Medicare Plan G covers most of what Original Medicare does not

Medicare Plan G is a Medigap policy sold by private insurance companies. It pays many of the costs that Original Medicare leaves you responsible for — hospital deductibles, coinsurance, and copayments. Plan G does not cover prescription drugs, dental, vision, or hearing aids. It also does not cover services Medicare itself does not cover, such as long-term care or routine foot care.

Plan G is one of ten standardized Medigap plans (A through N). The letter determines what is covered; the insurance company you buy from determines the price. Two Plan G policies from different companies cover exactly the same things, but one may cost $50 a month more than the other.

Plan G is the most popular Medigap choice for people turning 65 now, because it covers nearly everything Original Medicare requires you to pay. The main exception is the Part B deductible, which you pay once per year before Plan G begins to help.

Key Takeaways

  • Plan G pays the hospital deductible, hospital coinsurance, skilled nursing facility coinsurance, and Part A and Part B copayments that Original Medicare does not cover.
  • You still pay the Part B deductible (the amount you must spend on doctor visits before Medicare starts paying) out of your own pocket each year.
  • Plan G does not cover prescription drugs, dental, vision, hearing aids, or any service that Original Medicare does not cover.
  • The same Plan G coverage costs different amounts depending on which insurance company sells it to you, so comparing prices from multiple insurers saves money.
  • You must be enrolled in Original Medicare Part A and Part B to buy Plan G; you cannot use it with Medicare Advantage.

What Plan G pays for hospital and inpatient care

Plan G covers the Part A deductible, which is the amount you pay before Medicare hospital insurance begins to cover inpatient hospital stays. In 2024, this deductible is $1,632 per benefit period. A benefit period starts when you enter the hospital and ends 60 days after you leave; if you go back to the hospital more than 60 days later, a new benefit period begins and you pay the deductible again.

Plan G also covers hospital coinsurance — the daily cost-sharing amounts you would owe for days 61 through 90 of a hospital stay, and for up to 60 additional "lifetime reserve days" if your stay is longer than 90 days. Without Plan G, you would pay these amounts yourself. Plan G pays them.

For skilled nursing facility care (a facility that provides medical care after a hospital stay, not a long-term care home), Plan G covers the coinsurance you owe for days 21 through 100 of each benefit period. Medicare covers days 1 through 20 with no cost to you; Plan G covers the rest.

What Plan G pays for doctor visits and outpatient care

Plan G covers the Part B coinsurance — usually 20 percent of the cost of doctor visits, lab work, imaging, and outpatient hospital services. If your doctor charges $100 and Medicare approves $80, Medicare pays $64 (80 percent) and you would normally owe $16. Plan G pays that $16.

Plan G also covers Part B copayments for mental health services and emergency room visits. These are fixed dollar amounts rather than percentages. The copayment amounts vary by service and change each year.

One important limit: Plan G does not cover the Part B deductible, which is $240 in 2024. You must pay this amount yourself before Medicare and Plan G begin to help with doctor visits and outpatient services. Once you have paid $240 out of pocket in a calendar year, Plan G starts covering your coinsurance.

What Plan G does not cover

Plan G does not cover prescription drugs. You need a separate Part D prescription drug plan for that coverage. You can enroll in Part D when you first become may be able to access for Medicare, or during the annual open enrollment period in October and November. If you delay enrolling in Part D and do not have other creditable drug coverage, you may pay a penalty when you do enroll.

Plan G does not cover dental, vision, or hearing services. Medicare itself does not cover routine dental care, eye exams, eyeglasses, or hearing aids, so Medigap plans cannot cover them either. Some Medicare Advantage plans include dental or vision benefits, but Original Medicare with Plan G does not.

Plan G does not cover services that Original Medicare does not cover. This includes long-term care (nursing home care for chronic conditions), routine foot care, most acupuncture, and cosmetic surgery. It also does not cover care you receive outside the United States, except in limited circumstances when you are traveling.

How Plan G pricing works and what you pay each month

Plan G has a monthly premium that you pay to the insurance company that sells it to you. This premium varies widely — from roughly $100 to $300 per month depending on your age, location, and the insurer. The same Plan G coverage from Company A might cost $120 a month while the same coverage from Company B costs $180 a month.

Insurance companies use different pricing methods. Some charge the same premium to everyone who buys Plan G at the same age (community rating). Others charge more if you are older (age-rated). Some increase your premium each year based on your age; others increase it based on inflation or their claims experience. These differences add up to thousands of dollars over time, which is why comparing quotes from multiple insurers matters.

Your total out-of-pocket costs for healthcare include the Plan G premium, the Part B deductible you pay yourself, and any costs for services Plan G does not cover (drugs, dental, vision, hearing). If you use a lot of healthcare, the Part B deductible ($240) is usually the only significant amount you pay beyond the premium.

When you can enroll in Plan G and how to switch plans

You have the strongest protection when you enroll in Plan G during your Medigap open enrollment period, which is six months starting the month you turn 65 and enroll in Medicare Part B. During this window, insurance companies must sell you Plan G at the lowest price they offer anyone your age, and they cannot deny you or charge more based on your health history.

If you enroll in Plan G after your open enrollment period ends, insurance companies may charge you more or deny you coverage based on your health. Some states have additional protections that extend this window or allow you to switch plans more easily, so check with your state insurance commissioner's office.

You can switch from one Plan G insurer to another at any time, but you may face medical underwriting (health questions) if you switch outside your open enrollment period. You can also switch from Plan G to a different Medigap plan (such as Plan N) during the annual open enrollment period in October and November, though again, health questions may explore.

Plan G compared to other Medigap options

Plan G and Plan N are the two most popular Medigap choices today. Plan N is less expensive but requires you to pay copayments at the doctor's office ($20 for most visits) and the emergency room ($50, waived if admitted). Plan G has no copayments but costs more per month. Over a year, the difference depends on how often you see doctors.

Plan F covers everything Plan G does plus the Part B deductible, making it the most comprehensive Medigap option. However, Plan F is no longer sold to people who are new to Medicare (those who turned 65 after January 1, 2020). If you were already enrolled in Plan F before that date, you can keep it.

Older adults sometimes choose Medicare Advantage (Part C) instead of Original Medicare with Medigap. Medicare Advantage plans often have lower premiums but require you to use in-network doctors and may have higher copayments. They also include prescription drug coverage and sometimes dental or vision benefits. The trade-off is less flexibility and potentially higher costs if you use a lot of healthcare.

Frequently Asked Questions

Do I have to pay the Part B deductible every year?

Yes. The Part B deductible resets on January 1 each year. Once you have paid $240 out of pocket for covered services in a calendar year, Plan G begins to cover your coinsurance for the rest of that year. The deductible amount changes each year; it was $226 in 2023 and $240 in 2024.

Does Plan G cover my medications?

No. Plan G does not cover prescription drugs. You must enroll in a separate Medicare Part D prescription drug plan. You can choose from multiple Part D plans during the annual open enrollment period in October and November, and plans vary in which drugs they cover and what you pay.

Can I use Plan G with Medicare Advantage?

No. Plan G is a Medigap policy designed to work with Original Medicare (Parts A and B). If you are enrolled in Medicare Advantage, you cannot buy Medigap. If you want to switch from Medicare Advantage to Original Medicare with Plan G, you can do so during the annual open enrollment period, though you may face health questions when explore for Plan G.

What if I travel outside the United States?

Plan G covers emergency care you receive while traveling outside the United States in limited situations. Coverage is typically 80 percent of the cost after you pay a deductible. For planned care or routine services outside the U.S., Plan G does not cover you. If you travel internationally often, ask your Plan G insurer about their specific rules.

How do I compare Plan G prices from different insurance companies?

Contact insurance companies directly by phone or visit their websites to request quotes. You can also use the Medicare Plan Finder tool on Medicare.gov, which shows available plans and premiums in your area. Because the same Plan G coverage varies in price, getting quotes from at least three insurers helps you find the lowest cost.