Medicare Supplement Plan G Review

In this article, I’m going to give you five reasons why Medicare Supplement Plan G is my favorite plan.

• #1.  No prior authorizations
• #2.  No referrals
• #3.  No networks
• #4.  No benefit changes
• #5.  No disputes with CMS or the federal government

I’ll break down what these five things mean and how they affect you as a Medicare beneficiary.

I’m Mark Prip. I’ve been a licensed agent since 2003, exclusively working with folks to select the right Medicare plan. I want to give you some highlights and reviews on Medicare Supplement Plan G – and why I think it is one of the best plans.

Talking points:

I’ll discuss coverage, cost, Plan G vs. Plan N, and Plan G vs. a Medicare Advantage plan.

I’ll also provide review data on customer satisfaction for those currently on Plan G.

Let’s jump right in.

General Review

Plan G offers extensive coverage and the freedom to choose any network provider. Plan G is the most popular Medigap plan today, with over 3.5 million people enrolled.

One key feature of Plan G is that its benefits are consistent year after year. Plan G is standardized, which means any insurance company offering it is required to offer the same Plan G benefits.

There are no network limitations or referrals, and it boasts lower premiums than Plan F. It’s offered by over 90% of Medigap providers in the country. Your Plan G policy is guaranteed for life as long as you pay your premiums on time.

Benefits of Medicare Supplement Plan G

Let’s look at the benefits and see what this plan entails in terms of your responsibility vs. the cost covered by Original Medicare.

Right out of the gate, you, as the member, experience a $0 copay for anything associated with Medicare Part A. When it comes to Medicare Part B, it covers 100% after you pay a $240 annual deductible.

Coverage includes:

• Outpatient testing
• Doctor office visits
• Part A hospice care coinsurance (or copayment) 
• Hospitalization
• Skilled nursing facility care for up to the first 100 days
• An extra 365 days of hospital care after the Original Medicare lifetime reserves have been used

There is also a foreign travel emergency benefit. Beneficiaries receive 80% coverage for emergency care outside of the United States or its territories. Plan G has a lifetime maximum of $50,000 for foreign travel emergency care after a $250 deductible.

How Much Does Medigap Plan G Cost?

 In 2024, the average monthly cost of Plan G is between $110 and $180. However, the monthly premium for Plan G can vary depending on your state, age, gender, and tobacco use.

I recommend you consider these factors and compare rates among different insurance companies so you can find the most affordable, suitable Plan G coverage. 

This chart gives you an idea of Plan G premiums from various Medigap providers in several states:

Medigap Provider	Alabama	Georgia	Texas	Florida	Pennsylvania
Cigna	$138.14	$147.85	$134.67	$169.76	$123.83
ACE	$116.08	$128.17	$108.58	$177.75	$106.58
Mutual of Omaha	$191.70	$176.29	$138.01	$176.43	$140.58
Aflac	$133.08	$152.45	$131.76	$187.24	$121.87
Allstate	$143.68	$125.15	$110.92	$191.23	$105.95
Aetna	$169.02	$150.52	$162.27	$224.74	$135.20
Plan G sample quotes are for a 65 y/o nonsmoking female.

What Does Plan G Not Cover?

As I mentioned before, Plan G does not cover the Part B deductible. You’ll be responsible for the first $240 of outpatient care per calendar year. Plan G will cover Part B excess charges.

It does not cover pharmacy or RX benefits, so you would need to consider enrolling in a separate prescription drug (Part D) plan.

Plan G vs. Plan N

Plan N is definitely the second most popular plan compared to Plan G, so they are very similar.

Medigap Plan G offers coverage for Part B excess charges, while Medigap Plan N does not. Plan N requires you to pay copays or coinsurance for certain services, such as doctor and emergency room visits, while Plan G covers 100% of these areas.

So let me jump back to the excess charges. That means that a doctor is allowed to charge upwards of 15% above the Medicare allowance. When you’re on Plan G, it will pay that for you.

If you’re on Plan N, those excess charges for Part B would not be covered. Those would be your responsibility.

Plan G vs. Medicare Advantage

This is probably the most important part of this page that I want you to pay really close attention to because, as I’m sure you’re fully aware, the two most common avenues for folks on Medicare are a Medicare Supplement (usually Plan G) or a Medicare Advantage plan. The two operate very, very differently.

So let’s start with Medigap. 

Probably the single most important factor is that Medigap Plan G does not require prior authorizations.

• Prior Authorizations
  • When you’re taken to the hospital, a prior authorization means the insurance company has to be notified about the recommended procedure by the facility, doctor, or hospital. The Medicare Advantage company can then deny or approve that prior authorization request.

I’ll point out that in a 2021 Kaiser Family Foundation study, over 35 million Medicare Advantage prior authorization requests were processed, and over 11 million were denied.

Consider it this way:

• You’re experiencing chest pain. You go to the emergency room.  They’re going to run you through a stress test, some lab work, and then maybe do a heart catheterization.
• For every one of those steps, the Medicare Advantage plan could require prior authorization, meaning they won’t go through with the procedure until that prior authorization is approved – it could be minutes, hours or days.
• Medigap plans (no matter which Medigap plan you have) have no prior authorizations.  That means your care can continue quickly, without any middlemen deciding whether that procedure is approved or not.

The next big thing is Medigap Plan G does not require referrals.

You do not have referrals, nor do you have to work inside of networks like an HMO or a PPO. You have the freedom to go wherever you want. As long as Original Medicare is accepted, any Medicare Supplement plan, including Plan G, is then automatically accepted by that provider.

No benefit changes. With Medicare Advantage plans, there’s potential that those change every calendar year. Maybe your copays will go up. Maybe your pharmacy list changes. Maybe your premium goes up, or maybe you had a plan without a premium, and now it has a premium.

• Important:

  Medicare Advantage has a greater potential for plan and benefit changes. Once enrolled in Medigap Plan G – whatever your benefits are – they’re locked in and stay the same year after year.

And last on my list is no CMS disputes.

Because CMS, or the federal government, goes into a contract with a Medicare Advantage company, every year, CMS decides how much they’re going to reimburse a Medicare Advantage plan company for your enrollment.

So, over the years, that amount could be favorable. Insurance companies are grateful, and they don’t change anything. That amount can come down in other years, and CMS offers a lower reimbursement rate. That Medicare Advantage plan will now be pressed to figure out how to remain profitable, so they may squeeze your benefits, remove medications from the RX list, or change the network.

• If CMS does not increase the reimbursement to that company, the company’s only option is to reduce its benefits or change the network to offset the amount the federal government is not paying.

There are many ways to rein in the cost of Medicare Advantage, so when I say no CMS disputes, that’s the beauty of Medigap Plan G. There are no reimbursement rates. There’s no negotiating. It’s very simple, very black-and-white.

Original Medicare pays its bulk, which is generally 80% of the claims. Medigap plan G comes in and pays the difference. There’s no money being exchanged from a Medigap company and CMS about enrollment. You simply pay your Original Medicare A and B cost, and your Medigap premium. There’s no in-between reimbursement between the two.

Customer Plan G Reviews

I wanted to point out the strong Plan G reviews. Now that Plan F is no longer available to new Medicare beneficiaries, Medigap Plan G has the highest enrollment among every available Medigap plan. More than half, 58%, of beneficiaries turning 65 purchased Plan G.

Medicare Plan G saw a remarkable 22% surge in enrollment compared to the previous year, attracting an additional 660,000 enrollees. Plan G clearly demonstrates the highest growth rate.

A study performed by AHIP revealed that people are satisfied with their Medicare Supplement coverage. The findings were this:

• 93% of beneficiaries are satisfied with their Medicare Supplement.
• 83% call their coverage good or excellent.
• 96% agree that Medigap coverage allows them to see trusted providers and specialists without worrying about out-of-pocket costs.
• 77% of beneficiaries find the most valuable benefit to be the coverage of hospital expenses.

Final Thoughts

My biggest thought on this is that with Medicare Advantage, the big print gives, and the fine print takes away.

And what I mean by that is, from the surface, a Medicare Advantage plan is very appealing because roughly 77% of Medicare Advantage plans have a $0 monthly premium. That’s very appealing to a lot of people.

BUT – then you have copays for all the various services. You may pay $20 for a doctor. You may pay $70 for a specialist. You may pay $400 a day per hospital stay per day. So, if you’re going in for three days at $400, that $1,200 adds up pretty quickly.

With Medigap Plan G, you start with a higher monthly premium. There are no copays. Medigap Plan G pays for any deductibles that Original Medicare has outside of your Part B deductible, which is very small— only $240 per year.

No network changes, referrals, or disputes between a provider and the insurance company or CMS. 

If you can afford Medigap Plan G, I highly recommend it. If you have questions about either one, email or give us a call. Our job is to try to make the Medicare road easier because, as I’m sure you’ve seen, it’s very complicated. 

Kaiser Family Foundation  |  AHIP Research  |  AHIP Trends

FAQs

• Which Medicare Supplement plan has the highest level of coverage?

  Plan G provides the highest level of coverage for new Medicare beneficiaries.

• What are the best Medicare Supplement providers?

  We work with trusted providers such as Aetna, Cigna, Mutual of Omaha, Allstate, ACE, and Aflac.

• When am I eligible for Medicare coverage?

  Medicare coverage starts at age 65 for the majority of Medicare beneficiaries.