Medicare Supplement Plan G in Pennsylvania offers fairly comprehensive coverage for Medicare beneficiaries looking for help with health care medical expenses. Because it’s supplemental health insurance, you are required to remain enrolled in the Federal Medicare program, better known as Original Medicare or Medicare Part A and Part B.
Medicare Supplement Plan G in Pennsylvania frequently referred to as Medigap Plan G, might be the best Medicare Supplement insurance plan for beneficiaries who want broad plan benefits but who are willing to pay a little bit out-of-pocket. Plan G ranks as the second most popular plan behind Medicare Plan F.
When you compare plans, Medigap Plan G rates are more affordable compared to Plan F and, with the exception of covering your Part B deductible, offers the same plan benefits. Medicare Supplement Plan G benefits include coverage for the following medical services:
- Durable medical equipment
- Doctor’s office visits
- Hospital costs
- Lab work
- Preventive care
What does Medicare Plan G Cover in Pennsylvania?
Medigap Plan G in Pennsylvania covers the same basic benefits regardless of which insurance company sells the policy. Those benefits are:
- Medicare Part A coinsurance
- Hospital costs for another 365 days after your Medicare benefits are used up
- Medicare Part B copayment or coinsurance
- First 3 pints of blood
- Medicare Part A copay or hospice care coinsurance
- Coinsurance for skilled nursing facility care
- Medicare Part A deductible
- Medicare Part B excess charges
- Foreign travel up to plan limits
What is not covered by Medicare Supplement Plan G?
For many Medicare beneficiaries, Plan G is the best Medigap policy because it offers broad benefits. However, it doesn’t cover everything. Plan G does not cover:
- Your annual Part B deductible. After you pay your Part B deductible, Plan G in Pennsylvania pays the copayment and coinsurance amounts that you would be responsible for.
- Outpatient prescription medications. To get coverage for your outpatient medications, you must buy a separate standalone prescription drug plan policy.
It’s important to remember that Medicare Supplement Plan G works with Original Medicare. If Original Medicare does not approve a service, Medigap Plan G won’t cover it, either. Here are some services that are not eligible for Medicare benefits:
- Experimental drugs or surgeries
- Cosmetic procedures
- Routine dental, vision, and hearing
How Much Does Medicare Supplement Plan G cost in Pennsylvania?
Medigap plans are standardized, which means Medigap Plan G is the same as in Mississippi. Choosing the best Medicare Supplement Plan G involves a comparison of the pricing method each insurer uses to set its Medicare Supplement Plan G rates.
Health insurance companies offering Medicare Supplement plans use one of three calculation methods when setting rates:
- Issue age: Monthly premiums hinge on your age when you buy your Medicare Supplement insurance Plan G.
- Attained age: Monthly premiums are based on your current (attained) age.
- Community-rated: Your monthly premium will be the same as everyone else buying Plan G.
It’s important to compare pricing methods to determine the best Medicare Supplement Plan G rates because it affects how the price of your monthly premium increases in the future. With an attained-age policy, your monthly premium will increase each year simply because you’re getting older.
The other two pricing methods typically have a lower premium compared to attained-age policies. Community-rated and issue-age Medicare Supplement plans can increase due to inflation, but they cannot increase due to your age.
Rate increases are typically planned specifically between insurance companies. Because Plan G has a high volume of enrolled beneficiaries, it can spread the risk among beneficiaries more effectively than other Medicare Supplement plans. This ability to spread the risk creates better long-term stability with an insurance company’s rates.
When can I enroll in Medigap Plan G?
The best time to enroll in Medicare Plan G in Pennsylvania is during the Medigap Open Enrollment Period (OEP). The OEP is the best time because you don’t have to answer any health questions and the insurance company can’t deny you coverage. Your OEP is a six-month period that starts when you are 65 and enrolled in Part B.
If you apply outside of your OEP, insurers can require you to undergo medical underwriting. If you have pre-existing conditions, our Medicare supplement insurance specialists can help you compare the best health insurance company, plan, and rate for your situation.
Medicare Supplement Plan G vs Medicare Plan N
Plan N benefits come in a close second to Plan G benefits. It’s important to compare the benefits to find out which plan is best for your health needs:
- Benefits: Plan N does not cover Part B excess charges; Plan G does. Plan N pays all of your Part B coinsurance except for a $20 doctor’s office visit copay and a $50 emergency room copay. Plan G has no copays. Otherwise, the benefits are identical under the two plans.
- Rates: Plan N rates are usually lower than Medigap Plan G rates because Plan N offers less coverage. Although rates differ based on location, the average difference nationwide between Plan N rates and Medicare Plan G rates is $10.
- Access to care: Since Plan G covers excess charges, you can access services from any healthcare provider. Plan N does not cover excess charges, so if a non-participating provider provides medical services, you are responsible for any Medicare Part B excess charges.