Plan G covers most of what Original Medicare leaves unpaid
Plan G is a Medicare supplement insurance policy sold by private insurers. It pays many of the costs that Original Medicare (Parts A and B) does not cover — copayments, coinsurance, and deductibles. Plan G does not replace Medicare; it works alongside it. Medicare pays first, then Plan G pays its share of what remains.
Plan G is one of ten standardized supplement plans (A through N). The letter determines what gets covered, and that coverage is identical across all insurers. The price varies by company and by your age and location, but the benefits do not.
Plan G is the most comprehensive supplement available to people who turned 65 on or after January 1, 2020. For those who turned 65 before that date, Plan F (which covers one additional cost) is still available, but Plan G is the standard choice for newer Medicare enrollees.
Key Takeaways
- Plan G pays the Part B deductible, coinsurance on hospital and doctor visits, and copayments for most services that Medicare covers.
- Plan G does not cover the Part A deductible (hospital deductible), and it does not cover services Medicare itself does not cover.
- You must have both Original Medicare (Parts A and B) and Plan G for the supplement to work; Plan G cannot be used with Medicare Advantage.
- Plan G premiums vary by insurer, age, and location, and they typically increase each year as you age.
- You can switch to a different supplement plan during the annual open enrollment period (October 15 to December 7) or during your initial enrollment window.
What Plan G actually pays for
Plan G covers the Part B deductible — the amount you pay out of pocket before Medicare starts paying for doctor visits and outpatient services. In 2024, that deductible is $240, and Plan G pays it in full.
Plan G pays coinsurance on hospital stays after you have used your hospital benefit days. If you stay in the hospital beyond 60 days in a benefit period, Medicare stops paying and you owe coinsurance. Plan G covers that coinsurance for days 61 through 90, and for an additional 60 "lifetime reserve days" if you need them.
Plan G covers 20% coinsurance on doctor visits, lab work, imaging, and other outpatient services after you have met the Part B deductible. Once Medicare pays its 80%, Plan G pays the remaining 20%.
Plan G covers copayments for skilled nursing facility care after you have stayed in the hospital for at least three days. Medicare covers the first 20 days in full; from day 21 through day 100, you owe a daily copayment. Plan G pays that copayment.
Plan G covers blood transfusions — specifically, the cost of the first three pints of blood you receive in a calendar year. Medicare covers transfusions, but you pay for the first three pints unless a supplement covers them. Plan G does.
What Plan G does not cover
Plan G does not cover the Part A deductible — the amount you owe when you are admitted to the hospital. In 2024, that deductible is $1,632 per benefit period. If you want that covered, you need Plan F (available only if you turned 65 before January 1, 2020) or Plan C or D.
Plan G does not cover services that Original Medicare does not cover. This includes dental work, vision care, hearing aids, and most prescription drugs. If you need those services, you must purchase separate coverage — a dental plan, a vision plan, a hearing aid plan, or a Part D prescription drug plan.
Plan G does not cover excess charges — amounts that some doctors charge above what Medicare allows. If a doctor does not accept Medicare assignment (meaning they do not agree to accept Medicare's approved amount as payment in full), they can charge up to 15% more than Medicare allows. Plan G does not pay that overage. You would owe it yourself.
Plan G does not cover care outside the United States. Medicare covers emergency care in Canada and Mexico under specific conditions, but Plan G does not supplement that coverage. If you travel internationally, you would need a separate travel insurance policy.
How Plan G works with Medicare
When you receive care, the provider bills Medicare first. Medicare determines what it will pay based on the service and your deductible status. The provider then bills Plan G for the portion Medicare did not pay. Plan G pays according to its coverage rules, and you pay any remaining balance.
For example: You see a doctor who accepts Medicare assignment. The visit costs $150. Medicare's approved amount is $100. You have already met your Part B deductible. Medicare pays $80 (80% of $100). Plan G receives a bill for $20 (the remaining 20%). Plan G pays $20. You owe nothing.
If you have not met your Part B deductible yet, the process is different. Medicare would pay $0 until the deductible is met. Plan G would pay the deductible amount up to $240, then Medicare and Plan G would split costs as described above.
You do not submit claims yourself in most cases. The provider handles the billing to Medicare and then to Plan G. You receive an Explanation of Benefits from Medicare and a separate statement from Plan G showing what each paid.
Plan G premiums and how they change
Plan G premiums vary significantly by insurance company, your age, and your location. There is no single "Plan G price." A 65-year-old in one state might pay $120 per month with one insurer and $180 with another. The same person at age 75 will pay more with both insurers.
Most insurers use age-based pricing, meaning your premium increases as you get older. Some use issue-age pricing, where your premium is locked based on your age when you first buy the plan, then increases only for inflation and claims experience — not for your age. A few use attained-age pricing, where your premium increases both for your age and for inflation. Ask the insurer which method they use before you buy.
Premiums also increase when the deductibles or coinsurance amounts set by Medicare increase. If the Part B deductible goes up, Plan G premiums typically rise the following year.
You can shop for Plan G rates every year during the annual open enrollment period (October 15 to December 7). You can switch to a different insurer's Plan G plan without medical underwriting during this window. Outside this window, switching plans may require you to answer health questions, and the new insurer can deny you or charge more based on your health history.
When you can buy Plan G
You have the strongest protection when you buy Plan G during your initial enrollment window — the six-month period that begins the month you turn 65 and enroll in Medicare Part B. During this window, insurers cannot deny you coverage or charge more based on your health. This is called may provide issue.
If you miss this window, you can still buy Plan G, but insurers can require medical underwriting. They may ask about your health history, recent doctor visits, and medications. They can deny you or charge a higher premium based on your answers. Some states have additional protections that limit how much insurers can charge, but not all do.
You can also buy Plan G if you are switching from another supplement plan. If you switch to Plan G from Plan A, B, C, D, F, or another plan during the annual open enrollment period, you do not need to answer health questions. If you switch outside the open enrollment period, you may need to.
Plan G compared to other supplement plans
| Coverage | Plan G | Plan N | Plan A |
|---|---|---|---|
| Part B deductible | Covered | Not covered | Not covered |
| Part A deductible | Not covered | Not covered | Not covered |
| Coinsurance on hospital stays (days 61–90) | Covered | Covered | Covered |
| Coinsurance on doctor visits (20%) | Covered | Covered | Not covered |
| Skilled nursing facility coinsurance | Covered | Covered | Covered |
| Excess charges (above Medicare-approved amount) | Not covered | Not covered | Not covered |
Plan G is more comprehensive than Plan N or Plan A. Plan N has a lower premium but requires you to pay copayments at the doctor's office ($20 for most visits) and coinsurance on some services. Plan A has the lowest premium but does not cover the Part B deductible or coinsurance on doctor visits.
Plan F, available only to those who turned 65 before January 1, 2020, covers everything Plan G covers plus the Part A deductible. If you are may be able to access for Plan F, it is more comprehensive than Plan G, but premiums are typically higher.
Frequently Asked Questions
Can I use Plan G with Medicare Advantage?
No. Plan G is a supplement to Original Medicare only. If you have Medicare Advantage (Part C), you cannot buy a supplement plan. Supplements are designed to fill gaps in Original Medicare, not Advantage plans. If you want to switch from Advantage to Original Medicare with a supplement, you must do so during the annual open enrollment period.
Does Plan G cover prescription drugs?
No. Plan G does not cover prescription medications. You must enroll in a Part D prescription drug plan separately. You can buy Part D from any insurer during the annual open enrollment period or when you first turn 65. If you do not enroll when first may be able to access, you may pay a penalty when you do enroll later.
What happens if I switch from Plan G to a different supplement plan?
You can switch to another supplement plan during the annual open enrollment period (October 15 to December 7) without medical underwriting. Outside this window, the new plan's insurer may require health questions and can deny you or charge more based on your answers. Some states protect you from denial or high charges; check your state's rules before switching.
Does Plan G cover the Part A hospital deductible?
No. Plan G does not cover the Part A deductible, which is $1,632 in 2024. If you want that covered, you would need Plan F (if may be able to access), Plan C, or Plan D. Plan G covers coinsurance on hospital stays after day 60, but not the initial deductible when you are admitted.
Can a doctor refuse to see me if I have Plan G?
No. Doctors cannot refuse to see you because of your insurance. However, some doctors do not accept Medicare assignment, meaning they do not agree to accept Medicare's approved amount as full payment. These doctors can charge up to 15% more than Medicare allows, and Plan G does not cover that overage. You would owe the difference yourself.