Medicare is a federal health insurance program that is available to seniors and those who are disabled and helps them manage their healthcare costs. It is also confusing, with multiple parts and plans available that all cover different things. Plan G is one example of a Medicare Supplement (or Medigap plan). To understand what it does, it’s important to understand how Medicare in general works.
Basic Medicare is made up of Part A, which covers the costs of inpatient hospital stays, Part B, which covers the costs of doctor visits and outpatient hospital treatments, and Part D, which covers prescription costs. Each of these plans leave patients with a certain amount of copay and coinsurance to pay on their own. There are also deductibles, coverage gaps, and donut holes during which costs go up; sometimes patients must pay 100% of the bill on their own.
Medigap plans help to pay for some of those costs. Part G, one of these Medigap or Medicare Supplement programs, helps to pay certain costs, although its coverage is not as complete as Plan F. Part G covers:
- Hospitalization benefits, including the Part A coinsurance. Medicare Supplement Plan G also pays for an additional 365 days of hospitalization after Part A no longer pays.
- Medical expenses, such as the Part B coinsurance and co-pays for doctor visits and outpatient hospital treatments.
- Part A deductibles, Part B excess charges (the difference between what your doctor charges and what Medicare pays) and skilled facility nursing care.
Essentially, Medigap Plan G covers all of the medical benefits that Plan F does, but Plan F also pays for the Medicare Part B premium.
Determining which Medicare Supplement plan – if any – is right for a particular person is a very personal process. All of the Medigap plans have a monthly premium. Some people would prefer to pay each month and know that their healthcare costs are covered; others are comfortable with the idea of needing to pay more for individual visits or appointments, but not needing that extra monthly overhead. Each person must decide what is the best solution for them.
There is an initial open enrollment period for Medicare Supplement programs that activates at the same time as someone becoming eligible for Medicare. At this time, people can sign up for a Medigap plan without their health needing to be examined. After that open enrollment, however, it is possible to change plans, but a person’s health will be considered. Based on health risks, they may be charged a higher premium or denied coverage entirely.
If the decision is that Medicare Supplement (Medigap) Plan G will be beneficial, however, participants should know that each company that offers Plan G provides the same benefits, due to rules from the Federal government. Beneficiaries are therefore free to choose a plan from an insurance company they trust. Contact us today, and our Medicare agents can help you pick the best option for your needs.