Plan G covers everything Plan F covers except the Part B deductible, which is a modest amount reset each year. For most beneficiaries, the premium savings versus Plan F more than make up for that deductible.
Best for
- Anyone newly eligible for Medicare seeking comprehensive supplemental coverage
Watch out for
You pay the Part B deductible out-of-pocket each year (~$240).
What Plan G covers
- Part A coinsurance & 365 extra hospital daysCovered in full
- Part B coinsurance or copaymentCovered in full
- Blood (first 3 pints)Covered in full
- Part A hospice coinsurance / copayCovered in full
- Skilled nursing facility coinsuranceCovered in full
- Part A deductibleCovered in full
- Part B deductibleNot covered
- Part B excess chargesCovered in full
- Foreign travel emergency (up to plan limits)Covered in full
Compare to other Medigap plans
- Plan AThe minimum-coverage Medigap plan - basic benefits only.
- Plan BPlan A plus the Part A deductible.
- Plan CComprehensive coverage - closed to anyone newly eligible after Jan 1, 2020.
- Plan DPlan G minus Part B excess. Modest savings, modest reduction in benefit.
- Plan FThe 'everything' plan - closed to newly eligible after Jan 1, 2020.
- Plan KLower premium, partial coverage with out-of-pocket cap.
- Plan LLike Plan K but covers more - 75% of most cost-sharing.
- Plan MSplits the Part A deductible 50/50 between you and the plan.
- Plan NLower premium than Plan G in exchange for office and ER copays.
What Does Medigap Plan G Actually Cover?
Plan G is the most popular Medicare Supplement plan sold today. It fills almost every gap Original Medicare leaves open. After you meet one yearly deductible, your covered care is usually paid in full.
Plan G works alongside Original Medicare, not in place of it. Medicare pays first, and your policy pays the share Medicare left behind. You keep your red, white, and blue card, and any provider who takes Medicare can treat you.
The benefits Plan G pays for
Part A hospital coinsurance
Your daily hospital coinsurance, plus 365 extra hospital days after Medicare benefits run out.
Part A deductible
The hospital deductible for each benefit period. This is the single largest gap most people face.
Part B coinsurance
The 20 percent share you would owe for doctor visits, labs, imaging, and outpatient care.
Skilled nursing coinsurance
The daily coinsurance for a covered nursing facility stay that follows a qualifying hospital stay.
Blood and hospice
The first three pints of blood each year, plus your share of hospice drugs and respite care.
Part B excess charges
A few providers bill above the Medicare-approved amount. Plan G pays that extra charge, so you do not.
Foreign travel emergency
Emergency care outside the United States, up to the limits printed in your policy.
The short version
Plan G leaves you one predictable bill each year: the Part B deductible. Every other benefit on the standard Medigap list is covered in full.
What Does Plan G Leave You to Pay?
One gap stays yours. Plan G does not pay the yearly Part B deductible. You cover that once per calendar year, and then the plan behaves like full coverage. Medicare sets the amount, and it changes each year.
- The Part B deductible, once each calendar year.
- Your standard Part B premium, which Medicare adjusts each year.
- Your Plan G premium, paid to the carrier you choose.
- Prescription drugs, routine dental, vision, and hearing care.
- Long-term custodial care, such as daily help with bathing or dressing.
Drug coverage is a separate purchase
No Medigap plan includes prescriptions. Most Plan G members add a stand-alone Part D plan. Part D now has a yearly cap on what you pay out of pocket for covered drugs. That cap changes each year.
Who Is Plan G Genuinely the Right Fit For?
Who this is for
Plan G tends to fit you well if:
- You want the fewest surprise medical bills possible.
- You travel, or want any Medicare doctor without a network.
- You see specialists often, or expect a procedure soon.
- You prefer a steady premium over uneven bills.
- You are newly eligible and want the most complete plan still open.
Plan G is not the best value for everyone. The honest tradeoff is price. It carries a higher monthly premium than most other letters, and you still owe the Part B deductible.
How Does Plan G Compare to Plan N?
Plan N is the closest alternative for most people shopping today. Both cover the Part A deductible, skilled nursing care, and emergency care abroad. The differences look small on paper and can matter in real life.
Plan G vs. Plan N at a glance
Plan G
The most complete Medigap plan open to new enrollees.
- Monthly premium
- Higher of the two
- Part A deductible
- Covered in full
- Part B deductible
- You pay it once a year
- Office visit copay
- None
- Emergency room copay
- None
- Part B excess charges
- Covered in full
- Foreign travel emergency
- Covered to plan limits
- Best for
- Frequent care users who want steady bills.
Plan N
A lower premium in exchange for small copays at the point of care.
- Monthly premium
- Lower than Plan G
- Part A deductible
- Covered in full
- Part B deductible
- You pay it once a year
- Office visit copay
- A small copay at some visits
- Emergency room copay
- Larger, but waived if admitted
- Part B excess charges
- Not covered
- Foreign travel emergency
- Covered to plan limits
- Best for
- Moderate care users trimming monthly cost.
The math is simple. Add up a year of premium savings on Plan N, then compare that to the copays you would likely pay. See doctors often, and Plan G usually wins. See them rarely, and Plan N often does.
What about Plan F?
Plan F is closed to anyone who became eligible for Medicare on or after January 1, 2020. If you already hold Plan F, you may keep it. We still compare your rate against Plan G every year.
How Do California's Birthday Rule and Trial Rights Work?
California gives Medigap members a yearly do-over that most states do not. It is called the birthday rule. It lets you change carriers without answering health questions.
Using the California birthday rule
- 01
Watch your birthday
A 60-day window opens on your birthday each year. California carriers must accept you during it, with no underwriting.
- 02
Match or step down
You may move to the same letter with another carrier, or to lesser benefits. The rule does not allow an upgrade.
- 03
Get quotes early
Ask for a re-quote about two months ahead. Some carriers want the application in hand before the window closes.
- 04
Do not cancel first
Keep your current policy until the new one is issued. Your agent lines up the dates so no gap appears.
Medigap trial rights are a separate federal protection. They help people who tried Medicare Advantage and want Original Medicare back. Each one is a guaranteed-issue right, so no health questions apply.
- You joined Medicare Advantage when you first turned 65. Leave within the first 12 months, and you may buy any Medigap plan sold in California.
- You dropped a Medigap policy to try Medicare Advantage for the first time. Switch back within 12 months, and you may reclaim your old policy. If that carrier no longer sells it, Plan G is on the list you may buy.
Windows close quietly
Nobody calls to remind you that a trial right is ending. Mark the date and start shopping about 60 days ahead. We build these reminders into every client's annual review.
What Does Underwriting Look Like Outside a Guaranteed-Issue Window?
Your best window is Medigap open enrollment. It runs six months from the month you turn 65 and have Part B. During it, no carrier may turn you down or charge you more for health reasons.
Outside that window, carriers may review your health. This is called medical underwriting. Approval is not certain. A decline never affects your Original Medicare coverage.
- Health questions about conditions treated in the past two to five years.
- A prescription history check, which carriers pull electronically in minutes.
- Height and weight, compared against the carrier's build chart.
- Recent or planned care, such as a scheduled surgery or a pending test.
- A short phone interview, used by some carriers to confirm your answers.
One carrier's answer is not every carrier's answer
Underwriting rules differ a lot between companies. A condition that stops one carrier can be routine for another. That is the practical value of an independent agency. We know which carriers are friendly to which health histories before you apply.
How Do You Choose a Plan G Carrier in Orange County?
Here is the part many people miss. Every Plan G policy covers the same benefits, because federal law standardizes them. A claim paid by one carrier would be paid by all. Only price, service, and rate history differ.
- Current rate for your age and ZIP code across every carrier we represent.
- Rate increase history, so a low first-year price does not surprise you later.
- Household and payment discounts, which many carriers offer quietly.
- Underwriting appetite, if you apply outside a guaranteed-issue window.
Talk it through with a licensed agent
Harmony SoCal Insurance Services is an independent multi-carrier agency at 2135 N Pami Circle, Orange, CA 92867. Call (714) 922-0043 or request a review. California license #0718082. We meet in person, by video, or by phone, in English and Spanish, with Korean, Mandarin, and Vietnamese available. New to all this? Start with the Medigap overview.