Due to the government implementation of MACRA, Medicare Supplement Plans C and F are no longer available for those who become eligible for Medicare after January 1, 2020. As a result, many are turning to Plan G as the next best option. Although Plan G requires beneficiaries to pay the annual Part B deductible, which is $226 in 2023, it provides extensive coverage for all Medicare gaps, including hospital deductibles, copays, coinsurance, and the 20% that Part B does not cover. Plan G also covers inpatient hospital costs, skilled nursing, and hospice care, as well as outpatient medical services like doctor visits, lab work, diabetes supplies, x-rays, ambulances, and surgeries. Plan G pays for the remaining costs after Original Medicare Part A and Part B have been paid first, and beneficiaries have paid the Part B deductible. It is an excellent option for those seeking comprehensive coverage at a reasonable cost.
What Does Plan G Cover?
Perhaps the most appealing aspect of Plan G coverage is that it offers to fill in for all of the gaps in Medicare, which ensures that beneficiaries have comprehensive medical coverage without any out-of-pocket costs, apart from the small annual Part B deductible. This plan is designed to help cover many medical expenses that traditional Medicare doesn’t cover, which provides peace of mind for beneficiaries.
Plan G is an excellent option for those who are looking for a comprehensive coverage plan that covers most, if not all, of their medical expenses. Although the annual Part B deductible must be paid, it is a small price to pay for the extensive coverage that beneficiaries receive. Furthermore, with Plan G, beneficiaries can see any healthcare provider who accepts Medicare, and there are no network restrictions. This means that they can get the medical care they need without worrying about whether their doctor or hospital is in-network or out-of-network.
Therefore it provides beneficiaries with extensive coverage, including Part B excess charges, foreign travel emergency coverage up to plan limits, Part B coinsurance or copayment, Part A coinsurance and hospital costs for up to an additional 365 days after Medicare benefits have been exhausted, the first three pints of blood, Part A hospice care coinsurance or copayment, skilled nursing facility care coinsurance, and durable medical equipment like wheelchairs and walkers.
What High Deductible Plan G covers?
High Deductible Plan G is a type of Medicare supplement plan that has a higher annual deductible than regular Plan G. In 2023, the annual deductible for High Deductible Plan G is $2,700. Once the beneficiary has paid the deductible, the plan covers the same benefits as regular Plan G, including Part B excess charges, foreign travel emergency coverage up to plan limits, Part B coinsurance or copayment, Part A coinsurance and hospital costs for up to an additional 365 days after Medicare benefits have been exhausted, the first three pints of blood, Part A hospice care coinsurance or copayment, skilled nursing facility care coinsurance, and durable medical equipment like wheelchairs and walkers.
High Deductible Plan G can be a good option for beneficiaries who want a lower monthly premium but are willing to pay a higher annual deductible. However, it’s important to note that the deductible must be met each year before the plan starts covering medical costs.
High Deductible Plan G Pros and Cons
High Deductible Plan G, like any Medicare supplement plan, has its own set of pros and cons. Here are some of the main advantages and disadvantages of choosing a High Deductible Plan G.
- Lower monthly premiums: The primary advantage of High Deductible Plan G is that it typically has lower monthly premiums than regular Plan G. This can make it an attractive option for beneficiaries who want to save money on their Medicare supplement plan premiums.
- Comprehensive coverage: Once the annual deductible is met, High Deductible Plan G provides the same comprehensive coverage as regular Plan G. This means that beneficiaries will have coverage for all of the gaps in Medicare, including deductibles, coinsurance, and copayments.
- Flexibility: High Deductible Plan G provides beneficiaries with the flexibility to choose any healthcare provider who accepts Medicare. There are no network restrictions, so beneficiaries can get the medical care they need without worrying about whether their doctor or hospital is in-network or out-of-network.
- High annual deductible: The primary disadvantage of High Deductible Plan G is the high annual deductible that must be met before the plan starts covering medical costs. In 2023, the annual deductible is $2,370, which is significantly higher than the deductible for regular Plan G.
- Out-of-pocket costs: Until the annual deductible is met, beneficiaries are responsible for paying all of their medical costs out of pocket. This can be a significant financial burden for some beneficiaries.
- Limited availability: High Deductible Plan G is not offered by all insurance companies that offer Medicare supplement plans. This means that beneficiaries may have fewer options to choose from when selecting a plan.
High Deductible Plan G vs. Plan G: Which Should I Choose?
Choosing between a Medigap High Deductible Plan G and a regular Plan G can depend on your individual healthcare needs and budget. Here are some key differences to consider:
- Cost: Medigap High Deductible Plan G typically has a lower monthly premium than regular Plan G. However, you must pay a higher annual deductible ($2,700 in 2023) before the plan starts paying for your medical costs.
- Coverage: Once you meet the annual deductible, both plans offer the same coverage. Plan G covers all of the gaps in Original Medicare except for the Medicare Part B deductible, which is $164.90$ in 2023.
- Out-of-pocket costs: With Medigap High Deductible Plan G, you will be responsible for paying the annual deductible before your coverage kicks in. With regular Plan G, you will not have to pay an annual deductible, but you will be responsible for the Part B deductible and any other out-of-pocket costs that Original Medicare does not cover.
- Risk tolerance: If you are healthy and do not anticipate needing many medical services, a Medigap High Deductible Plan G may be a good option as you will pay a lower monthly premium. However, if you are someone who wants the security of comprehensive coverage and is willing to pay a slightly higher premium, regular Plan G may be a better choice.
Ultimately, the decision between Medigap High Deductible Plan G and regular Plan G will depend on your individual circumstances and health care needs. It may be helpful to compare the monthly premiums, annual deductibles, and out-of-pocket costs of each plan before making a decision. It may also be wise to consult with a licensed insurance agent who can help you compare plans and determine which option is best for you.