Plan G covers the costs Medicare Part A and Part B don't pay

Medicare Supplement Plan G is designed to fill gaps in Original Medicare coverage. It pays the coinsurance, copayments, and deductibles that Medicare leaves you responsible for — but only for services Medicare itself covers. Plan G does not cover dental, vision, hearing aids, or long-term care. It also does not cover services outside the United States, except in limited circumstances.

Plan G is one of ten standardized supplement plans. The letter designation (A through N) determines which gaps the plan covers. Plan G covers more than Plans A, B, or D, but less than Plan F (which is no longer sold to people new to Medicare). If you are comparing plans, the coverage differences are set by federal law — all Plan G policies cover the same benefits regardless of which insurance company sells it.

Key Takeaways

  • Plan G pays Medicare Part A deductibles, coinsurance for hospital stays, and skilled nursing facility coinsurance after day 20.
  • Plan G pays the Part B deductible, coinsurance for doctor visits and outpatient services, and excess charges that doctors bill above Medicare's approved amount.
  • Plan G does not cover dental, vision, hearing aids, prescription drugs, or care outside the United States.
  • You must have both Original Medicare (Part A and Part B) and Plan G; the supplement does not work with Medicare Advantage plans.

Hospital and inpatient care covered by Plan G

Plan G covers the Part A deductible, which is the amount you pay out of pocket before Medicare hospital coverage begins. This deductible resets each benefit period (typically each calendar year, though Medicare defines it differently). Plan G pays this in full.

For hospital stays, Plan G covers coinsurance — the daily cost-sharing amount you would otherwise owe for days 61 through 90 of a hospital stay, and for days 91 and beyond if you use your lifetime reserve days. It also covers the full coinsurance for stays in a skilled nursing facility after day 20 (Medicare covers days 1–20 fully; you pay coinsurance on days 21–100).

Plan G does not cover the cost of care after your Medicare benefits end — for example, if you exhaust your 100 lifetime hospital days in a benefit period. It also does not cover custodial care (help with daily living activities when skilled nursing is not medically necessary).

Doctor visits and outpatient services covered by Plan G

Plan G covers the Part B deductible, which you pay once per year before Medicare begins to cover doctor visits, lab work, imaging, and outpatient procedures. After you meet this deductible, Medicare typically covers 80 percent of approved services, and you pay 20 percent coinsurance. Plan G pays that 20 percent coinsurance for most outpatient services.

Plan G also covers excess charges — the difference between what a doctor bills and what Medicare allows. If a doctor charges $150 for a visit but Medicare's approved amount is $100, Medicare pays $80 (80 percent of $100) and you would normally owe $20 coinsurance plus the $50 excess charge. Plan G pays both the $20 coinsurance and the $50 excess charge. This protection matters most if you see doctors who do not accept Medicare assignment (meaning they do not agree to charge only Medicare's approved amount).

Plan G covers coinsurance for mental health visits, physical therapy, occupational therapy, and other outpatient rehabilitation services that Medicare covers. It does not cover services Medicare does not cover, such as routine eye exams, hearing tests, or dental cleanings.

Blood, hospice, and emergency care covered by Plan G

Plan G covers the coinsurance for the first three pints of blood you receive in a hospital or outpatient setting during a calendar year. After three pints, Medicare covers blood at no cost to you, so Plan G's role ends.

For hospice care, Plan G covers coinsurance and copayments for drugs and respite care (short-term inpatient care to give family caregivers a break). It does not cover room and board if you live in a hospice facility, because Medicare does not cover that either.

If you travel outside the United States, Plan G covers 80 percent of the cost of emergency care during the first 60 days of a trip, after you pay the Part B deductible. This is a limited benefit and applies only to true emergencies, not routine or planned care.

What Plan G does not cover

Plan G does not cover prescription drugs. If you want drug coverage, you must enroll in a separate Medicare Part D plan through a private insurance company. Part D is not included in any supplement plan.

Plan G does not cover dental care, routine eye exams, eyeglasses, hearing aids, or hearing exams. It does not cover routine foot care, acupuncture, or cosmetic surgery. It does not cover services that Medicare does not cover, even if another insurance plan might.

Plan G does not cover care you receive outside the United States, except for the limited emergency coverage described above. It does not cover long-term care, assisted living, or custodial care in any setting. It does not cover private-duty nursing or care coordination services.

How Plan G works with Medicare and other insurance

Plan G is a supplement to Original Medicare, not a replacement. You must be enrolled in both Medicare Part A and Part B to buy Plan G. When you see a doctor or go to the hospital, Medicare processes the claim first, determines what it will pay, and sends the bill to Plan G. Plan G then pays its share of what Medicare did not cover.

You cannot use Plan G with a Medicare Advantage plan (Part C). If you have a Medicare Advantage plan and want to switch to Original Medicare with a supplement, you have limited windows to do so without facing waiting periods or higher premiums.

If you have other insurance — such as coverage through a current or former employer, a union, or Medicaid — Plan G coordinates with that coverage. The order in which plans pay depends on federal coordination rules and the type of other coverage you have.

Plan G premiums and how they are set

Plan G premiums vary by insurance company, by state, and by your age and health status at the time you first buy the plan. There is no single "Plan G premium" — you must get quotes from multiple insurers to compare costs. Premiums also increase over time as you age.

Insurance companies use one of three pricing methods: community-rated (everyone in your state pays the same premium regardless of age), age-rated (premiums increase as you age), or issue-age-rated (your premium is based on your age when you buy the plan and increases with inflation, not with your age). The method varies by company and state.

Plan G premiums are separate from your Medicare Part B premium. You pay both. You also pay Part B coinsurance and deductibles before Plan G begins to cover them (Plan G pays them after the fact, not upfront).

Frequently Asked Questions

Does Plan G cover my prescription medications?

No. Plan G does not cover any prescription drugs. You must enroll in a separate Medicare Part D prescription drug plan if you want coverage. Part D is sold by private insurance companies and has its own premiums, deductibles, and formularies (lists of covered drugs).

Can I use Plan G if I have a Medicare Advantage plan?

No. Plan G is a supplement to Original Medicare only. If you have a Medicare Advantage plan and want to switch to Original Medicare with Plan G, you can do so during the annual open enrollment period (October 15 to December 7) or if you may have access to for a special enrollment period. When you switch, you may face a waiting period for pre-existing conditions, depending on your state.

Does Plan G cover care outside the United States?

Plan G covers 80 percent of emergency care during the first 60 days of a trip outside the U.S., after you pay the Part B deductible. Routine or planned care is not covered. If you travel internationally often, ask your insurer about supplemental travel insurance.

What is the difference between Plan G and Plan F?

Plan F covers the Part B excess charges and the Part B deductible, just like Plan G. However, Plan F is no longer sold to people who became may be able to access for Medicare on or after January 1, 2020. If you are newly may be able to access, Plan G is the most comprehensive supplement available to you.

Do I have to pay Plan G premiums even if I do not use Medicare services?

Yes. You pay Plan G premiums every month regardless of whether you see a doctor or go to the hospital. The premium is the cost of having the coverage available. You also continue to pay your Medicare Part B premium.