Medicare Plan G is a Medigap policy that covers most of what Original Medicare leaves you paying out of pocket
Medicare Plan G is a supplemental insurance policy sold by private insurers. It works alongside Original Medicare (Parts A and B) to cover costs that Medicare itself does not pay — copayments, coinsurance, and deductibles. Plan G covers nearly everything Original Medicare does not, which is why it is one of the most popular Medigap choices for people who can afford the monthly premium.
When you see a doctor or go to the hospital, Original Medicare pays its share first. Then Plan G pays most of what is left. You are responsible for the monthly premium to the insurance company, and in some cases a small copay at the doctor's office, but the coverage is predictable and broad.
Key Takeaways
- Plan G covers the Part B deductible, copayments, coinsurance, and excess charges that Original Medicare does not pay.
- You must be enrolled in Original Medicare Parts A and B to buy Plan G, and you pay both Medicare premiums and a Plan G premium.
- Plan G does not cover dental, vision, hearing aids, or long-term care — those require separate coverage or out-of-pocket payment.
- You can buy Plan G during your initial enrollment window or during the annual open enrollment period, though insurers can deny you if you wait.
- The monthly premium varies by insurer, age, and location, and can change year to year.
What Plan G actually covers
Plan G covers the Part B deductible — the amount you pay before Original Medicare starts paying. In 2024, that deductible is $240, but it changes each year. Once you meet it, Plan G covers your coinsurance (usually 20 percent of the cost of doctor visits, tests, and outpatient procedures) for the rest of the year.
It also covers excess charges, which are amounts a doctor can bill above what Medicare allows. Not all doctors charge excess amounts, but if yours does, Plan G pays the difference. This protection is especially valuable if you see specialists or live in a high-cost area.
Plan G covers hospital copayments and coinsurance for Part A (hospital stays), skilled nursing facility coinsurance after the first 20 days, and emergency care when you travel outside the United States. It does not cover the Part A deductible — that is one of the few gaps in Plan G coverage.
What Plan G does not cover
Plan G is not a comprehensive plan. It does not cover dental work, eyeglasses, hearing aids, or routine vision exams. If you need these services, you either pay out of pocket or buy a separate policy. Some seniors add a dental discount plan or a standalone vision plan to fill these gaps.
Plan G also does not cover long-term care — nursing home care, assisted living, or home health aides for non-medical reasons. If you think you may need long-term care later, you would need to buy a separate long-term care insurance policy, and the time to do that is before you turn 65 or while you are still in good health.
Prescription drugs are not covered by Plan G. You need Medicare Part D (a prescription drug plan) to cover medications. You can enroll in Part D at the same time you enroll in Plan G, and you should, because waiting can result in a penalty.
How much Plan G costs
The monthly premium for Plan G varies widely depending on which insurance company you choose, your age, and where you live. In some areas, Plan G is the least expensive Medigap option; in others, it is more costly than Plan N or Plan K. You have to compare quotes from multiple insurers in your area to find the best price.
Premiums also increase over time. Some insurers raise rates based on your age (called age-rated plans), others raise rates for everyone in your area equally (community-rated plans), and some use a combination. Ask each insurer how they adjust rates so you understand what to expect in future years.
You pay the Plan G premium on top of your Medicare Part B premium, which is deducted from your Social Security check or paid directly to Medicare. The total out-of-pocket cost for Original Medicare plus Plan G is usually lower than the cost of a Medicare Advantage plan, especially if you have significant medical needs.
When you can enroll in Plan G
The best time to enroll in Plan G is during your initial enrollment window, which is the six-month period that starts the month you turn 65 and enroll in Medicare Part B. During this window, insurers cannot deny you coverage or charge you more based on your health history — a protection called may provide issue.
If you miss this window, you can still buy Plan G during the annual open enrollment period, which runs from October 15 to December 7 each year. Coverage begins January 1. However, outside your initial enrollment window, insurers can ask health questions and may deny you or charge you a higher premium if you have pre-existing conditions.
Some states have additional enrollment windows for people who lose employer coverage or move to a new state. Contact your state's insurance commissioner's office or the State Health Insurance information Program (SHIP) to learn what windows explore to you.
Plan G versus other Medigap options
Medicare offers ten standardized Medigap plans, labeled A through N. Plan G covers more than most other plans — only Plan F covers more, and Plan F is no longer sold to people newly may be able to access for Medicare after 2020. Plan N covers less than Plan G but has a lower premium; it requires small copayments at the doctor's office and does not cover excess charges.
Plan G is different from Medicare Advantage (Part C), which is an alternative to Original Medicare sold by private insurers. Medicare Advantage typically has lower premiums but requires you to use doctors in a network and may have higher copayments. Plan G works with Original Medicare, so you can see any doctor who accepts Medicare anywhere in the country.
| Plan | Part B Deductible | Excess Charges | Typical Premium Range |
|---|---|---|---|
| Plan G | Covered | Covered | Varies by location and insurer |
| Plan N | Covered | Not covered | Usually lower than Plan G |
| Plan F | Covered | Covered | Not available to new enrollees |
Questions to ask your doctor and insurance company
Before you enroll in Plan G, ask your current doctors whether they accept Medicare and whether they charge excess amounts above what Medicare allows. If your doctor charges excess amounts and you see them frequently, Plan G's coverage of those charges could save you thousands of dollars per year.
Ask the insurance company you are considering: How do you adjust premiums each year? Do you use age-rating, community-rating, or both? What is the process if I need to file a claim? Do you have a customer service phone line, and what are the hours? Some insurers are easier to reach than others, and that matters when you have a billing question.
Also ask whether the insurer offers a discount if you pay the annual premium upfront instead of monthly, and whether they offer automatic payment from your bank account. Small discounts add up over time.
Frequently Asked Questions
Do I have to use Plan G doctors, or can I see any doctor?
You can see any doctor in the United States who accepts Medicare. Plan G has no network restrictions. This is one of the main advantages over Medicare Advantage, which limits you to in-network providers in most cases.
What happens if I do not enroll in Plan G during my initial window?
You can still enroll during the annual open enrollment period (October 15 to December 7), but insurers can deny you or charge you more if you have health problems. Some states have additional windows. Contact your State Health Insurance information Program to learn your options.
Can I switch from Plan G to a different Medigap plan later?
Yes, you can switch during the annual open enrollment period, but insurers can deny you or charge more if you have health conditions. Switching is easier if you do it within the first year of enrollment. If you are thinking about switching, talk to your current insurer and the new one about your health history first.
Does Plan G cover the Part A deductible?
No. Plan G covers most costs, but the Part A deductible (the amount you pay for your first hospital stay each year) is one gap. In 2024, the Part A deductible is $1,632, but it changes yearly. This is one reason some people choose Plan F if they can still enroll in it.
What if my income is low — can I get help paying the Plan G premium?
If your income is low, you may be able to get help through your state's Medicaid program or through a program called the Medicare Savings Program. Contact your state Medicaid office or your State Health Insurance information Program to learn whether you may have access to.