Medicare Plan G is a Medigap policy that covers most of what Medicare Part A and Part B don't pay

Medicare Plan G is a standardized Medigap insurance policy sold by private insurers. It pays for many of the costs that Original Medicare leaves you responsible for — copayments, coinsurance, and deductibles. Plan G does not cover prescription drugs; that requires a separate Part D plan.

Plan G became the most popular Medigap choice for people who turned 65 on or after January 1, 2020, because it covers the Part B deductible that Plan F no longer covers for that group. If you enrolled in Medicare before that date, Plan F may still be available to you and covers slightly more, but Plan G is the standard choice for newer enrollees.

The monthly premium you pay to the insurance company varies by age, location, and the insurer you choose. The coverage itself is standardized — Plan G sold by one company covers exactly the same things as Plan G sold by another — but the price does not.

Key Takeaways

  • Plan G covers the Part B deductible, copayments for hospital stays and doctor visits, coinsurance for Part B services, and the cost of a second medical opinion before surgery.
  • Plan G does not cover prescription drugs, dental, vision, hearing aids, or long-term care — you need separate coverage or out-of-pocket payment for those.
  • You must have both Medicare Part A and Part B to buy Plan G, and you pay the Medigap premium on top of your Medicare Part B premium.
  • The price of Plan G varies by insurer and your age, but the coverage is identical across all insurers because Medigap plans are standardized by federal law.
  • You can switch to a different Plan G insurer or to a different Medigap plan during the annual open enrollment period or within 63 days of turning 65 or losing other coverage.

What Plan G actually covers

Plan G covers the Part B deductible — the amount you pay out of pocket before Medicare Part B starts paying. For 2024, that deductible is $240, though it changes each year.

It also covers coinsurance for Part B services. After you meet the deductible, Medicare Part B typically pays 80 percent of the cost of doctor visits, lab work, imaging, and outpatient procedures. Plan G pays the remaining 20 percent coinsurance. This continues for the rest of the calendar year, with no upper limit — Plan G has no out-of-pocket maximum.

For hospital stays covered by Medicare Part A, Plan G covers the Part A deductible (the amount you owe for the first hospital admission each year) and coinsurance for days 61 through 90 of a hospital stay. If you stay longer than 90 days, you have 60 additional "lifetime reserve days" that Medicare covers; Plan G pays your coinsurance for those as well.

Plan G also covers the cost of a second surgical opinion if Medicare covers the first one, and it covers emergency care outside the United States during the first 60 days of a trip, after you meet a small deductible.

What Plan G does not cover

Plan G does not cover prescription medications. You need a separate Medicare Part D plan for that, which you buy from a private insurer during the annual enrollment period.

Dental, vision, and hearing are not covered by any Medigap plan, including Plan G. Some Medicare Advantage plans (Part C) include dental or vision benefits, but Original Medicare with Plan G does not. If you need these services, you either pay out of pocket or purchase separate dental and vision insurance.

Plan G also does not cover long-term care, nursing home care, home care, or adult day care. These require separate long-term care insurance or out-of-pocket payment. Plan G covers only the hospital and doctor costs that Medicare Part A and Part B are designed to cover.

How much Plan G costs and what affects the price

The monthly premium for Plan G varies based on three main factors: your age, your location (state and sometimes county), and which insurance company you choose. There is no federal cap on Medigap premiums, so prices can differ significantly between insurers in the same area.

Most insurers use one of three pricing methods: attained age (your premium rises as you get older), issue age (your premium is based on your age when you first buy the plan and rises more slowly), or no-age (everyone pays the same regardless of age). Issue-age pricing is often the cheapest at the start but may cost more over time; attained-age pricing typically starts lower but increases faster each year.

You pay the Plan G premium directly to the insurance company each month, separate from your Medicare Part B premium. This means your total monthly cost is your Part B premium plus your Plan G premium plus any Part D premium if you have one.

Who can buy Plan G and when

You must have both Medicare Part A and Part B to buy Plan G. You cannot have it if you are on Medicare Advantage (Part C) instead of Original Medicare.

The best time to buy Plan G is within 63 days of turning 65 or within 63 days of losing other health coverage. During this window, insurers cannot deny you or charge you more based on your health history — this is called may provide issue. If you wait longer, insurers can charge you more or refuse to sell you the plan based on pre-existing conditions.

If you already have a Medigap plan, you can switch to Plan G during the annual open enrollment period (October 15 through December 7 each year), though you may face medical underwriting if you are switching to a plan that covers more than your current plan.

How Plan G compares to other Medigap plans

Plan G is one of ten standardized Medigap plans (A, B, C, D, F, G, K, L, M, N). The main difference between them is what they cover. Plan F covers slightly more than Plan G — it covers the Part B deductible — but Plan F is no longer sold to people who turned 65 on or after January 1, 2020.

Plan N is cheaper than Plan G but covers less: it does not cover the Part B deductible, and it charges a copayment for doctor visits and emergency room visits. Plan N is a reasonable choice if you want to lower your monthly premium and are willing to pay more when you use services.

Plan A is the cheapest Medigap option but covers the least. It covers only the Part A deductible and coinsurance, plus some hospital costs. It does not cover the Part B deductible or coinsurance, so you pay 20 percent of most doctor and lab costs out of pocket.

If you are considering Medicare Advantage (Part C) instead, you get different coverage: lower or zero premiums, but you must use in-network doctors, you have copayments for each visit, and you have an annual out-of-pocket maximum. Medigap plans like Plan G have no network restrictions and no out-of-pocket maximum, but higher monthly premiums.

How to compare Plan G prices and switch insurers

Because Plan G is standardized, the coverage is identical no matter which company you buy from. The only reason to choose one insurer over another is price and customer service. You can compare quotes by contacting insurers directly or using online comparison tools, though you will need to provide your age, location, and tobacco use status.

If you already have Plan G with one insurer and want to switch to a cheaper one, you can do so during the annual open enrollment period without medical underwriting. Outside that window, the new insurer may require you to answer health questions and can deny you or charge you more based on your answers.

When you switch, make sure the new coverage starts before the old one ends, so you have no gap. Contact the new insurer to confirm the start date, then notify the old insurer that you are canceling.

Frequently Asked Questions

Do I have to buy Plan G, or can I just use Original Medicare without it?

You can use Original Medicare without any Medigap plan, but you will pay 20 percent coinsurance for most doctor and lab services, plus deductibles and copayments for hospital stays. Plan G reduces these costs significantly, though you pay a monthly premium for it. Whether it makes financial sense depends on how much medical care you use and the premium price in your area.

Can I use Plan G with Medicare Advantage instead of Original Medicare?

No. Medigap plans, including Plan G, work only with Original Medicare (Part A and Part B). If you have Medicare Advantage (Part C), you cannot buy a Medigap plan. You would need to switch back to Original Medicare first, which you can do during the annual open enrollment period.

Does Plan G cover my prescriptions?

No. Plan G covers hospital and doctor costs, not medications. You need a separate Medicare Part D prescription drug plan, which you buy from a private insurer. You can enroll in Part D when you first turn 65 or during the annual open enrollment period.

What happens if I buy Plan G after the 63-day window following my 65th birthday?

You can still buy Plan G, but the insurer may require medical underwriting. They can deny you, charge you a higher premium, or exclude coverage for pre-existing conditions. Some states have additional protections, but may provide issue is not automatic. It is best to buy within the 63-day window if possible.

Can I switch from Plan G to a different Medigap plan?

Yes, during the annual open enrollment period (October 15 through December 7) you can switch to any other Medigap plan without medical underwriting. Outside that window, the new plan's insurer may require health questions and can deny you or charge more based on your answers. Switching to a plan that covers less may be easier than switching to one that covers more.