The G Medigap plan is one of the original plans available on the market in light of more recent changes and additions. It now stands as the second richest Medicare supplement insurance plan (to the F plan) which put it’s slightly out of order. The difference with the F plan is slight and since the F plan is the most popular and complete Medigap plan, not every carrier will offer the G plan in addition to the F plan. Let’s walk through the basic benefits of traditional Medicare and see how the G plans fill in the major gaps except for one.
The G plan is an interesting plan in that it covers all the primary Medicare categories except for one Part B deductible. Let’s walk through the others first. First, we have the Part A benefits which reflect hospital-based care. Medicare has a deductible and 20% co-insurance that follows for these services. This means that you will first pay the deductible amount (indexed to increase annually based on inflation) and then pay 20% of the hospital charges indefinitely. You will continue to pay this 20% if you only have Medicare by itself. The G plan will pay both this deductible and 20% so you should have very little if any out-of-pocket expenses for hospital related care.
Part B of physician charges are where the G plan is different from the F plan. Part B is related to doctor expenses (essentially those Medicare-covered benefits outside of hospital for facility-setting based care). The G Medigap plan will cover the 20% co-insurance (which is covered by all Medigap plans to some extent) but not the deductible and this is the one difference between the G and F plan. The F plan will cover the deductible. So how do we evaluate this? Simple. Look at the premium difference (with the F plan) on an annual basis and compare it with the Part B deductible. Keep in mind that the Part B deductible will increase with time but so should the premium difference to compensate all things being equal. Usually, the difference in premium is not enough to justify losing the Part B deductible coverage. This Part B deductible is an amount you are very likely to meet every year since it’s the first dollar coverage of physician charges. It makes sense to cover it.
The G plan will cover all the remaining Medicare categories. This includes the important items such as Hospice care which is a separate category that deals with end-of-life services. You also have Skilled Nursing Facility which is equally important in that the costs can be significant for this type of service since it can continue for longer periods of time. Further more, there’s Emergency Foreign travel for true emergencies out of the country. The first 3 pints of blood and the preventative co-insurance will also be covered with the G Medicare supplemental plan. These are lesser benefits but more likely to be used during the course of a year, especially for the preventative benefit co-insurance.
So really, the only Medicare supplement category not covered by the G plan is the Part B deductible. For 2011, it was $ 162. That’s roughly $ 13/monthly so compare the G Medicare plan quote you receive from us against an F plan. It usually makes sense to go with the F plan which is why it’s so popular on the market.