Free Guide to Medicare Supplement Plan G Costs

What Medicare Supplement Plan G Is and How It Works

Medicare Supplement Plan G, often called Medigap Plan G, is one of ten standardized insurance plans sold by private insurance companies. These plans work alongside Original Medicare (Parts A and B) to help cover costs that Medicare alone does not pay. Understanding what Plan G covers requires knowing the basics of how Medicare cost-sharing works.

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Original Medicare requires beneficiaries to pay certain amounts out of pocket. For hospital stays, there is a deductible. For doctor visits and other Part B services, there is also a deductible, and beneficiaries typically pay 20 percent of approved amounts after meeting that deductible. Additionally, Original Medicare does not cover certain services at all, such as routine dental care, vision exams, or hearing aids. Plan G is designed to fill many—but not all—of these gaps.

Plan G covers the Part A hospital deductible, which was $1,676 per benefit period in 2024. It also covers coinsurance for hospital stays beyond 60 days and daily copayments for days 61-90 in the hospital. The plan pays the Part B deductible ($240 in 2024) and the 20 percent coinsurance that beneficiaries would otherwise owe for doctor visits, lab work, and imaging. Plan G also covers up to 365 additional days of hospital care after Medicare's coverage ends, though this is rarely used.

One important exception: Plan G does not cover the Part B excess charges. Excess charges are amounts that some doctors charge above what Medicare considers reasonable. If a doctor charges $150 for a service but Medicare's approved amount is $100, the excess charge is $50. Plan G does not pay this $50. In most states, however, relatively few doctors charge excess amounts, so this gap affects fewer beneficiaries.

Practical takeaway: Plan G reduces out-of-pocket costs for deductibles and coinsurance under Original Medicare. Reviewing what Plan G does and does not cover helps determine whether this plan matches a person's healthcare needs and budget.

Monthly Premium Costs and How They Vary

Plan G premiums vary significantly based on several factors, and understanding these variations is essential when considering costs. As of 2024, Plan G premiums across the United States ranged from approximately $90 per month to over $300 per month, depending on where someone lives and which insurance company offers the plan.

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Insurance companies use three main approaches to set premiums: community rating, issue-age rating, and attained-age rating. Community rating means the company charges the same premium to all people in a geographic area, regardless of age. This approach is used in only a few states. Issue-age rating bases the premium on the person's age when they first enroll in the plan. Attained-age rating increases premiums as the person gets older, which is the most common approach. Under attained-age rating, a person who enrolls at age 65 pays less initially than someone who enrolls at age 75, and both will see their premiums increase as they age.

Geographic location is the single largest factor affecting premium costs. Rural areas and smaller states typically have lower premiums than urban areas and larger states. For example, in 2024, Plan G premiums in Mississippi averaged around $120 per month, while premiums in New York averaged closer to $250 per month for the same coverage. This difference reflects the varying costs of healthcare services in different regions and the level of competition among insurers in each state.

The insurance company chosen also affects cost. Multiple insurers typically offer Plan G in any given state, and they price their plans differently. One company might charge $110 monthly while another charges $150 monthly for the same Plan G coverage. This is because insurers base premiums on their own claims experience, operating costs, and business strategies. Shopping among companies in a person's area can result in meaningful savings.

Practical takeaway: Monthly Plan G premiums are not uniform nationally. Comparing costs from multiple insurers in a specific state or county is necessary to understand actual out-of-pocket expenses for this coverage.

When and How to Review Plan G Costs

Plan G can be reviewed during specific times throughout the year. Understanding these timeframes helps people make informed decisions about their coverage and costs without missing important periods.

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The Annual Enrollment Period (AEP) for Medicare Supplement plans runs from October 15 through December 7 each year. During this time, anyone with Medicare can enroll in a new Medigap plan or switch from one plan to another with most insurance companies. Changes made during AEP take effect on January 1 of the following year. This is the standard time when people review their healthcare costs for the year and decide whether their current coverage still meets their needs.

People new to Medicare have a guaranteed issue right for Medigap plans. This means they can enroll in any plan offered in their state during a six-month window that generally begins the month they turn 65 and enroll in Medicare Part B. During this initial enrollment period, insurers cannot deny coverage or charge more based on health conditions. This is the most favorable time to enroll because of these protections.

Outside these windows, enrollment in Plan G depends on state rules and insurer policies. Some states allow enrollment year-round, while others restrict it. Some insurers use medical underwriting, meaning they review health history before approving enrollment. Others do not. The rules vary considerably by state and company, so checking with specific insurers about their enrollment periods is important.

Some people have Medigap coverage through previous employers or unions. These group plans may follow different enrollment rules and deadlines. Reading the plan documents or contacting the plan administrator clarifies the specific enrollment periods and options available.

People should also review their Plan G costs annually even if they do not change plans. Reviewing premium increases, comparing to other insurers' current rates, and assessing whether the plan still fits their healthcare usage patterns helps ensure the coverage remains suitable.

Practical takeaway: Review Plan G options during AEP (October 15 - December 7) each year, or during the initial six-month Medicare enrollment period. Checking costs annually with multiple insurers helps identify whether a plan change might reduce expenses.

Actual Cost Examples and Scenarios

Looking at real-world examples shows how Plan G costs work in practice and how total expenses compare to Original Medicare without supplemental coverage.

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Consider Sarah, age 68, living in Georgia. She enrolls in Plan G with a monthly premium of $145. Over one year, her premium costs equal $1,740. During the year, she visits her primary care doctor four times ($0 cost under Plan G after Medicare pays), sees a cardiologist twice for specialist care ($0 cost for the 20 percent coinsurance that Plan G covers), and has blood work done ($0 cost). She also spends two nights in the hospital for a routine procedure. Under Plan G, she pays her $145 monthly premiums but no deductibles or coinsurance—total out-of-pocket cost is $1,740 for the year.

If Sarah had Original Medicare without Plan G instead, she would have paid $240 for the Part B deductible, then 20 percent coinsurance on all her doctor visits and testing, plus the Part A hospital deductible of $1,676. Assuming the approved amounts for her care totaled $2,000, the 20 percent coinsurance would be $400. Her total out-of-pocket cost without Plan G would be approximately $2,316. The Plan G premium of $1,740 costs less than the $2,316 she would pay without it.

Now consider James, age 70, living in Florida with a Plan G premium of $190 per month. His annual premium is $2,280. During the year, he is generally healthy, makes one annual doctor visit, and has no hospitalizations or complex care. His total out-of-pocket cost is $2,280. Without Plan G, his costs would have been just the Part B deductible of $240 and perhaps $80 in coinsurance for his single doctor visit—total around $320. In this scenario, Plan G cost him significantly more because his healthcare needs were minimal.

These examples illustrate an important principle: Plan G makes sense for people who expect moderate to high healthcare usage, where the supplement premium is offset by reduced deductibles and coinsurance. It may cost more for people with minimal healthcare needs.

Practical take