Medicare Supplement Plan G in Illinois
Overview of Plan G
Medicare Supplement Plan G in Illinois is designed for beneficiaries who want to minimize out-of-pocket costs while keeping predictable monthly expenses. It works alongside Original Medicare (Part A and Part B), helping to pay for costs that Medicare does not fully cover, like copayments, coinsurance, and certain deductibles.
Enrolling in a Medigap plan like Plan G allows you to see any doctor or visit any nationwide hospital that accepts Medicare, without worrying about restrictive networks or referrals.
What Does Medicare Supplement Plan G Cover in Illinois?
Medigap Plan G offers standardized coverage across all states (except Massachusetts, Minnesota, and Wisconsin, which have different standardization rules). In Illinois, Plan G covers:
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Medicare Part A coinsurance and hospital costs (up to an additional 365 days after Medicare benefits are exhausted)
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Medicare Part B coinsurance or copayment
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First three pints of blood
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Part A hospice care coinsurance or copayment
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Skilled nursing facility coinsurance
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Medicare Part A deductible
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Medicare Part B excess charges (costs beyond Medicare-approved amounts)
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Emergency care during foreign travel (up to plan limits)
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Coverage for doctor visits, surgeries, lab work, preventive care, and durable medical equipment
These comprehensive benefits help shield beneficiaries from the high costs of unexpected medical care and provide greater financial peace of mind.
What Isn’t Covered by Medicare Supplement Plan G?
Despite its broad coverage, there are gaps:
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Medicare Part B deductible: You are responsible for paying this amount each year before Plan G begins covering Part B costs.
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Prescription drugs for outpatient use: You must enroll separately in a Medicare Part D plan to cover these medications.
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Routine dental, vision, and hearing care, including exams, hearing aids, eyeglasses, and dentures.
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Long-term custodial care, cosmetic procedures, acupuncture, and experimental treatments.
Plan G only supplements costs that Original Medicare approves, so your Medigap plan will not cover services or procedures denied by Medicare.
How Much Does Medicare Supplement Plan G Cost in Illinois?
Monthly premiums for Plan G typically range from $125 to $250, depending on several factors:
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Pricing method:
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Issue-age-rated: The price is set based on your age when you enroll and won’t increase as you age.
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Attained-age rated: Premiums are based on your current age and rise as you age.
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Community-rated: Everyone in the area pays the same premium regardless of age.
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ZIP code and local healthcare costs
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Gender, tobacco use, and household discounts
Understanding the pricing method used by each insurer is crucial, as it directly affects your future premium increases.
When Can I Enroll in Medigap Plan G?
The Medigap Open Enrollment Period is the best time to enroll. It lasts six months, beginning the month you are both 65 or older and enrolled in Medicare Part B.
During this period:
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You have guaranteed issue rights — no health questions or medical underwriting.
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Afterward, insurers can use medical underwriting, and your acceptance may be subject to health conditions.
Medicare Supplement Plan G vs. Plan N
Choosing between Medicare Supplement Plan G and Plan N is one of the most common decisions Medicare beneficiaries face when looking for comprehensive coverage that works alongside Original Medicare. Both plans offer excellent protection from large out-of-pocket expenses but differ subtly, significantly impacting your overall costs and experience.
Coverage of Excess Charges
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Plan G covers Medicare Part B excess charges, which can occur if you see a doctor who does not accept Medicare’s standard “assignment” rate. These providers can legally charge up to 15% more than Medicare’s approved amount, and Plan G pays these additional costs.
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Plan N does not cover excess charges, so if you see a non-participating provider, you are responsible for paying these additional charges out of pocket.
Example:
If you see a specialist who charges excess fees of $150, Plan G would cover that, while Plan N would not, leaving you to pay the entire $150 yourself.
Office Visit and ER Copayments
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Plan G: Once you meet your annual Medicare Part B deductible ($240 in 2025), you have no additional copays for doctor visits, specialist appointments, or emergency room visits. This makes your costs more predictable throughout the year.
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Plan N: You are responsible for up to a $20 copay for each office visit and up to a $50 copay for each emergency room visit (the ER copay is waived if you are admitted to the hospital).
Practical consideration:
If you see your primary care doctor or a specialist multiple times a year, these copays can add up quickly. For example, if you have 12 doctor visits annually, that’s potentially up to $240 in copays on top of your premiums and deductible.
Premium Differences
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Plan N typically has a lower monthly premium, often about $10–$30 less per month than Plan G (though this varies depending on your location, age, and insurance company).
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The trade-off is that you may pay more in copays and possible excess charges, making overall yearly expenses potentially similar to or even higher than Plan G if you need frequent care.
Premium example:
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Plan G: $150/month (approximate)
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Plan N: $125–$140/month (approximate)
Predictability vs. Potential Savings
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Plan G is ideal for beneficiaries who want to minimize surprises and prefer predictable, fixed costs. After paying the Part B deductible, nearly all Medicare-approved costs are covered without further out-of-pocket expenses or copays.
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Plan N is best suited for beneficiaries who are generally healthy, have fewer doctor visits each year, and are comfortable taking on small copays to enjoy a lower monthly premium.
Access to Care
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Both Plan G and Plan N allow you to see any doctor or specialist in the U.S. who accepts Medicare, with no networks or referrals required.
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However, because Plan N does not cover excess charges, some beneficiaries feel more confident with Plan G, knowing they can visit any Medicare provider without worrying about unexpected charges.
Long-Term Cost Considerations
While Plan N’s lower premium may seem attractive initially, it is crucial to evaluate your anticipated healthcare usage:
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Frequent medical visits or specialist care? Plan G may save you money overall and provide better peace of mind.
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Few medical visits and generally good health? Plan N may help you reduce premiums and overall spending.
Additionally, it’s wise to consider that healthcare needs often increase as we age. A plan with predictable costs (like Plan G) can help avoid future financial surprises.
Key Takeaway
Feature | Plan G | Plan N |
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Excess charges | Covered | Not covered |
Doctor visit copay | $0 | Up to $20 per visit |
ER copay | $0 | Up to $50 per visit |
Monthly premium | Higher | Lower |
Cost predictability | Very high | Moderate (copays vary) |
Best for | Beneficiaries who want no surprises and full coverage flexibility | Healthy beneficiaries are willing to trade some predictability for lower premiums |
Best Medigap Insurance Companies Offering Plan G in Illinois
Selecting the right insurance company is as important as choosing the plan itself. Several highly rated insurers offer Medigap Plan G. Beyond premiums, consider each company’s financial stability, history of rate increases, customer service quality, and added member perks.
Mutual of Omaha
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Financial strength: Consistently strong ratings for financial stability and reliability.
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Rate history: Known for moderate, predictable rate increases, which can help you plan long-term.
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Service reputation: Excellent customer support and fast claims processing.
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Discount opportunities: Offers household discounts, which can reduce premiums for spouses living together.
Cigna
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Pricing: Often competitive for first-time Medigap enrollees, making it attractive for budget-conscious shoppers.
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Added benefits: Wellness programs, 24/7 nurse hotlines, and online resources to help members manage their health.
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Stability: Good track record of stable premium rates in many states.
Anthem Blue Cross Blue Shield
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Brand recognition: Strong name and established provider relationships throughout Illinois.
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Provider access: Broad acceptance among providers, making it easier to find doctors and specialists who accept your plan.
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Extras: Often includes member discounts on vision, hearing, and fitness programs, even though routine coverage isn’t included in the core plan.
Humana
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Competitive premiums: Frequently offers competitive rates, especially for non-smokers and healthy applicants.
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Member programs: Access to a range of wellness resources, including SilverSneakers fitness programs, preventive health reminders, and virtual care tools.
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Service quality: Known for responsive customer support and user-friendly online member portals.
Local and regional carriers
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State-based or regional insurers: Some smaller or regional insurance companies may offer highly competitive rates, especially in certain counties or ZIP codes.
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Personalized service: These companies often provide more individualized customer service, with locally based agents who understand Illinois’s healthcare landscape.
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Potential savings: Depending on your area, these insurers may provide discounts or additional perks to attract local enrollees.
Why Company Choice Matters
While Plan G benefits are standardized by law, premium pricing, customer service experience, and rate stability vary significantly between companies. A lower initial premium might come with higher annual increases. Conversely, a slightly higher starting rate from a financially stable company with a strong track record might save you money and stress in the long run.
When evaluating insurers, ask about:
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Historical rate increase patterns over the last 5–10 years.
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Availability and requirements for household or loyalty discounts.
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Local reputation and service satisfaction scores.
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Any value-added benefits or wellness programs.
Plan G vs. Medicare Advantage: Real-Life Scenario:
Meet Barbara
Barbara is a 67-year-old retiree living in Illinois. She enjoys gardening and occasionally travels to North Carolina to see her grandchildren. Barbara has a few chronic health conditions, including high blood pressure and arthritis, and she visits her doctor regularly.
Barbara is deciding between two options: Medicare Supplement Plan G (Medigap Plan G) with Original Medicare, and a Medicare Advantage plan with a $0 premium available in her area.
Option 1: Medigap Plan G
Costs
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Monthly premium: $160 for Plan G (Illinoisaverage), plus $30 for a standalone Part D drug plan.
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Part B deductible: $240 annually.
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Total annual predictable premium costs: Around $2,280 (Plan G + Part D).
Coverage & Access
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After the Part B deductible is met, there are no copays for doctor visits, lab work, or specialist appointments.
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Freedom to see any doctor or hospital nationwide that accepts Medicare — no network restrictions.
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Coverage for Part B excess charges if she sees a specialist who doesn’t accept Medicare assignment.
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Emergency foreign travel coverage up to plan limits.
Scenario
Barbara needs frequent specialist visits for arthritis and occasional outpatient procedures. With Plan G, she knows exactly what she’ll pay each month, and after meeting her Part B deductible, she doesn’t have to worry about additional copays.
When she visits her grandchildren in North Carolina, she doesn’t need to worry about whether her doctor there is in-network — she shows her Medicare card, and her Plan G coverage follows her.
Option 2: Medicare Advantage Plan
Costs
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Monthly premium: $0.
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Copays: $25 per primary care visit, $50 per specialist visit.
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Maximum out-of-pocket limit: $5,500 per year (in her plan).
Coverage & Access
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A local network of doctors and hospitals (HMO) must be used.
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Needs referrals for specialist visits.
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Includes built-in Part D drug coverage.
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Additional benefits include dental and vision coverage, gym memberships, and possibly transportation to medical appointments.
Scenario
Barbara appreciates the $0 premium and bundled extra benefits. However, her arthritis specialist is not in-network, so she would need to find a new provider. Each visit would come with a copay; if she needed frequent specialist care, these costs could add up quickly.
When visiting her family in North Carolina, she would have to pay out-of-network rates or might not have coverage for routine care at all. She may only be covered for emergencies outside her plan’s service area.
Side-by-Side Comparison
Plan G | Medicare Advantage | |
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Monthly Premium | ~$160 + ~$30 for Part D | $0 |
Predictability | High — minimal extra costs after Part B deductible | Lower pay-as-you-go copays can vary significantly |
Provider Access | Nationwide — any provider that accepts Medicare | Restricted to the network; referrals are usually required |
Specialists | No referrals needed | Referrals typically required |
Extra Benefits | No routine dental, vision, or hearing; separate coverage needed | Often includes dental, vision, hearing, and fitness benefits |
Travel Coverage | Nationwide and foreign emergency | Limited to the network, emergency only out-of-area |
Final Thoughts
Medicare Supplement Plan G remains the most popular choice for Illinois residents seeking comprehensive, predictable coverage and broad access to providers. Although it doesn’t cover everything, its robust benefits and simplicity make it an excellent option for those wanting peace of mind.
Choosing the right insurer is essential to maximize these benefits and protect yourself from future rate surprises. Comparing quotes, company ratings, and value-added services can help ensure you select a plan that supports your health and your budget for years to come.