Plan G: The Plan With The Most Value
Medicare Plan G coverage is very similar to Plan F, which is no longer available for people new to Medicare on or after January 1, 2020. Plan G offers great value for beneficiaries willing to pay a small annual deductible. After that, Plan G provides full coverage for all of the gaps in Medicare. It pays for your Medicare Part A hospital deductible, copays, and coinsurance. It also covers the 20% that Medicare Part B doesn’t cover. Doctors and other healthcare providers must accept a Medigap Plan G if they accept Original Medicare. Plan G policies can be used across the U.S. since they do not have network limitations, and the premium costs can be very reasonable for the coverage you receive.
What Medical Services Does Plan G Cover?
Medicare Supplement Plan G covers your percentage of any medical benefit that Original Medicare covers, except for the outpatient deductible. So, it helps to pay for inpatient hospital costs, such as the first three pints of blood, skilled nursing facility care, and hospice care. It also covers outpatient medical services such as doctor visits, lab work, diabetes supplies, cancer treatment, durable medical equipment, x-rays, ambulance, surgeries, and much more. This means Plan G covers the coverage gaps with Original Medicare and all Plan G products must provide you with the exact same coverage.
Medicare pays first, then Plan G pays the remaining amount after you pay the once-annual deductible. In addition, Plan G Medicare Supplements offer up to $50,000 in foreign travel emergency benefits (up to plan limits).
Medigap Plan G: A Small Deductible = Big Savings
Medicare Plan G, also called Medigap Plan G, is an increasingly popular Supplement for several reasons.
First, Plan G covers each of the gaps in Medicare except for the annual Part B deductible. This deductible is only $233 in 2022. In fact, if you have a Plan F that has been in place for years, we can probably help you on premiums by looking at Plan G. When we help you shop rates at Boomer Benefits, we can often find a Supplement Plan G that saves quite a bit in premiums over Plan F, usually substantially more than the $233 deductible that you’ll pay out. You pocket the difference.
Second, it has great coverage. For hospital stays, it covers all your hospital expenses. Most importantly, it pays the hospital deductible, which is over $1,556 in 2022. It also covers the expensive daily copays that you might encounter for a hospital stay that runs longer than 60 days. It provides an additional 365 days in the hospital after your Medicare benefits run out, and it covers your skilled nursing facility co-insurance, too.
Medicare Supplement G usually costs more than Plan N because it covers more. People seem to like the security and peace of mind that a comprehensive policy like Plan G appears to offer and, therefore, are willing to pay the higher premium cost.
Medicare Plan G Case Study: Amazing Coverage
Frank is a diabetic who has Medicare Supplement Plan G. He sees his primary care doctor once per year, but visits his endocrinologist several times a year to renew his prescriptions. In January, he goes to his first doctor visit for the year. The specialist bills Medicare, which pays 80% share of the bill except for the $233 outpatient deductible, which is billed to Frank for payment.
His Medicare Supplement Plan G pays the rest. Frank’s coverage even provides his lancets, test strips, and a new glucose meter at no charge to him. Medicare and his Supplement work together to pay 100% of the costs for these diabetes supplies.
For the rest of the year, Frank will owe absolutely nothing out of pocket for covered Part A & B services. His Medicare Plan G coverage takes care of the cost-sharing amounts for him. His only copays will be for his medications under his separate Part D prescription drug card.
This means he doesn’t have to worry about any more doctor copays. He won’t pay for lab work or imaging. If he has surgery, Medicare will cover 80% of the cost and his Plan G will cover 20%. Plan G is a really great Medigap plan in this respect.
How to Enroll in a Plan G
There are a few different ways to apply for a Medigap Plan G policy. A majority of enrollees will use the Medigap Open Enrollment period to apply for a policy. When you enroll during this window, you will not have to answer health questions on the application and the insurer cannot deny you coverage. It is a six-month window from your Part B effective date. Those who qualify for Medicare before 65 due to disability will have an additional Open Enrollment window when they turn 65.
However, you may need to answer health questions, and your approval is not guaranteed when you are outside that window. So, you could be denied based on certain health conditions. Additionally, the price could change if the insurance company decides to approve you but rate you up.
Some states have exceptions to this rule, such as California and Maine. The state law for both states allows enrollees to change their policy with no health questions from year to year. However, rules will vary with each state as well as the Medicare Supplement insurance company. Residents in these states can take advantage of this exception when the cost of premiums increases each year.
Medigap enrollments are different from Medicare Advantage plan enrollments as you can only apply for an Advantage plan during specific times of the year.
We can enroll you today…NO ENROLLMENT FEES!
Reach out to us today: https://www.azhealth.us/contact-us/