Article 9 min

Medigap Plan G Explained: Coverage, Costs, and How It Compares

Medicare Supplement (Medigap) Plan G fills most of Original Medicare’s out-of-pocket “gaps,” covering Part A costs (including the deductible), Part B coinsurance, excess charges, skilled nursing facility coinsurance, the first three pints of blood, hospice coinsurance, and limited foreign travel emergency care. It does not cover the Medicare Part B deductible ($257 in 2025) or items like prescriptions, vision, dental, long-term care, or private-duty nursing. Plan G is widely available and highly comprehensive for new Medicare members, but premiums are typically higher than for alternatives like Plan N or Plan D; some states also offer a high-deductible Plan G option. The ideal time to enroll is during your six-month Medigap open enrollment window when medical underwriting cannot raise your price or deny coverage.

Summary

🙂 What Is Medicare Supplement Plan G?

Medicare Supplement Plan G is one of 10 standardized Medigap plans (lettered A–N in most states) designed to pay eligible costs that Original Medicare (Part A and Part B) leaves for you to cover. For people new to Medicare, Plan G is the highest-coverage Medigap plan available because Plans C and F (which included the Part B deductible) aren’t sold to most beneficiaries who became eligible on or after Jan. 1, 2020. To buy any Medigap plan, you must be enrolled in both Part A and Part B; these policies cannot be sold alongside Medicare Advantage (Part C) unless you are switching back to Original Medicare. For many newcomers, Plan G effectively steps into the role Plan F used to play—maximizing protection against unpredictable hospital and outpatient costs while leaving just the Part B deductible on you each year.

Takeaways:

• Plan G is the most comprehensive Medigap plan that new Medicare members can buy.
• You must have Parts A and B to purchase it; it’s not paired with Medicare Advantage.
• It pays most out-of-pocket costs after Medicare, except the Part B deductible.

Key Terms

• Medigap: Private insurance that helps pay Original Medicare’s cost gaps.
• Original Medicare: Government-run Part A (hospital) and Part B (medical) coverage.
• Part B deductible: The annual amount you pay before Part B starts sharing costs.

⚖️ Pros and Cons of Plan G

Pros. (1) Maximum benefits for new members: Plan G’s benefits are the broadest permitted, including coverage of Part B excess charges—a feature rare among Medigap plans. (2) Wide availability: Most Medigap insurers offer Plan G in their portfolios, making shopping and switching easier. (3) Predictability: By wiping out most variable hospital and outpatient coinsurance, Plan G can help stabilize annual medical costs.

Cons. (1) Premiums are often higher than Plan N or Plan D. (2) Part B excess charges—while covered by Plan G—are uncommon because the vast majority of providers that take Medicare assignment do not bill them. (3) Depending on your usage, lower-premium plans (like N) may deliver similar protection at a lower total cost.

Takeaways:

• Broad coverage and availability make Plan G popular.
• You’ll likely pay more in premiums than for near-equivalents like Plan N.
• Excess-charge protection is nice to have, but it may not matter often.

Key Terms

• Part B excess charge: Allowed extra billing above Medicare’s approved amount (where permitted).
• Medicare assignment: A provider’s agreement to accept Medicare’s approved amount as full payment.

🧾 What Plan G Covers (and What It Doesn’t)

What it covers. Plan G pays the Part A deductible; Part A coinsurance and hospital costs (up to an extra 365 days); hospice coinsurance/copays; Part B coinsurance/copays; Part B excess charges (where allowed); the first three pints of blood; skilled nursing facility coinsurance; and 80% of approved foreign travel emergency care (deductible and limits apply).

What it doesn’t cover. Plan G does not pay the Part B deductible ($257 in 2025). It also does not include outpatient prescription drugs (Part D), routine dental or vision, long-term custodial care, or private-duty nursing. You may add a separate Part D plan for prescriptions and consider stand-alone dental/vision policies if needed.

Takeaways:

• Plan G covers nearly all major Medicare cost gaps except the Part B deductible.
• Foreign travel emergencies are covered at 80% (with limits).
• Routine dental, vision, long-term care, and drugs require separate coverage.

Key Terms

• Part A deductible: Up-front inpatient cost before Medicare pays hospital benefits.
• Skilled nursing facility coinsurance: Your share for extended SNF care under Part A.

💡 Real-World Cost Examples With Plan G

Hospitalization. Without Medigap, a 90-day inpatient stay could mean paying the Part A deductible ($1,676 in 2025) plus daily copays for days 61–90 ($419/day in 2025). That scenario can exceed $14,246 out of pocket under Original Medicare. With Plan G, Medicare-covered hospital costs during that period can drop to $0 beyond your premiums. Even with a hypothetical $250/month premium ($3,000/year), you’d still come out far ahead versus paying those hospital costs yourself.

Outpatient care. Under Part B, you first pay the annual deductible ($257 in 2025). After that, Medicare pays 80% of approved outpatient services and you normally owe 20%. With Plan G, that 20% coinsurance is covered—so once you’ve met the deductible, your Medicare-covered outpatient costs for the rest of the year are typically $0.

Takeaways:

• Plan G can erase large, unpredictable hospital and outpatient bills after the Part B deductible.
• Annual budgeting is easier: premiums + Part B deductible are your primary predictable costs.

Key Terms

• Coinsurance: Your percentage share of costs after Medicare pays its portion.
• Deductible: The amount you pay each year before coverage begins.

💵 How Much Does Plan G Cost?

Premiums vary by age, location, tobacco use, rating method, and insurer. For a 65-year-old female nonsmoker in a city with average pricing (e.g., Atlanta), standard Plan G premiums can range roughly from the low $100s to the $400s per month; your local market could be lower or higher. Some states offer high-deductible Plan G: you pay a larger annual deductible ($2,870 in 2025) before benefits kick in, but monthly premiums may be substantially lower (e.g., ~\$40–\$90/month for similar demographics). Because Plan G benefits are standardized, the cheapest policy delivers the same medical coverage as the most expensive—differences are in price, service, discounts, and rate-increase history.

Takeaways:

• Benefits are identical across insurers; pricing, discounts, and rate history differ.
• High-deductible Plan G trades a bigger deductible for a smaller monthly premium.
• Shop multiple insurers in your ZIP code to compare total value.

Key Terms

• Community/issue/attained-age rating: Methods insurers use to set Medigap premiums.
• High-deductible Plan G: Same benefits after a higher annual deductible is met.

🗓️ The Best Time to Buy: Medigap Open Enrollment

Your one-time, six-month Medigap open enrollment window starts when you are both 65 (or older) and enrolled in Part B. During this period, insurers cannot use your medical history to deny coverage or increase your premium. After it ends, you may face medical underwriting, higher prices, or denial based on health. If you delayed Part B because you had creditable employer coverage, your six-month window begins after that coverage (and active employment) ends. Some states also permit or require insurers to offer Medigap to beneficiaries under 65 with disabilities—check your State Health Insurance Assistance Program (SHIP) for local rules.

Takeaways:

• Buy during your six-month Medigap window for guaranteed issue and best pricing.
• If you’re still working at 65 with creditable coverage, your window starts after that coverage ends.
• State rules vary; SHIP can explain options for under-65 enrollees with disabilities.

Key Terms

• Guaranteed issue: Insurers must sell you a policy at standard rates regardless of health.
• Creditable coverage: Employer/group insurance considered as good as Medicare’s.

🔍 Plan G vs. Plan N vs. Plan F

Plan G vs. Plan N. Plan N typically has lower premiums but includes copays for certain office and emergency department visits and doesn’t cover Part B excess charges. If you expect minimal office/ER use and your providers accept assignment (so excess charges aren’t a factor), Plan N’s lower premium may save money. If you anticipate frequent visits or want excess-charge protection everywhere it’s permitted, Plan G could be more cost-effective.

Plan G vs. Plan F. Plan F covers the Part B deductible; Plan G does not. But Plan F generally isn’t available to people new to Medicare (post-2020 eligibility). Even if you can buy Plan F, compare prices carefully: if Plan F’s extra premium over a year exceeds the Part B deductible ($257 in 2025), Plan G is usually the better financial choice.

Takeaways:

• Plan N: lower premium, some copays, no excess-charge coverage.
• Plan G: higher premium, no routine copays, includes excess-charge coverage.
• Plan F: includes Part B deductible but rarely available to new beneficiaries; may cost more than it saves.

Key Terms

• Copay: A fixed dollar amount you pay at the point of service.
• Compare total cost: Premiums + expected out-of-pocket = real-world value.

🧭 Is Plan G Right for You?

Choose Plan G if you want top-tier protection against Medicare’s cost-sharing and prefer the peace of mind of minimal unpredictable bills. If your budget is tight and your expected care needs are lighter, consider Plan N for a lower premium—especially if your doctors accept Medicare assignment. If you are comfortable trading higher annual risk for lower monthly costs, explore the high-deductible Plan G. No matter your direction, shop several insurers, review rate-increase history, and time your purchase to your open enrollment window for the best outcome.

Takeaways:

• Plan G suits people who value comprehensive coverage and predictability.
• Plan N may fit lighter users comfortable with occasional copays.
• High-deductible Plan G can trim monthly costs if you can handle a larger annual deductible.

Key Terms

• Risk tolerance: Your comfort with paying higher costs if you need care.
• Rate-increase history: An insurer’s track record of premium changes over time.

Conclusion

Medigap Plan G gives new Medicare members the broadest benefits available, covering nearly every major gap in Original Medicare except the Part B deductible. It’s widely offered, straightforward to use, and can dramatically reduce financial surprises from hospital and outpatient care. Balance its higher premiums against your expected usage, consider Plan N or high-deductible G if you want to lower monthly costs, and enroll during your six-month Medigap window to secure the best pricing and guaranteed coverage.