Facts about Medicare Part G

Medicare supplements can only be used to cover initial Medicare costs, and cannot be used in a Medicare Advantage plan.

Some states do not offer Medigap policies for people over 65 and for Medicare with a disability, and there are certain restrictions on who is eligible for Medicare. If you buy a Medicare supplemental plan, you can sign up and stay in the original Medicare plan for the rest of your life, but you can’t enroll in Medicare Advantage plans or Medicare Part G plans. Some states, such as California, New York, Massachusetts, and New Jersey, call a Medi-Cal policy “Medicare Advantage Plan” or “Medi-G Plan,” and some states do not offer it to people under 65 or under Medicare disability. A Medigap policy offers several advantages that allow you to choose the one that best suits your needs.

About two-thirds of Medicare beneficiaries are enrolled in traditional Medicare health insurance, but most also have some form of additional health insurance, because Medicare’s benefit concept involves significant costs – sharing requirements to limit pocket spending. Private supplemental insurance, known as Medigap in 2015, has the advantage of helping you spend and limiting you to catastrophic Medicare costs – covered services such as dental, vision and mental health care. They can choose to receive their Medicare benefits in Part A or B, or in Medicare Part G.

If Medicare is your primary source of coverage, you may be limited to a specific network of doctors and hospitals. You can see a doctor or a hospital that accepts Medicare, but not all. For people who rely on traditional Medicare benefits that do not have union-sponsored coverage for retirees, Medigap could be an important source of additional coverage if their costs are too high to qualify.

Medicare Part G can help you cover Medicare expenses such as deductibles, co-payments, co-pay and other medical expenses. Plan F provides full coverage for patients, with the remaining costs not covered by Medicare being paid for. B covers all costs of Medicare, as well as the cost of prescription drugs, hospital visits, medical care, home care and more.

Medicare Supplement in Plan F helps policyholders pay out-of-pocket costs that traditional Medicare will not cover. Medicare supplement plans, also known as Medigap or MediSupp, offer optional coverage to supplement full coverage of Medicare, such as deductibles, copayments, co-pay and other medical expenses. The Medicare supplement in Plan G may have higher premiums than those that offer less coverage, but it covers all the costs of prescription drugs, hospital visits, medical care, home care, and more.

You may be eligible for Medicare in 2020 or later, but you may have to look for another option. You can behave as if you were eligible for Plan G for the first two years of Medicare Part G coverage, and then you won’t be eligible.

Forbes.com reports, according to AHIP, in 2016, 55% of those with Medigap policies had Plan F or its high-deductible version.

Plan G is one notch down from that. It covers eight of the nine benefits. The individual is responsible for the Part B deductible, which is $185 in 2019. Once the individual has paid the first $185 for outpatient services, the plan will cover the Medicare costs for the remainder of the year, according to Forbes.com. 

Medicare Supplement Plan G offers the basic benefits that Plan F offers with a deductible in Part B. The benefits of Medigap insurance with Plan G are the same as with Medigap Plan C and Plan D, with one exception.

The majority of Medicare supplement insurance plans do not cover Part B deductibles, so you must pay out-of-pocket for Part B Medicare deductibles covered by Medigap Plans C and F with Medigap Plan G. If your out-of-pocket expenses reach the Part B deductible, you are eligible to pay for Medicare-approved benefits under Plan G, such as prescription drugs.

Many Medicare Advantage plans include Part D drug insurance, and you can supplement that coverage. You can also purchase a standalone policy to choose from a Medicare Advantage plan that does not include regular or traditional Medicare, which includes Medicare Part B, Medicare D or Medicare C, and Medicare G.

When you sign up for Medicare, you get Parts A and B, but you need to take action yourself to purchase an additional policy. As a couple, each spouse must purchase their own policy and pay the Medigap premium in addition to the Medicare Part B premium.

About one-third of Medicare beneficiaries participate in an all-inclusive Medicare Advantage plan, which offers additional benefits through the use of a network-based health care provider.

You can switch from the original Medicare to Medicare Advantage at any time, but you may not be able to get the Medigap plan of your choice and may have to pay more because of your health. Your customer who originally opted for Medicare can later switch to a lower-cost Medicare Advantage plan. Only after you have selected a Medicare benefit plan will your customer choose a supplemental Medigap plan. You cannot switch back to original Medicare if you have chosen an original prescription drug plan or a non-Medicare plan, and at no point can you opt out of original Medicaid for Medicare Advantage.

There are also some circumstances in which you have special enrollment rights that allow you to switch from the original Medicare to Medicare Advantage. If you are already enrolled in a Medicare Advantage plan, you can cancel it and enroll in an original Medicare Part D plan. There are exceptions, but if you leave Medicare Advantage after you switch to Original Medicaid for Medicare Advantage or Medicare Supplemental Insurance (Medigap), you are not entitled to receive the same benefits as under Original Medicaid or Original Prescription Drug Plans, although there are some exceptions.