Medicare plan G is one among the 10 supplement policies offered by Medicare, filling the coverage gaps in parts A and B, which are the original parts. The original parts, A and B, cover different services, which include doctor visits and hospital stays. But even with this coverage, the copays, coinsurance, and deductibles are high. The Medigap policies referred to as Medicare supplements, come in to help cover the gaps left, and they can additionally offer other services.
Plan G offers the widest coverage range compared with the other plans, except Medigap plan F. It is comprehensive but does not cover Medicare part B deductible. However, it is reasonable that many seniors go for it to reduce out-of-pocket costs when seeking medical care under Medicare.
How does it work?
Plan G is a supplement policy which means it is not the primary coverage. It, however, helps fill many gaps in your Medicare policy. The benefits from part A or B will pay for health services you might need, and Plan G covers some of the expenses related to your policy. For instance, you would have to pay the deductible on Medicare Part A out of your pocket if you have not enrolled for Plan G. But when you have Plan G coverage, the health insurer will pay the deductible in its entirety. Medicare pays what its share is, and then the supplement covers the remaining costs.
This supplement is available to those over 65 years of age or those who are disabled and enrolled in Medicare Part A and B. Considering the health concerns of age or disability, supplementing your health plan is important and will come in handy when you need it the most. With this plan, you will relieve the healthcare pressure on yourself and your loved ones.
What does it cover?
According to Medicare services centres, the original Medicare does not offer full coverage in medical care. It will cater to doctor visits, hospital care, and related services, but you would still be expected to pay coinsurance feed and the deductible. The original plans also exclude services like hearing aids, routine dental care services, and cosmetic procedures which are not medically necessary. Your copays will be determined by the cost of the care you need, and this can take a toll on your budget. When you have the Medicare Plan G supplement, it will take care of your deductibles, copays, and coinsurance. You will also get to enjoy additional services, including:
- Coverage for an additional year of hospital care after exhausting Original Medicare benefits. You also get coverage for hospital deductibles and coinsurance
- Coverage for Part B copays and coinsurance
- Coverage for blood transfusion, first three pints
- Part A deductible and hospice copayment or coinsurance
- Foreign travel emergencies up to 80%
- Skilled nursing facility care
- Part B excess charges
It is important to note that the Plan G supplement does not cover dental care and other services excluded from the Original Medicare plans, including acupuncture. You can, however, find some policies that cover those services. The Medicare Advantage is one such policy you can choose under private insurance. It is a substitute for Original Medicare covering Part A and B needs, but it can only be bought under the Original Medicare Plan and not Medigap insurance.
How much does it cost?
The Plan G supplement averages $145 monthly for those over the 65 age gap. There is a range of prices for supplement policies because insurance companies use different methods in pricing their plans. Other factors determining the price you get for the plan include age, location, gender, and health. You can select what works best by comparing the rates from different providers. You can also use Medicare plan G reviews for insights to help you make the right decision.
Under this plan, the out-of-your-pocket costs will be for the monthly premium and the annual Part B Medicare deductible. The amount often changes, usually annually, going up a few dollars yearly. The deductible applies every 1st January towards the medical costs, and you will get the bill up to this deductible with the first doctor visit. It resets each year, and after meeting the deductible, supplement plan G covers any other costs approved for the rest of the year.
Medicare Plan G eligibility
You only become eligible for the plan at age 65. However, you can still enjoy the benefits of serious medical conditions or disabilities before this age. Your location, work history, and citizenship can affect eligibility, but your income does not. But you can still enjoy further reductions for medical expenses if you have a low income by enrolling in both Medicaid and Medicare.
When you qualify by age, the enrollment should start three months before the birthday month and ends three months after the month. Eligibility through disability or a medical condition will see the coverage start two years after the disability benefits are received. The waiting period might vary from case to case, but there is no waiting for conditions like end-stage-renal disease or Lou Gehrig’s disease.
As for residency and citizenship, in most cases, you will need to be a United States citizen and live here too. Permanent US residents also qualify if they have lived in the country continuously for five years before the Medicare application.
If you are worried about location, Medicare plans are available across the country, government-issued ones. This might be different with parts offered privately by insurance companies. You might be eligible for plans specific to your area in some situations. Your primary residence is used for the eligibility evaluation; the options might differ in the nearby county. You can get quotes using your zip code to see what plans are available to you.
Takeaway
Your health should be a priority, and with so many Medicare plans, you should also find a plan that covers your needs and possible outcomes. There is no reason why you should suffer from medical care when you are ageing and probably not working. Check out the options available and plan to have a stress-free retirement.
Adam Mulligan did his degree in psychology at the University of Hertfordshire. He is interested in mental health, wellness, and lifestyle.
