Medicare is a great benefit that helps cover many things, including doctor’s visits and prescription drugs. Moreover, it’s free for most people. It can, however, be complicated to understand the different coverage available and what you should do. One of the most significant decisions is choosing a Medicare Supplement Plan. There are many plans on the marketplace, but Plan G offers high-deductible insurance coverage that is perfect for those who want some protection against unforeseen medical costs but don’t want a lot of additional expenses. In addition, it has a relatively low monthly premium and can be combined with other Medigap plans, offering maximum cover. However, Medigap doesn’t cover most dental care. And depending on where you live, the cost of prescriptions can vary greatly. Below is a more in-depth look at Plan G to help you better understand the coverage and determine whether or not this plan is right for you.
What are High Deductibles?
High-deductible plans are designed to pay some expenses that Medigap doesn’t cover. Furthermore, they are designed to help save money in case a high medical cost arises and you don’t have the funds to pay for it. The two most common high-deductible plans are the Medigap Advantage Plan G and the Medigap Part D Prescription Drug Plans. The former is considered transitional because it’s intended to help you adjust from traditional Medigap assistance, which covers doctor’s visits and hospital stays, to a new program that doesn’t include those benefits. But on the other hand, Part D is a prescription coverage plan that costs a small monthly premium.
These include deductibles, copays, and coinsurance.
Deductible: Deductibles are the first amount you pay for covered services before Medicare kicks in. When choosing a high deductible plan, you must decide how high the deductible will be before your initial payment is made. The amount of money it pays for prescriptions and doctor’s visits depends on the plan. Some plans pay the same amount, while others will pay a slightly lower amount for doctor visits and a slightly higher amount for prescriptions.
Copay: This is the amount you pay for each visit or prescription. A high-deductible plan may have a lower copay, while a plan with higher costs will have a higher copay. Moreover, high-deductible plans will have a yearly maximum out-of-pocket (MOOP) limit that is the most you’ll have to pay for copays, deductibles, and coinsurance.
Coinsurance: The percentage of covered expenses the insurer pays, usually less than what would be covered without it. Medigap doesn’t cover most dental care because it’s considered an inpatient thing, but this generally depends on where you live and your specific coverage needs.
Medicare Plan G
Plan G, Medigap Supplement High Deductible Plan This means it has higher-than-average cost sharing and doesn’t include an allowance for physician visits and hospital stays. The main benefit of Plan G is that it has a lower monthly premium than other Medicare supplements because you have to pay the out-of-pocket costs first. In addition, Medigap also pays less than other plans for prescription drugs. A high deductible, however, means you’ll pay more for your prescriptions. And depending on where you live, these costs can vary from $0 to $510 per month.
When looking for a health plan, high deductibles are something you should consider. Plan G is an example of this type of plan. High Deductible plans have deductibles from $2,500 to $5,000. They require you to pay out of pocket for many services before coverage through your Medigap health and prescription drug plans kicks in. These deductibles can be a good fit for those who prefer to spend only a set amount before their insurance policy kicks in.
Medicare Plan G High Deductible Coverage
Plan G is a high-deductible plan, meaning you will generally be responsible for paying more out-of-pocket before Medigap coverage kicks in. Plan G is designed to help reduce the amount you will be responsible for and the monthly premiums that come with many other Medigap plans. Plan G still covers:
• Excess charges in Part B
• A travel emergency in another country (up to plan limits)
• Coinsurance for skilled nursing facility care
• Part A coinsurance or copayment for hospice care
• The initial three quarts of blood
• Coinsurance or copayment for Part B
• Coinsurance for Part A and hospital costs (up to an additional 365 days after Medigap benefits are used)
• Medical Equipment That Is Long Lasting (DME)
Am I Eligible for Medicare Plan G High Deductible?
Anyone eligible for Medigap Part A and B may be eligible to buy Medigap Plan G High Deductible. To be eligible, you must:
• Be enrolled in both Parts A (Hospital Insurance) and B (Supplementary Medical Insurance)
• Not have End-Stage Renal Disease
• Not receive hospice care regularly
• Not be an inpatient in a hospital or skilled nursing facility.
How Much Does Medicare Plan G Cost?
Medicare Plan G High Deductible is generally cheaper than other Medigap plans. If you choose one of the plans with a lower premium, you will pay the difference on your own. Plans that include a monthly premium and don’t require you to pay part of your costs out-of-pocket usually have higher monthly premiums but offer more coverage at lower monthly rates.
Plan G includes a monthly premium, an annual deductible, and coinsurance. The deductible is the amount you must pay for health care services in a year before your Medigap coverage begins to pay for them. The coinsurance is the amount you pay for covered services after you have paid the deductible. Most Medigap plans have similar deductibles but may vary depending on where you live and what other plan choices are available to you in your area.
Why Choose This Plan?
Plan G is a standalone supplemental Medicare plan. It does not have copayments for physician services like most other Medigap plans. Instead, the plan covers the cost of prescription drugs up to the deductible amount, so you pay the total cost of your prescriptions until you hit that amount. Want to speak to a licensed advisor? click here.