What Is Medicare Plan G
Medicare Plan G is a type of Medicare Supplement sold by private insurance companies. Plan G’s purpose is to pay secondary to Original Medicare and pick up approved costs Medicare doesn’t cover. With more than 40 million emergency room visits yearly among senior citizens, you might wonder if Medicare Plan G covers emergency visits and if it helps you save money. Keep reading to learn more about Medigap Plan G – Two Ways to Save.
What Does Medicare Plan G Cover?
As mentioned earlier, Plan G pays secondary to Original Medicare. There aren’t any network restrictions with Medicare or Medigap plans. So, you can visit any doctor in the U.S. that accepts Medicare and use a Medigap plan. Here are the type of services Plan G will cover:
- Part A deductible and inpatient costs
- Part A copay/coinsurance
- Hospice care copay/coinsurance
- Skilled nursing facility coinsurance
- 3 pints of blood
- Part B copay/coinsurance
- Part B excess charges
When you have Plan G, you will only pay the Part B deductible out-of-pocket for the year. So, after you pay the $226 Part B deductible in 2023, you are covered in full for the rest of the year. How does this apply to emergency room visits?
Plan G And Emergency Room Visits
Many think that when you visit the emergency room, your services are covered by Part A since you are at the hospital. But that’s not true. Emergency room visits are covered by Medicare Part B, as you are an outpatient and have not yet been admitted to the hospital.
Let’s say you experience a car accident and take an ambulance to the emergency room. (Read more on does Medicare cover ambulance rides here) The doctors and nurses run a series of scans on you, and everything turns out to be okay. You are discharged from the hospital and head home.
In a few months, you will receive a bill for your ambulance ride, scans, and emergency room visit. When you have Medicare Plan G, you will only pay the Part B deductible. So, after you pay the Part B deductible, Plan G will cover all the remaining costs for your emergency room services. It’s possible that you could have dished out a few thousand dollars, but not with Plan G.
But now, let’s say you didn’t get to go home, and you had to be admitted to the hospital as an inpatient. How would Plan G cover you, then?
Does Plan G Cover A Hospital Stay?
Medicare Part A covers inpatient care, which includes a semi-private hospital room and three-square meals a day. If you were to be admitted to the hospital, Medicare Plan G would cover your stay at 100%, meaning you would not have to pay a dime out-of-pocket for your hospital stay or services.
In 2026, the Part A deductible is $1,600. So, you are already saving a substantial amount of money by purchasing Plan G. Now, Medicare Part A will only cover up to 150 consecutive days as an inpatient. But Plan G will cover an additional 365 days after Medicare Part A stops covering you.
To qualify for Skilled Nursing coverage, you must be an inpatient for three consecutive days. If you qualify for Skilled Nursing, Plan G will cover the total cost of your stay and services.
Emergency Room Visits In Another Country
If you were to only have Original Medicare and experience a medical emergency outside of the United States, you would be responsible for all your expenses. But it’s different whenever you have Medicare Plan G!
Plan G offers a foreign travel emergency benefit for up to $50,000. Here’s how it works: If you were to experience a medical emergency within the first 60 days of your international travel, you can visit the nearest hospital, and you would pay a deductible of $250. After the deductible is paid, Plan G will cover 80% of your medical care, and you will pay the remaining 20% coinsurance.
Again, this benefit is for emergencies only. So, you can’t plan a doctor’s visit outside of the country ahead of time and expect Plan G to provide coverage. The $50,000 is also a lifetime benefit. Once your plan pays out $50,000, your foreign travel benefit is gone forever.
Medicare Plan G gives you predictable healthcare costs throughout the year while providing substantial coverage. If you ever have a visit to the emergency room, know that Plan G will have you covered.