September 12th 2024
By Ari Parker
Medicare Supplement Plan G is generally considered the best coverage. Explore the pros and cons of Medicare Supplement Plan G to see if Plan G is for you!
By Ari Parker
Medicare Supplement Plan G (also called Medigap Plan G) is often considered the best Medicare plan. If it’s “the best,” why isn’t everyone signing up for Medicare Plan G? Like with all health insurance plans, it’s not perfect. In this article, we’ll share all of the wonderful positive elements of Plan G, but we’ll also share the drawbacks associated with Plan G. Many of these pros and cons are common among all Medicare Supplement plans, so it’s important to understand how Medicare Supplement plans work in general. That said, we’ll indicate how Medicare Supplement Plan G has unique advantages.
Medicare Supplement Plan G reduces your out-of-pocket costs, giving you financial predictability.
Medicare Supplement Plan G gives you great access to care through no networks and no prior authorization requirements.
Medicare Supplement Plan G does have higher premiums than some Medicare Advantage plans and some of the other Medicare Supplement plans.
Medicare Supplement Plan G doesn’t provide prescription drug coverage or extra benefits that often come with Medicare Advantage plans.
Enrolling in a Medicare Supplement Plan G can pose challenges if you try to enroll outside of a guaranteed issue period.
Medicare Supplement Plan G is one of ten standard Medicare Supplement Plans. Medicare Supplement plans are also commonly referred to as Medigap plans. So, Medicare Supplement Plan G and Medigap Plan G are the same thing. It’s also worth noting that every Plan G has identical coverage, regardless of the insurance company that offers it or the monthly premium. All Medicare Supplement plans stack on top of Original Medicare to help cover the 20% of costs not covered by Original Medicare. This is different from Medicare Advantage, which replaces Original Medicare.
>> Learn about the pros and cons of Medicare Supplement vs Medicare Advantage
If you have Original Medicare and Medicare Supplement Plan G, you have the most comprehensive medical coverage you can get. That’s because Medicare Supplement Plan G covers almost all of your out-of-pocket costs—your Medicare Part B deductible is the only exception. That means that once you meet your Part B deductible, which is $257 in 2025, you’ll owe nothing else out of pocket for the medical services you receive. Need a surgery that costs $600,000? You’ll owe nothing. Especially since we generally need more medical services as we age, this makes Plan G a fantastic deal in the long run.
*Note: Medicare Supplement Plan F does cover the Part B deductible, making it more comprehensive—but those who turn 65 after January 1, 2020, are unable to enroll in Plan F.
All Medicare Supplement plans share some common advantages. In the following sections, we’ll indicate which advantages are and are not unique to Medicare Supplement Plan G. If you review the chart below, you’ll see that the only out-of-pocket cost that Plan G does not cover is the Part B deductible.
All Medicare Supplement plans reduce out-of-pocket costs. That said, Plan G reduces them the most. Outside of Plan F, which isn’t an option for most new Medicare enrollees, Medicare’s Plan G covers the most out-of-pocket costs. Medicare Supplement Plan N comes close to Plan G and is a good option for many. The only difference between Plan G and Plan N is that Plan N doesn’t cover Part B excess charges, which don’t apply in some states.
The only advantage that's totally unique to Medicare Supplement Plan G is having virtually zero out-of-pocket costs. This advantage should not be underestimated! Once you meet your annual Part B deductible of $257, which is low for health insurance, you will have no other out-of-pocket costs for the year. This enables you to go to the doctor and get the care you need without financial fear. There’s no reason to put a surgery off or skip an appointment because you won’t owe anything. Furthermore, you’ll be able to know exactly how much you’ll pay each year for healthcare because your out-of-pocket costs are so limited.
If you’re on Original Medicare, regardless of additional coverage, then you won’t have Medicare prior authorization requirements. So, this “pro” applies to people who are on Original Medicare, whether or not they have a Medicare Supplement plan.
Like with prior authorization requirements, if you’re on Original Medicare, regardless of additional coverage, you can see any doctor who accepts Medicare nationwide. This is great because over 90% of doctors nationwide accept Medicare. Particularly if you travel a lot domestically or split time between two states, this is a critical advantage that allows you to receive timely care. Many people also like that this gives them control over seeing the best specialists in the nation rather than one that's in their plan's network.
No health insurance plan is perfect, and all of them have their own pros and cons. Particularly when comparing Medicare Supplement Plan G to Medicare Advantage plans, there are a few drawbacks to address.
For the coverage you receive, the premiums are generally worth it when compared against Medicare Advantage plans and the other Medicare Supplement plans. That said, Medicare Plan G premiums are higher than those for many Medicare Advantage and Medicare Supplement plan options. In fact, many Medicare Advantage plans have zero-dollar premiums (keep in mind that you still need to pay your Part B premium).
Medicare Plan G premiums may not seem worth it if you’re healthy, don’t visit the doctor a lot, and don’t need a lot of medical care. Unfortunately, however, you cannot enroll in a Medicare Supplement plan when it makes sense for you. Medicare Supplement plans have enrollment restrictions. When you first enroll in Medicare, you are guaranteed acceptance into any Medicare Supplement plan. Outside of this time (and a handful of guaranteed issue periods), you’ll likely need to undergo medical underwriting. With medical underwriting, insurance carriers can deny your application or charge you more based on your answers and health history. Unfortunately, due to enrollment restrictions, some people are unable to enroll in a Medicare Supplement Plan G when they decide they want to.
One of the biggest advantages of Medicare Advantage plans is they provide extra benefits, like coverage for prescriptions and dental, vision, and hearing services. If you’re on Original Medicare, whether you have a Medicare Supplement plan or not, you’ll need to enroll in a standalone Part D plan to get your prescriptions covered. You also won’t receive coverage for dental, vision, and hearing services. That said, the average cost of Part D coverage is $45. Also, in many cases, the value of the dental, vision, and hearing coverage that comes with Medicare Advantage plans is also not very high.
Everyone’s situation is different. You’ll have different budget and medical needs than your next door neighbor, and even your spouse! We always recommend working with an independent Medicare agent to understand and compare all of your options. A Chapter Medicare Advisor can help you do just this. Get started today by giving us a call at 855-900-2427 or picking a time to talk today.
