Exploring Medicare Part G Coverage and Cost

Medicare Part G is a supplemental Medigap plan that adds coverage to base Medicare. Learn more about the benefits and buying Medicare Part G.

Medicare provides some of the best insurance coverage available. There are multiple Medicare plans available, each designed to provide coverage in a different area. Even if you invest in multiple parts of Medicare, there are still some gaps in the coverage. Fortunately, there are additional plans you can purchase, informally known as Medigap policies, which either cover areas not in the original Medicare plan, or expand on the coverage to provide better options. Like the base plan, there are multiple types of Medigap policies available. One of the newest plans Medigap policies is Part G.

Medicare Part G was built to replace Part F, which was phased out in 2020. Part F was previously the most popular Medigap plans, so since it was phased out, the majority of beneficiaries switched to Part G. Medicare Part G is accepted within any health network that accepts original Medicare coverage. Part G also provides limited coverage for overseas travel.

Medicare Part G Coverage

One of the complaints with Medicare ever since it was introduced was the complexity of the plan. Beneficiaries often struggled with the application process because they were unsure which parts they needed for coverage, with most proffering a single plan instead of multiple parts. Over the years, attempts were made to simplify the plans, mostly by consolidating the coverage into singular plans.

Because it is a supplemental plan, Medicare Part G builds off of existing coverage. It provides much better coverage than other Medigap plans, and was designed to simplify the process so you do not need multiple Medigap policies. Part G provides pays for all coinsurance and hospital costs after your original Medicare Part A benefits are used up. Unlike Part A, this coverage does not have any limits and lasts for the entire year. Once the year is over, your Medicare Part A benefits refresh and must be used again before you can activate your Part G coverage.

Medicare Part G also covers all of the costs of your Part A deductible and any hospice costs. You can also use your Part G plan to get your Part B coinsurance and copayments, but not deductible. Unrelated to the previous Medicare plans, you can also apply Part G coverage for coinsurance payments relating to skilled nursing facilities and blood tests, up to three pints. You can also use Part G coverage on oversea medical emergencies, up to 80 percent of the total cost.

Differences from Base Medicare Plans

Another point of confusion regarding Medicare is who provides coverage. As of writing, there are 10 different Medicare plans, but not all of the coverage comes from the government. Many Medicare policies, including Part G and other Medigap plans, are sold by private insurance companies. However, these insurance plans are regulated by both federal and state laws. These stricter requirements limit what changes private insurers are able to make, ensuring their beneficiaries receive affordable and fair coverage no matter where they live.

Applying for Medicare Part G

Medicare has multiple enrollment periods. When you first turn 65, you are first eligible to apply for Medicare coverage, no matter what time of the year. After your first year, you must apply during the Medicare open enrollment period. As of writing, open enrollment starts on October 15th and ends December 7th. There is a general enrollment period starting on January 1st and lasts until March 31st. After this period, it becomes harder to purchase Part G. Some private insurers will still sell plans, but charge more because you are outside the normal enrollment period. If you meet the general eligibility requirements for original Medicare, you will qualify for Part G.

Purchasing Medicare Part G

If you want to purchase Medicare Part G, you must have original Medicare, which consists of Part A and B. You cannot have both a Medicare Advantage plan and Medicare Part G. Other Medigap policies are compatible with Part G, but you must pay a monthly premium for each additional plan, as well as your base Medicare coverage.

The overall cost of a Part G plan varies depending on your insurance provider. If you are looking for a new plan, you are strongly encouraged to shop around to find the best price. Based on reports from 2020, the cost of Plan G varies between $99 to $500 per month. This is largely based on your total income, medical needs and location. While there are some states where Part G is more expensive, the average cost is typically underneath $200.

Humana

Humana is one of the largest insurance providers for Part G coverage. They also provide additional dental and vision coverage, which is not normally provided in Medicare. The company provides high-deductible insurance plans in nearly every state, except Missouri. Their website is detailed, fully explaining all the coverage, costs and application processes. Once you are a member, you gain access to the MyHumana app, which contains all your insurance information. Members also get access to a 24/7 nursing line, which provides answers to common medical questions.

AARP United Healthcare

AARP uses community-rating pricing, which means all insurance plans share the same price. The cost varies based on your state, but often leads to less expensive plans compared to other providers. It is also convenient since you do not have to wait for a quote to learn the insurance cost. AARP also offers several discounts to seniors, further reducing the cost of Part G coverage. In order to get coverage, you must sign up for an AARP membership, which carries additional fees.

Aetna

Another Part G provider is Aetna. Aetna shares many of the strengths of Humana. They provide a 24/7 help line, and also have options for dental and vision, as well as prescription plans. You can view the cost of plans online, but you must apply either in-person or over the phone for coverage. One of the strengths of Aetna comes from the home membership plan. If you and someone else in your home both purchase a plan, you receive a discount of up to 14 percent.