Plan G is a standardized Medicare supplement that covers most of the costs Medicare Part A and Part B don't pay

Plan G is one of ten standardized Medigap plans sold by private insurance companies. It covers coinsurance, copayments, and deductibles that Original Medicare leaves you responsible for — but it does not cover prescription drugs, dental, vision, or hearing aids. Plan G is the most comprehensive Medigap option available to people who enrolled in Medicare before January 1, 2020. If you enrolled on or after that date, Plan G is not available to you; you would look at Plan N instead.

The key difference between Plan G and other Medigap plans is breadth: it pays for more of your out-of-pocket costs than any other plan except Medigap Plan F, which is closed to new enrollees. You pay a monthly premium to the insurance company selling the plan, and in return, the plan pays its share of covered costs when you use healthcare.

Key Takeaways

  • Plan G covers the Part B deductible, coinsurance for hospital and doctor visits, and skilled nursing facility coinsurance that Original Medicare requires you to pay.
  • You must have both Original Medicare (Part A and Part B) and Plan G at the same time — Plan G supplements Medicare, it does not replace it.
  • Plan G premiums vary by insurance company and your age or location, and they increase over time; you pay the premium even in months you do not use healthcare.
  • Plan G does not cover prescription drugs, dental work, vision care, hearing aids, or long-term care — you need separate coverage for those.
  • If you enrolled in Medicare before January 1, 2020, you can purchase Plan G; if you enrolled after that date, Plan G is not available and you would consider Plan N instead.

What Plan G Actually Covers

Plan G pays for specific out-of-pocket costs that Original Medicare requires. These include the Part B deductible (the amount you pay before Medicare starts covering doctor visits and outpatient services), Part B coinsurance (usually 20 percent of the cost of doctor visits and outpatient care after you meet the deductible), and Part A coinsurance (the daily cost-sharing for hospital stays beyond 60 days). Plan G also covers coinsurance for skilled nursing facility care, blood transfusions, and hospice care copayments.

Plan G does not cover everything. It does not pay for prescription medications — you need Part D coverage for that. It does not cover dental cleanings, fillings, or extractions; vision exams or glasses; hearing aids; or long-term care in a nursing home or assisted living facility. It also does not cover routine foot care, cosmetic surgery, or care received outside the United States.

One important detail: Plan G covers the Part B deductible, but only after you have met it. You still pay the deductible amount out of pocket first, then Plan G reimburses you or pays the insurance company directly, depending on how the claim is processed.

How Plan G Fits With Original Medicare

Plan G is a supplement, not a replacement. You must keep both Original Medicare Part A and Part B active while you have Plan G. When you see a doctor or go to the hospital, Medicare pays its share first, then Plan G pays its share of what Medicare does not cover. You do not file separate claims — the providers and insurers handle the coordination.

This is different from Medicare Advantage (Part C), which is an alternative to Original Medicare run by private insurance companies. With Medicare Advantage, you do not have Original Medicare; the Advantage plan is your primary coverage. Plan G works alongside Original Medicare, not instead of it.

Because Plan G covers so many out-of-pocket costs, your total healthcare spending is more predictable. You know your monthly premium, and most of your other costs are covered. The trade-off is that the monthly premium for Plan G is higher than for less comprehensive plans like Plan N or Plan K.

Plan G Premiums and How They Work

You pay a monthly premium to the insurance company that sells you Plan G. The premium amount depends on which company you choose, your age, your location, and sometimes your health history (though most states limit health underwriting). The same Plan G coverage is identical across all insurance companies — the standardization is set by Medicare — but the price varies significantly.

Premiums increase over time. Insurance companies raise rates annually, and your personal rate may also increase as you age. Some companies use community rating, meaning everyone in your area pays the same premium regardless of age; others use age-based rating, where your premium rises as you get older. A few use issue-age rating, where your rate is locked to your age when you first buy the plan and stays lower than age-based plans, but the company raises it annually for everyone.

You pay the premium every month, whether you use healthcare that month or not. There is no deductible for Plan G itself, but you still pay the Part B deductible before Plan G's coverage kicks in.

Who Can Buy Plan G and When

Plan G is available only to people who enrolled in Medicare Part B before January 1, 2020. If you turned 65 and enrolled in Medicare on or after January 1, 2020, Plan G is not sold to you. This rule was set by federal law to encourage people to choose less comprehensive plans and manage costs.

If you enrolled before January 1, 2020, you can buy Plan G at any time — there is no important date. However, you have a six-month open enrollment period starting the month you turn 65 and enroll in Part B. During this window, insurance companies cannot deny you coverage or charge you more based on your health history. If you buy Plan G outside this window, the insurance company can underwrite your health and may refuse to sell you the plan or charge you a higher premium.

If you enrolled after January 1, 2020, you would look at Plan N instead, which is similar to Plan G but covers fewer costs and has a lower premium.

Plan G Versus Other Medigap Plans

Plan G is the most comprehensive Medigap option for people who can buy it. Plan F was more comprehensive, but it is closed to new enrollees. Plan N covers less than Plan G — it does not cover the Part B deductible, and it charges copayments for some doctor visits and emergency room visits — so Plan N premiums are lower. Plan K and Plan L cover even less and cost less still.

The choice between Plan G and Plan N often comes down to premium cost versus predictability. Plan G has a higher monthly premium but lower out-of-pocket costs when you use healthcare. Plan N has a lower premium but you pay more per visit. If you use healthcare frequently, Plan G may cost less overall. If you rarely see a doctor, Plan N might be cheaper.

Plan G is not the same as Medicare Advantage. Advantage plans are run by private insurance companies and replace Original Medicare entirely. They often have lower premiums but include network restrictions, prior authorization requirements, and different cost-sharing. Advantage plans may cover dental and vision, which Plan G does not. The choice between Medigap and Advantage is separate from the choice between Plan G and other Medigap plans.

How to Get Plan G Information and Compare Options

Insurance companies that sell Plan G in your state are listed on Medicare.gov. You can search by state and see which companies offer Plan G and what their current premiums are. Premiums change frequently, so checking multiple companies is worth your time — the difference between the cheapest and most expensive Plan G can be hundreds of dollars per year.

You can also call 1-800-MEDICARE to ask which companies sell Plan G in your area and to request printed materials. Some states have health insurance counseling programs (often called SHIP or HICAP) that offer free, one-on-one help comparing plans and understanding your options. These programs are run by your state and are not affiliated with any insurance company.

When you compare plans, look at the monthly premium, any annual increases the company has made in the past, and whether the company uses community rating, age-based rating, or issue-age rating. Read the plan documents carefully to confirm what is covered, because even though all Plan G plans are standardized, the details of how claims are processed can vary slightly by company.

Frequently Asked Questions

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

Yes, you can switch to another Medigap plan at any time, but the new insurance company can underwrite your health and may deny you coverage or charge you more if you have pre-existing conditions. Your best protection is to switch during your six-month open enrollment period after you first enroll in Part B, or during your state's annual Medigap open enrollment window if your state has one.

Does Plan G cover my prescription drugs?

No. Plan G does not cover prescription medications. You need to enroll in Medicare Part D (prescription drug coverage) separately. Part D is sold by private insurance companies and covers both brand-name and generic drugs. You can enroll in Part D when you first enroll in Medicare or during the annual open enrollment period.

What happens if I do not have Plan G and I use healthcare?

Without Plan G or another Medigap plan, you pay the out-of-pocket costs that Original Medicare does not cover. This includes the Part B deductible, coinsurance for doctor visits, and hospital coinsurance. These costs can add up quickly if you have a serious illness or injury. That is why most people with Original Medicare buy a Medigap plan.

Can I have Plan G and Medicare Advantage at the same time?

No. If you enroll in Medicare Advantage, your Original Medicare coverage ends, so Plan G no longer works. You can have Advantage and a separate prescription drug plan, but not Medigap. If you switch from Advantage back to Original Medicare, you can buy Plan G again, but you may face health underwriting unless you switch during an open enrollment period.

Will my Plan G premium go down when I turn a certain age?

No. Medigap premiums do not decrease with age. They stay the same or increase over time, depending on the rating method the insurance company uses. If your company uses age-based rating, your premium will increase as you age. If it uses issue-age rating, your rate was locked when you first bought the plan, but the company still raises it annually for inflation and claims costs.