Medicare Plans in Massachusetts – Preparing for Medicare Enrollment in Massachusetts
If you’re approaching 65 and retirement’s around the corner, you’re likely looking at healthcare options and planning
February 25, 2021
Medicare Supplement Plan G
When looking at Medicare Supplement Plans, some plans are more popular than others. One of the most popular MediGap plans is Medicare Supplement Plan G. If you’re asking why it’s so popular, then you’ve come to the right place.
While Plan F has previously been the most popular of all Medigap plans, Plan G has become the choice for many Medicare beneficiaries who are searching the market for a good supplement for their coverage. Plan G has very similar coverage to Plan F, but at a much lower premium. If you don’t mind paying a deductible, then this Plan will offer you a lot of benefits and savings.
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MediGap Plans: A Simple Review
When you turn 65, you can voluntarily enroll in Medicare. This is a federally-facilitated health insurance program that you have paid into for most of your working life. Original Medicare, also known as Medicare Part A and Medicare Part B, will only cover a portion of your healthcare, but you will be responsible for some of your remaining medical expenses.
Your cost-share under Original Medicare includes, but isn’t limited to, deductibles, coinsurances/copayments, and excess charges. These cost-shares can be considered your “gaps in coverage.”
In our retirement years the last thing we want to do is worry about unexpected medical costs piling up. Luckily, there are plans available that can help to fill in these gaps and give Medicare enrollees peace of mind. Plans that are designed specifically to work with Original Medicare are called Medicare Supplement Plans, or MediGap Plans.
Medicare Supplement Plans
Fortunately for you, the government has standardized these Medigap plans. This will mean that the only difference between each lettered plan is going to be how much you monthly for the premium based on the insurance company you enroll with. Essentially the benefits offered under a Plan N, regardless of insurance carrier, must be identical. CMS mandates each plan’s benefits, and a Plan N cannot offer more benefits or less benefits than another Plan N, just because the insurance carrier is different.
If you are currently covered under Medicare Part A and Medicare Part B, you’re eligible to purchase a Medicare Supplement plan. It is extremely beneficial to apply for a MediGap Plan to begin at the same time as your Medicare Part B, so you are not subjected to limitless out-of-pocket costs. We want all of our insurance coverage to be streamlined.
When it comes to your options for choosing a Medigap plan, there are going to be twelve to consider. They will be labeled as follows: A, B, C, D, F, high-deductible F, G, high-deductible G, K, L, M, and N. In case you were wondering what happened to plans E, H, I, and J, these plans won’t be available to purchase as a supplement to your Medicare. Also, if you turned 65 after January 1st, 2020, you are not eligible to enroll in Plan F, Plan C, or Plan F high-deductible.
What Does Medicare Supplement Plan G Cover?
MediGap Plan G is a Medicare Supplement plan that is designed to work with Original Medicare Part A and Part B to offer full coverage for your hospital and medical costs, while limiting your out-of-pocket. Aside from the Medicare Part B deductible, which is $203 in 2021, Medicare Supplement Plan G covers a significant portion of your Medicare cost-share at an affordable premium.
Here are just a few things MediGap Plan G covers after you’ve met your Part B deductible:
- Medicare Part A deductible for hospitalizations
- Medicare Part A copayments and coinsurance
- Medicare Part B copayments and coinsurance
- Medicare Part B Excess Charges
- Hospice or skilled nursing care
- First 3 pints of blood
- 80% of Foreign travel emergency- up to $50,000
- Medicare Part B preventive care
Benefits Covered | Plan G |
Part A Hospital Coinsurance and 365 Extra Hospital Days | 100% |
Part A Deductible | 100% |
Part B Coinsurance/ Copayments | 100% |
Part B Annual Deductible | |
Part B Excess Charges | 100% |
First 3 Pints of Blood | 100% |
Cost of Foreign Travel Emergency | 80% |
Hospice Care Coinsurance | 100% |
Part B Preventative Care Coinsurance | 100% |
Skilled Nursing Facility Care Coinsurance | 100% |
In short, you will be paying less each month by paying more upfront.
The benefits you will receive with this plan include:
- Coinsurance payments (Medicare Part A) for inpatient hospital care up to an additional year after the Medicare benefits have been used up
- Hospice care coinsurance expenses or copayments for Part A
- Part B excess charges
- Copayment or coinsurance expenses for Medicare Part B
- Skilled nursing facility care coinsurance
- Foreign travel emergency expenses but only up to plan limits
- First three pints of blood used in a medical procedure
- Durable Medical Equipment (DME)
High Deductible Plan G is eligible for anyone who has become eligible for Medicare on or after January 1, 2020. However, if you were eligible for Medicare before January 1, you will only be eligible for the High Deductible Plan F. High Deductible Plan F offers the same benefits, including the coverage for the Part B deductible.
MediGap Plan G Cost-Sharing
One of the best aspects of Medicare Supplement Plan G is the limited out-of-pocket. With MediGap Plan G, you are responsible for the Medicare Part B annual deductible, but that is it! There are no other coinsurances, copayments, or deductibles with this plan. The Part B annual deductible is $198.
Once you have met this deductible, you are fully covered for the rest of the year!
Essentially, you are responsible for the Part B annual deductible before Medicare or your Medicare Supplement Plan G will begin to pay for any item or service. Once you have paid this deductible, there is now an 80/20 split between Medicare and your Medicare Supplement Plan G. As long as Medicare covers a service, your Plan G will as well, and you will have no other out-of-pocket for the rest of the calendar year.
When comparing Medicare Supplement plans, it is important to remember that the only difference between Plan G and Plan F is this annual Part B deductible. Typically, however, the difference in premium for the year is almost always higher than $198, so Plan G is a more cost-efficient plan the majority of times.
Medicare Supplement Plan G vs Plan F Example:
Here is a small example of how Plan G works for your healthcare and covering those gaps in your Medicare coverage.
- Say you buy a Plan G for $125 a month. At this point, you’ll be responsible for covering the Part B deductible of $203. You also pay the $148.50 a month for your standard Part B premium. This will equate to $3,485 for the first year.
- Say you decide to go with Plan F instead. You purchase the Plan at $195 per month. With this plan, you won’t have to pay the deductible for Part B. You still have to pay the premium for Part B at $148.50 a month. For the year, you’ll pay $4,122.
“Plan G is usually a much more cost-efficient plan than Plan F. It is important to weigh both the price and benefits between the two plans.”
Keith Armbrecht
Medicare on Video
Medicare Supplement Plan G Cost
Now that you have seen the benefits of Medicare Supplement Plan G, you are probably wondering-
“How much does Medicare Supplement Plan G cost?”
The premiums for Medicare Supplement plans vary based on three factors: age, gender, and location.
The first aspect in determining your premium cost for a Medicare Supplement plan is your location. Dependent on your state, premiums may be attained-age rated, issue-age rate, or community rated. Visit our Cost of Medicare page for more information on these rating groups.
Premiums can also then vary based on your age of enrollment into the plan, as well as whether you are male or female. Each state, and even city, will have different premiums for Medicare Supplement plans, so it is important to look at plans specifically in your zip code.
Give us a call at 877-88KEITH (53484), an experienced agent will be able to review the premiums in your area for the available Medicare Supplement plan options.
What is Not Covered By MediGap Plan G?
The best way to remember what is covered or not covered by your Medicare Supplement plan is to keep in mind that your Medicare Supplement plan is following Medicare’s lead. What this means is that, if Medicare covers an item or service, so does your MediGap Plan G.
However, if Medicare does not cover a service, neither will your Medicare Supplement Plan G.
Essentially, Medicare Supplement Plan G does not cover things such as routine dental, vision, and hearing, or prescription drugs. Luckily, there are separate stand-alone plans that offer coverage for these services.
Give us a call at 877-88KEITH (53484), an experience agent will be able to review these additional plan options with you.
Medicare Supplement Plan G vs Plan N
As we mentioned earlier, there are some Medicare Supplement plans that are more popular than others. Medicare Supplement plan N often shows up next to Medicare Supplement Plan G as a viable option. It is important to weigh out the differences between these plans in order to decide which is more cost-efficient in the long-run as Medicare Supplement Plan N has more out-of-pocket than Plan G does.
In many areas of the country, the difference in premium between these two plans is less than $25. When this is the case, Plan G is definitely a more viable option, as it offers a higher coverage level with a lower annual out-of-pocket amount when using the plan. With Plan N the enrollee is responsible for things such as copayments and excess charges. With Plan G, those aspects are covered at 100% under the plan benefits.
Plan N is great coverage - but when to buy N instead of G? If it were me - I would buy N if it were at least $25 less in premium than G. If it were only $20 less - I'm buying G!
Keith Armbrecht
Medicare on Video
How to Enroll in Medicare Supplement Plan G
So, you have decided that the coverage level of Plan G is exactly what you need and the premium is affordable. Your next question may be “how do I get a Medicare Supplement Plan G?”
When it comes to enrolling in a Medicare Supplement Plan, you want to line up your enrollment to begin the same month that your Medicare Part B begins.
This way, your coverage is streamlined, and you aren’t left with any gaps in your coverage which can lead to unexpected medical bills. When your Part B begins, you have 6 months to enroll in a Medicare Supplement plan without having to answer any health questions. These 6 months are absolutely crucial if you have any underlying health conditions that may pose a problem for medical underwriting. If you apply after your 6-month window, you will have to answer a list of health questions, provide a list of your prescriptions, and likely complete a telephone interview, giving the insurance company the ability to either approve or deny your coverage at their discretion.
The easiest way to compare the Medicare Supplement Plan Gs available in your area is to contact an independent agent, such as ourselves, to analyze all of the offered plans in your zip code.
Give us a call at 877-88KEITH (53484), an experience agent will be happy to review all of your plan options and answer any additional questions you may have about the plan benefits.
The High Deductible Plan G?
Many people don’t realize that there is a high-deductible version of Medicare Supplement Plan G available. This plan is known as Medicare Supplement Plan G High-deductible. This plan is very similar to a standard Plan G, except it comes with, you guessed it, a high deductible. The deductible on this plan in 2021 is $2,370. With this plan you still pay your annual Part B deductible of $203 upfront before any Medicare coverage begins. From there, you will continue at an 80/20 split with Medicare, leaving you responsible for 20% until you’ve met your deductible of $2370. Once you have met the $2370 for the year, your Plan G high-deductible will then turn into a standard Plan G until the beginning of the next year when the deductible resets.
You may be wondering why someone would choose a plan with such a high deductible? The answer is easy- much lower premiums. In a few states, Medicare Supplement Plan G premiums are higher than they are in most other areas in the country. In states like these, Plan GHD often becomes a viable option to save money on a monthly basis, while still putting a stop to your spending for the year. For some, the lower monthly premiums are an attractive part of this Plan, especially if they’re on a limited budget and can’t afford a higher expense.
Comparing Medicare Supplement Plan G Options
When you are ready to look for a supplemental policy for your Medicare gap, it is important to remember that all of the MediGap plans offered are standardized. This means that every policy is required to follow any Federal or State laws that are made to protect you. All plans are required to offer the exact same core benefits at the same level of coverage, regardless of insurance carrier.
This is definitely a benefit to the consumer, as it gives you the freedom to compare the plans apples to apples.
When it comes to your healthcare, it’s essential to look at each plan available and choose the one that fits your needs and budget. Plan G is an excellent Medigap plan and will provide you with a lot of coverage after meeting the required deductible. Give us a call at 877-88KEITH (53484), an experience agent will be happy to review all of your plan options and answer any additional questions you may have about the plan benefits.
These policies can be challenging to understand at times. Once you get the information you need, you’ll be better able to take charge of your healthcare and enjoy your retirement and golden years. No one wants to deal with piles of hospital bills. Having the right supplement to your Original Medicare will be valuable in lowering your healthcare costs. As you get close to turning 65, start looking into what your Medicare will cover and what supplemental Plan you may need to consider to cover any gaps in your future or current health coverage. Ensure you have the right amount of coverage. That way, you stay protected, and your health concerns can be taken care of without you having to avoid getting help due to the cost.
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