the board. 

It is important to note that Plan G is for those already in Part A and B of Medicare, so if you are not enrolled, you would have to do so to start enjoying the benefits. 

How it works 

After getting the medical services you need, Original Medicare pays for qualifying costs. Next, Plan G pays any remaining costs after you have achieved the annual deductible. Original Medicare does not cover all medical services; the gaps it leaves are what Plan G tries to cover. 

Plan G costs will depend on the insurer you have chosen to work with, and you will see the benefits you stand to enjoy under the plan. 

The premiums are the monthly amounts you must pay to your insurance company, and the deductible is the amount you must pay from your pocket before G plan coverage covers you. Apart from the insurance company, your current location can also determine how much your plan costs. 

What is offered in one state may not match the next. In some cases, pre-existing conditions can affect the cost of your plan; it is also possible for smokers to face higher premiums compared with non-smokers. The best thing is to find out as much as possible about your insurer’s terms and conditions and whether they suit you. 

That small amount you pay goes a long way in reducing the overall hospital costs. Hospital deductibles change annually but only shoot by a small percentage. If your hospital stay is longer than 60 days, the daily copay can be quite expensive, making it very important to have Plan G coverage. 

The supplement offers you 365 days more in the hospital after the Medicare benefits are exhausted. 

What it covers 

When we talk about gaps left by Original Medicare, it is important to know exactly what Plan G covers. This supplement typically takes care of Part B deductibles, coinsurance, and copayments. Some plans also cater to emergency care, foreign travel, and excess charges. Generally, plan G supplement covers:

· Cancer treatments 

· Hospice care

· Hospital costs, including skilled nursing care in a facility 

· Doctor visits 

· X-rays, surgeries, and laboratory work

· Diabetes care supplies

· First three blood pints 

· Ambulance services  

The coverage list clearly shows that the Plan G supplement is comprehensive and will take care of most of your medical needs. But even with the added coverage, you will not be able to get prescription drug coverage under the supplement. If this is something you are interested in, you need to enroll in Part D of the plans. 

Eye exams are not covered under the supplement, but it is possible to find plans with eye care as an add-on option. You can enquire with your insurer to see whether this is possible, especially if eye care is crucial for you. 

· The other medical situations not covered under supplement Plan G are:

· Cosmetic procedures, especially those that are not medically necessary 

· Long-term care like in-home and nursing home services 

· Acupuncture 

This supplement plan is crucial because it covers most of what is left by the 80% of hospital and doctor bills paid by Original Medicare. It picks you up by ensuring your out-of-pocket costs are reduced as much as possible. Medicare supplement plans are 10 in total, denoted by letters, and the policies are sold to interested members by private insurers. 

However, all plans sharing the same letter offer the same benefits regardless of where you are in the United States. What changes are the premiums and this is because the insurers use different methods to reach their amounts. Medicare Plan G reviews can help you compare and choose a suitable plan. You can also use different tools to compare the prices before deciding. 

Why it’s loved 

Medicare is a leading health insurance program, and its Plan G is among the most popular supplements. The patients love the plans because:

· They offer the best coverage at reasonable prices 

· They come in different packages, thus making it possible for the patients to compare and choose what fits their budget and needs 

· Plan G also covers a wide range of medical costs, including x-rays and cancer treatments which can be quite costly otherwise

· The benefits can be enjoyed without pre-existing conditions being considered, but only when you enroll for the plans at the designated open period 

· They have low deductibles and reduced out-of-pocket costs; hence you get quality care without worrying about the money 

· The Plan G supplements policies are more affordable than Medicare Advantage plans hence their popularity, especially among patients who are budget conscious

One of the best things you can do for yourself is to take up health insurance coverage. The coverage is important to the young and old because medical situations do not choose by age. 

But considering that as you age, you are more exposed to medical issues, it is best to have the plan to relieve the pressure off your mind when you need quality medical care. With the right policy and supplement cover like Plan G, you can rest easy and enjoy your retirement, knowing your health is in good hands. 

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Written by Dr. Ganga Sapkota
Updated on July 25, 2023

A graduated medical physician with years of experience in the medical field. Working as a full-time physician in Puspanjali Hospital, Chitwan, Nepal.