Part G is a Medigap plan that covers costs Medicare Part A and Part B leave unpaid
Part G is a standardized Medigap insurance plan sold by private insurers. It pays some of the out-of-pocket costs that Original Medicare (Part A and Part B) does not cover — things like copayments, coinsurance, and deductibles. Part G is not a separate Medicare plan; it works alongside Original Medicare to reduce what you pay when you receive care.
Medigap plans are standardized by the federal government, which means Part G covers the same benefits no matter which insurance company sells it to you. The price varies by insurer and your location, but the coverage does not. Part G sits in the middle of the Medigap lineup — it covers more than some plans (like Plan A) and less than others (like Plan F or Plan G High Deductible).
You buy Part G from a private insurance company, not from Medicare. You keep your Original Medicare coverage and pay premiums to both Medicare and your Medigap insurer. Part G does not cover prescription drugs; you need a separate Part D plan for that.
Key Takeaways
- Part G covers the Part B deductible, coinsurance for hospital and doctor visits, and skilled nursing facility coinsurance, but not the Part A deductible.
- You must have Original Medicare (Part A and Part B) to buy Part G; it does not work with Medicare Advantage plans.
- Part G premiums vary by insurance company and location, and they typically increase each year.
- You can enroll in Part G during your initial Medicare enrollment period or during the annual Medigap open enrollment period, though some states allow year-round enrollment.
- Part G does not cover prescription drugs, dental, vision, or hearing aids — you need separate plans or out-of-pocket payment for those.
What Part G covers and what it does not
Part G covers the Part B deductible (the amount you pay before Medicare starts paying for doctor visits and outpatient services). It also covers Part B coinsurance, which is typically 20 percent of the cost of doctor visits, lab work, and outpatient procedures after you meet the deductible. Part G pays for skilled nursing facility coinsurance — the daily cost-sharing for days 21 through 100 of a nursing home stay covered by Medicare.
Part G does not cover the Part A deductible, which is the amount you pay for a hospital stay. This is a key difference between Part G and Plan F (the most comprehensive Medigap plan), which does cover the Part A deductible. Part G also does not cover routine dental, vision, hearing aids, or prescription drugs. It does not cover care outside the United States, except in limited circumstances during travel.
Part G covers excess charges — the amount some doctors charge above what Medicare allows — up to the limit set by law. This protection matters if you see doctors who do not accept Medicare's payment as full payment.
How Part G works with Original Medicare
When you receive care covered by Original Medicare, the billing works in stages. Medicare pays its share first. Then Part G pays what Medicare did not cover, up to the limits of the plan. You pay any remaining balance.
For example: you see a doctor for an office visit. The allowed charge is $200. You have not met your Part B deductible yet. Medicare pays nothing. Part G pays the $200 deductible on your behalf. You pay $0. In a second example: you have met your deductible and see the same doctor. The allowed charge is $200. Medicare pays $160 (80 percent). Part G pays $40 (the 20 percent coinsurance). You pay $0.
Part G does not change how you access care. You still use any doctor or hospital that accepts Medicare. You still show your Medicare card. The Medigap plan straightforward reduces your out-of-pocket cost when the bill arrives.
Part G premiums and how they are priced
Part G premiums vary widely depending on which insurance company sells the plan and where you live. The same plan from two different insurers can cost $50 per month from one and $150 per month from another. Your age, gender, and tobacco use also affect the price, depending on the insurer's rating method.
Premiums typically increase each year. Some insurers raise rates because of inflation and claims experience; others raise rates as you age. A few insurers use community rating, which means everyone in your state pays the same premium regardless of age. Most use age-rated or issue-age pricing, which means your premium is based on your age when you enroll and rises as you get older.
You pay your Medigap premium directly to the insurance company, separate from your Medicare Part B premium. Both premiums are usually deducted from your Social Security check if you receive benefits, or you can pay by check or automatic bank transfer.
When you can enroll in Part G
The best time to enroll in Part G is during your initial Medicare enrollment period, which runs from three months before you turn 65 through three months after the month you turn 65. If you enroll during this window, you cannot be denied coverage or charged more because of pre-existing conditions.
If you miss this window, you can still enroll during the annual Medigap open enrollment period, which runs from October 15 through December 7 each year. Coverage begins January 1. Some states allow year-round enrollment, but you may face medical underwriting (questions about your health) and possible denial or higher premiums if you enroll outside the open period.
You can also enroll in Part G if you are leaving a Medicare Advantage plan. If you switch from Medicare Advantage to Original Medicare and Part G within 63 days, you have may provide issue rights — meaning the Medigap insurer cannot deny you or charge more based on health.
Part G versus other Medigap plans
Part G covers more than Plans A, B, C, and D, but less than Plan F. The main difference: Plan F covers the Part A deductible, which Part G does not. Plan F is no longer sold to people new to Medicare after 2020, so most people choosing between plans today are comparing Part G to Plans A, B, D, or N.
Plan A is cheaper but covers fewer costs — it does not cover the Part B deductible or excess charges. Plan N is also lower-cost but requires you to pay a copayment for some doctor visits and emergency room visits. Part G sits between these options: higher premium than Plan A or N, but broader coverage.
The right plan depends on how much you use healthcare and how much premium you can afford. If you see doctors frequently, Part G's broader coverage may save you money overall. If you rarely use healthcare, a cheaper plan like A or N might make sense.
Part G and prescription drug coverage
Part G does not include prescription drug coverage. You must enroll in a separate Part D plan (a prescription drug plan) if you want coverage for medications. Part D plans are sold by private insurers and vary in which drugs they cover and what you pay.
You can enroll in Part D when you first become may be able to access for Medicare or during the annual enrollment period (October 15 through December 7). If you go without Part D coverage when you are first may be able to access, you may pay a penalty when you eventually enroll, unless you have other creditable drug coverage (such as coverage through a current or former employer).
Some people with low income and limited resources may may have access to for the Low-Income Subsidy, which helps pay Part D premiums and out-of-pocket costs. This is a separate program from Part G and requires a separate process through Social Security.
How to compare and choose a Part G plan
Start by getting quotes from multiple insurers. Medicare's official Medigap comparison tool at Medicare.gov lets you enter your state and zip code and see plans and prices from insurers in your area. You can also contact insurers directly or work with an insurance broker who represents multiple companies.
When comparing, look at the premium, the deductible (if any), and whether the insurer uses age-rated or community rating. Check customer service ratings and complaint histories through your state's insurance commissioner's office. Some insurers have better reputations for claims processing and customer service than others.
Remember that the coverage is the same across all insurers — only the price and service quality differ. Choosing the cheapest option saves money now, but poor customer service or slow claims processing can cost you time and frustration later. Read reviews and ask questions before you enroll.
Frequently Asked Questions
Can I switch from Part G to a different Medigap plan later?
Yes, you can switch to another Medigap plan at any time, but the new insurer may require medical underwriting and can deny you or charge more based on your health — unless you switch during the annual open enrollment period (October 15 through December 7) or within 63 days of leaving a Medicare Advantage plan. Switching during open enrollment gives you may provide issue rights.
Does Part G work with Medicare Advantage?
No. Part G is a Medigap plan that only works with Original Medicare (Part A and Part B). If you have a Medicare Advantage plan, you cannot buy Part G. If you want to switch to Part G, you must first disenroll from Medicare Advantage and enroll in Original Medicare.
What happens if I do not enroll in Part G during my initial enrollment period?
You can still enroll later during the annual Medigap open enrollment period (October 15 through December 7), but outside that window, the insurer may ask health questions and can deny you or charge a higher premium. Some states allow year-round enrollment without medical underwriting. Check your state's rules with your state insurance commissioner's office.
Does Part G cover care outside the United States?
Part G includes limited coverage for emergency care outside the United States during travel — typically 80 percent of the cost after you pay a deductible. Routine care abroad is not covered. If you travel internationally frequently, ask your Medigap insurer about the specific terms and consider whether you need additional travel insurance.
Can I have Part G and Part D at the same time?
Yes. Part G covers medical costs; Part D covers prescription drugs. You need both if you want comprehensive coverage for doctor visits and medications. You enroll in them separately, pay separate premiums, and they work together to reduce your out-of-pocket costs.