Learn what Medigap Covers (2024)

FAQs

What plan G does not cover? ›

Plan G does not cover the Part B deductible or any service that Medicare does not cover. For example, Medicare does not cover routine dental, vision, or hearing; therefore, Plan G won't cover those services. Medicare pays first, and then Plan G pays the remaining amount after you pay the once-annual deductible.

Medigaps may cover outstanding deductibles, coinsurance, and copayments. Medigaps may also cover health care costs that Medicare does not cover at all, like care received when travelling abroad. Remember, Medigaps only work with Original Medicare. If you have a Medicare Advantage Plan, you cannot buy a Medigap.

The downside of high-deductible Plan G can, of course, be your upfront cost before you receive help with out-of-pocket expenses. Assuming you have this high-deductible Medigap plan and receive a Medicare Part B-covered service, you'll be responsible for the Part B deductible, which is $240 in 2024.

Medigap plans generally don't cover: Long-term care (like care in a nursing home) Vision or dental care. Hearing aids.

By and large, Plan F is the most popular Medicare Supplement plan due to its coverage of more out-of-pocket Medicare costs than any other Medigap plan type.

With Medicare Supplement Plan F, you get the most complete coverage available. And because Plan F also covers costs in excess of Medicare-approved amounts, you may have no out-of-pocket costs for hospital and doctor's office care.

Benefits Of Plan G. Plan G covers 100% of the Medicare Part A and Part B co-pays and coinsurance, those gaps and holes that Medicare doesn't cover. Plan G covers Skilled Nursing and rehab facility stays and also Hospice care. You also won't have to worry about any balance billing, known as excess charges.

Medigap plans offer additional coverage for people enrolled in Original Medicare, but they exclude prescription drugs. Meanwhile, Medicare Advantage plans offer the same coverage as Original Medicare plus additional benefits, such as prescription drugs, vision, dental, hearing and other wellness services.

Why is Medicare Plan F being discontinued? Medigap Plan F is being phased out as part of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), which prohibits the sale of Medicare Supplement plans that cover Medicare Part B's annual deductible in full.

Do Medigap plans cost more as you age? ›

Yes, your Medigap premiums may increase with age in some cases. Premium cost increases depend on the rating type for the plan you choose. Attained-age-plan premiums increase as you get older, but also with inflation and for other reasons. Issue-age-rated Medigap plans have higher premiums if you join when you're older.

Network restrictions are another common reason why beneficiaries leave their Medicare Advantage plans. With Medicare Advantage plans, staying within your policy's network is key to paying the lowest possible costs for health services. Going out of your network could mean high fees or no coverage.

FREEDOM 2: With a Medicare Supplement Plan G, one can go to any of the vast number of hospitals or facilities that accept Medicare. With a Medicare Advantage plan, one can only go to a hospital or facility on the HMO or PPO list.

Once the cumulative out-of-pocket expenses reach the specified maximum limit for the year, the Medigap policy kicks in to cover all additional Medicare-approved costs. This means the policyholder is no longer responsible for paying out of pocket for covered services.

For Medigap plans, this is dependent on whether your doctor accept Medicare itself. Medigap plans “follow” Medicare. In other words, if a doctor or hospital accepts Medicare (your primary coverage), they will also accept your Medigap plan, regardless of which company or plan you have.

– Plan G covers everything that Medicare Part A and B cover at 100% except for the Part B deductible. – Premium costs vary widely, depending on where you live. In many states, costs also vary based on your gender and whether you smoke or vape. – If you qualify for Original Medicare, you may be able to enroll in Plan G.

Plan G covers 100% of the Medicare Part A and Part B co-pays and coinsurance, those gaps and holes that Medicare doesn't cover. Plan G covers Skilled Nursing and rehab facility stays and also Hospice care. You also won't have to worry about any balance billing, known as excess charges.

However, if you have a comprehensive Medigap plan, such as Plan G, you wouldn't have to worry about your Part B coinsurance or Part B excess charges as Medigap Plan G covers both costs. Instead, your colonoscopy would be 100% covered regardless of the type of doctor you see.