Plan G pays your Part B deductible, but not your Part A deductible

Plan G (also called Medigap Plan G) covers the Part B deductible — the amount you pay out of pocket before Original Medicare's Part B coverage kicks in. For 2024, that deductible is $240, though the amount changes each year. Plan G does not cover your Part A deductible, which is much larger and applies to hospital stays.

Plan G is one of the most comprehensive Medigap plans available. Beyond the Part B deductible, it also covers coinsurance, copayments, and the costs of skilled nursing facility care after Medicare stops paying. The main gap in Plan G coverage is the Part A deductible — you pay that yourself when you are admitted to a hospital.

If you want a Medigap plan that covers both deductibles, you would need Plan F instead. However, Plan F is only open to people who were may be able to access for Medicare before January 1, 2020. If you became may be able to access for Medicare on or after that date, Plan G is the closest option available to you.

Key Takeaways

  • Plan G covers your Part B deductible ($240 in 2024), meaning you do not pay that amount yourself before Part B coverage begins.
  • Plan G does not cover your Part A deductible, which you must pay when admitted to a hospital — this deductible is separate and much higher.
  • Plan G covers coinsurance and copayments for most Medicare-covered services, reducing your out-of-pocket costs significantly.
  • Only people who became may be able to access for Medicare before January 1, 2020 can purchase Plan F, which covers both Part A and Part B deductibles.
  • Your actual out-of-pocket costs depend on which services you use and whether you see doctors who accept Medicare assignment.

How the Part A and Part B deductibles work

Original Medicare has two separate deductibles. The Part A deductible applies to hospital stays, skilled nursing facility care, hospice, and home health services. In 2024, this deductible is $1,632 per benefit period — a much larger amount than Part B. You pay this amount once per benefit period (which is roughly a hospital stay plus 60 days of recovery time).

The Part B deductible applies to doctor visits, outpatient services, and medical equipment. In 2024, it is $240 per year. Once you have paid this amount, Medicare covers its share of Part B services for the rest of that calendar year.

Plan G steps in and pays your Part B deductible for you. This means when you see a doctor or use an outpatient service, you do not have to reach that $240 threshold before coverage begins. However, if you are admitted to a hospital, you still owe the Part A deductible yourself — Plan G does not cover it.

What else Plan G covers beyond the Part B deductible

Plan G covers far more than just the Part B deductible. It pays the Part B coinsurance — normally 20% of the cost of doctor visits and outpatient services after the deductible is met. It also covers Part B copayments for things like emergency room visits and mental health services.

Plan G covers the skilled nursing facility coinsurance, which is the amount you owe for days 21 through 100 of a skilled nursing facility stay. It also covers Part A coinsurance for hospital stays — specifically, the copayments you owe for days 61 through 90 of a hospital stay, and for lifetime reserve days beyond that.

Plan G also covers excess charges — the amount a doctor can bill you above what Medicare allows, but only if you see a doctor who accepts Medicare assignment. It covers foreign travel emergency care at 80% of the cost, up to a lifetime limit of $250,000. It does not cover dental, vision, hearing aids, or long-term care.

The gap: what Plan G does not cover

The most significant gap in Plan G is the Part A deductible. If you are admitted to a hospital, you pay this amount yourself — Plan G will not pay it. For 2024, that is $1,632. This is the main reason some people choose Plan F if they are may be able to access, since Plan F covers this deductible.

Plan G also does not cover services that Original Medicare does not cover — things like routine dental work, vision exams, hearing aids, or long-term custodial care in a nursing home. It does not cover prescription drugs; you need a separate Part D plan for that. It does not cover care outside the United States, except for the limited foreign travel emergency benefit.

Plan G does not cover copayments for preventive services that Medicare covers at no cost, because there are no copayments to cover. It also does not cover charges from doctors who do not accept Medicare assignment, though it will cover excess charges from doctors who do accept assignment.

Plan G versus Plan F: which covers more

Plan F covers everything Plan G covers, plus the Part A deductible. This makes Plan F slightly more comprehensive. However, Plan F is closed to new enrollees — only people who were may be able to access for Medicare before January 1, 2020 can purchase it. If you became may be able to access for Medicare on or after that date, Plan G is your most comprehensive option.

Plan F also typically costs more per month than Plan G, even for people who are may be able to access to purchase it. The trade-off is that you avoid paying the Part A deductible, which can be substantial if you are hospitalized. For someone who expects to use hospital services, the extra monthly premium for Plan F may be worth it. For someone who rarely uses hospital care, Plan G may be the better value.

If you are not may be able to access for Plan F and want to cover the Part A deductible, you would need to purchase a different Medigap plan — but no other plan covers it as comprehensively as Plan F does. Plan G remains the best option for most people who became may be able to access for Medicare after 2020.

How your actual costs break down with Plan G

Your total out-of-pocket costs with Plan G depend on which services you use. If you see doctors regularly but never go to the hospital, Plan G covers most of your costs after you pay the monthly premium. You would pay nothing for the Part B deductible, and Plan G would cover the coinsurance and copayments.

If you are hospitalized, your costs are higher. You pay the Part A deductible ($1,632 in 2024) out of pocket. After that, Plan G covers the coinsurance for days 1 through 60 of the hospital stay. For days 61 through 90, you owe copayments that Plan G covers. For days 91 and beyond, you owe copayments for lifetime reserve days that Plan G also covers.

The monthly premium for Plan G varies by insurance company and by state. In 2024, premiums typically range from $100 to $200 per month, though some companies charge more and some charge less. You pay this premium whether you use services or not. When comparing Plan G to other Medigap plans, factor in both the monthly premium and your expected out-of-pocket costs for the services you actually use.

When to enroll in Plan G and how it affects your deductible

You can purchase Plan G during your Medigap Open Enrollment Period, which is the six-month window starting the month you turn 65 and enroll in Part B. During this period, insurance companies cannot deny you coverage or charge you more based on your health history. If you miss this window, you may face medical underwriting and higher premiums.

Plan G coverage begins on the first day of the month after you purchase it, or on a date you choose if you purchase it before your Medicare coverage starts. Your Part B deductible resets on January 1 each year. If you enroll in Plan G partway through the year and have already paid part of your Part B deductible, Plan G will cover the remainder for that year.

If you switch from Original Medicare to Plan G, you should do so during your Medigap Open Enrollment Period to avoid medical underwriting. If you switch from another Medigap plan to Plan G, the rules are different — some states allow you to switch without underwriting, while others do not. Check with your state insurance commissioner's office for the rules in your state.

Frequently Asked Questions

Does Plan G cover the Part A deductible if I go to the hospital?

No. Plan G covers the Part B deductible but not the Part A deductible. If you are admitted to a hospital, you pay the Part A deductible ($1,632 in 2024) yourself. Plan G covers the coinsurance and copayments after that deductible is met, but not the deductible itself.

What is the difference between Plan G and Plan F?

Plan F covers the Part A deductible; Plan G does not. Plan F is closed to new enrollees — only people may be able to access for Medicare before January 1, 2020 can purchase it. Plan G is open to everyone. Plan F typically costs more per month but saves you money if you are hospitalized frequently.

If I already paid part of my Part B deductible before enrolling in Plan G, does Plan G cover the rest?

Yes. Plan G covers your Part B deductible for the calendar year you enroll, even if you have already paid part of it. If you enrolled in Plan G in June and had already paid $150 of the $240 deductible, Plan G covers the remaining $90.

Does Plan G cover prescription drugs?

No. Plan G covers deductibles, coinsurance, and copayments for Original Medicare services, but not prescription drugs. You need a separate Part D prescription drug plan to cover medications. You can enroll in Part D at the same time you enroll in Plan G.

Can I switch from Plan G to Plan F if I become may be able to access later?

No. Plan F is closed to new enrollees. If you did not purchase Plan F before January 1, 2020, you cannot purchase it now, even if you later become may be able to access for Medicare. You can switch to other Medigap plans, but Plan F is no longer an option for you.