Have you heard of Plan G before?
If you’re on Original Medicare A & B and don’t have Medigap Plan G (or Plan N), you’re likely either overpaying or underinsured. Let’s look at why Plan G is the sweet spot when it comes to Medicare plans…
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How it Works
Plan G is a Medigap Plan, also known as a Medicare Supplement. With any Medigap Plan, you have Original Medicare as your primary insurance. So as long as the healthcare provider you go to takes Medicare, they take whatever Medigap insurance you have, it doesn’t matter which insurance company provides it, or what plan you have.
You can see Plan G highlighted in the chart below.
The only thing that’s missing in Plan G’s coverage is the $183 Medicare Part B deductible. So, as long as you see a healthcare provider who accepts Medicare, and whatever test, treatment, procedure, etc. you have done is “medically necessary”, then the most you’ll have to pay for the entire year in out-of-pocket expenses is $183. Medicare and your Plan G will pay the rest.
Another exception to this rule is if you’re treated outside of the U.S. Original Medicare does not cover you outside of the country (except in rare cases), so your Plan G is covering 80% of your expenses. However, before Plan G pays, you do need to meet a $250 deductible first. Also, any Medigap plan you have will have a lifetime benefit maximum of $50,000.
Also, keep in mind, Medigap plans sold after 2005, like Plan G, don’t cover prescription drugs anymore.
But what makes Plan G so special?
Plan G Doesn’t Have Plan F’s Problems
You can read here about the 3 reasons Plan F is too expensive. Plan G doesn’t have any of these 3 issues. This results in a lower amount of claims per Plan G member, which keeps the premiums low as well.
Let’s take a look at a few examples at how Plan G rates stack up to Plan F.
So, looking at the 75080 zip code example, the monthly savings is $28.34/mo. or $340.08 for the year. Since the most you're responsible for paying is a $183 annual deductible, there's a minimum annual savings of just over $157.
Plan G Doesn’t Have Copays
Plan N is another wonderful Medigap plan, but it’s the only Medigap plan that has copays for some office visits and trips to the emergency room. If you don’t want to deal with the hassle or expense of doctor’s office or ER copays, Plan G is the way to go.
Plan G Covers Excess Charges
Now this isn’t going to be a problem you’ll come across very often, but sometimes healthcare providers don’t accept Medicare’s billing amount (assignment) for your tests, treatment, procedure, etc. If this is ever the case, Plan G will pick up these additional “excess” charges, but a plan like Plan N won’t. So if you like having a fixed potential out-of-pocket expense each year ($183 in 2017), rather than any potential copays or excess charges, Plan G is what you want.
Plan G is the sweet spot when it comes to keeping your both your premiums and your out-of-pocket expenses low on your Medigap plan. Have a Plan F now? Give me a call at 866-240-8639 or send me an email at email@example.com to see how much you can save with Plan G.
Just getting on Medicare Part B for the first time? Get on Plan G to start with and keep your costs as low as possible for years to come.