A Quick View of Medicare Supplemental Plan G

At age 65 Medicare becomes your basic health insurance coverage. There are two essential parts to Medicare –
Part A and Part B.

  • Part A covers hospital and skilled nursing facility costs
  • Part B covers physician services, diagnostic tests and surgical expenses

With Medicare there are gaps in coverage (deductibles and coinsurance). These are costs you need to pay if you don’t have supplemental insurance for Medicare. Some medical costs can be quite large. Supplement plans for Medicare act like an umbrella to protect you from those Medicare gaps in coverage by paying those extra costs for you.

With the Medicare Supplement Plan G, your only costs for health care will the Part B Deductible ($233 in 2022).  After you meet that deductible, your Medicare Supplement will pay all the other costs including surgery and hospital costs.  In other words, the most you will pay is $233/year; there will be no additional medical costs. And the premiums for supplemental Medicare plans are much smaller than premiums in the under-65 market, where a comparable Platinum level plan might cost $2000/month!

Note: with Medicare, prescription drugs are separate from regular medical costs. You will be able to get an affordable Prescription Drug Plan (PDP) that will average around $15/month.

Part A is extremely important. It is possible to have a $500,000+ hospital bill. In contrast, a surgery may only cost $5,000. The hospital bill is often the most expensive part of the total medical bill. Medicare Part A covers the costs for facility stays such as at a hospital or skilled nursing facility.

Medicare (Part A) – Hospital & Skilled Nursing Facility Services

Services
Medicare Pays Plan G Pays You Pay
Hospitalization –
First 60 Days
All but $1,556 $1,556
(Part A deductible)
$0
Skilled Nursing Facility –
First 20 days
All approved amounts $0 $0
Skilled Nursing Facility –
21st through 100th day
All but $194.50 a day Up to $194.50 a day $0

For the first 60 days you are in the hospital—which is a substantial amount of time—Medicare Part A pays all of the expenses except $1,556. This is called the Part A deductible.

Medicare Supplement Plan G pays the Part A deductible. Your net cost is $0. Zero is nice! 🙂

Normally hospitalization is for acute care. Once you are stabilized—often around 3 to 7 days—you are moved to a Skilled Nursing Facility to recover. For the first 20 days in a Skilled Nursing Facility, Medicare pays all the expenses. For days 21 to 100, Medicare pays all except $194.50 per day. Your supplemental insurance for Medicare pays the $194.50 per day. Your net cost is, once again $0. Zero is nice! 🙂

Medicare Part B pays for non-facility, professional services such such as doctor’s visits, lab work, x-rays, MRIs, CT Scans, surgeons, assistant surgeons, anesthesiologists, chief bottle washer, you name it!

Medicare (Part B) – Medical Services 

Services
Medicare Pays Plan G Pays You Pay
Medical Expenses – In or Out of Hospital and Outpatient Hospital Treatment
First $233 of Medicare Approved Amounts $0 $0 $233
(Part B deductible)
Remainder of Medicare Approved Amounts Generally 80% Generally 20% $0

Clinical Laboratory Services
Tests for
Diagnostic Services
100% $0 $0

For the first $233 of non-facility medical services, Medicare Part B pays $0. That $233 is your Part B deductible. Since the plan does not pay that deductible, you are required to pay the first $233 of medical expenses.  For all additional costs over $233, your net cost is $0. Zero is nice! 🙂

Blood tests are covered 100% by Medicare after meeting the deductible. 

For all other expenses, Medicare pays 80% of the costs and you pay 20%.  Your Medicare Supplement Plan G pays that 20% for you and you pay $0.

If, for example, after satisfying the deductible, you have an MRI that costs $1,000, your 20% coinsurance (what you are responsible for) is $200. However, you don’t have to pay that amount. Your Medicare Plan G will pay it for you!

If you have cancer that requires chemo and radiation therapy costing $100,000, your 20% responsibility would be $20,000. Ouch. But your Medicare Supplemental Plan G will pay that $20,000 for you. Your net cost is… say it with me, “$0.” Zero is really nice in this situation.

If you have Medicare Supplement Plan G, how much will you pay for the following scenario?

You go to the doctor complaining about fatigue. Your doctor requests a variety of blood tests, and when you return, there is a frown on the doctor’s face.“I’m concerned about your health and want you to get an MRI and a CT Scan.”

When the doctor reviews your scans, he informs you that you have a very serious medical condition. You are admitted to the hospital right way, have extensive surgery; and end up in hospital for 14 days, with another 60 days spent recovering in a skilled nursing facility.

The total cost is north of $500,000.

If you have Medicare Supplement Plan G, how much will you be required to pay?

    1. $500,000
    2. $250,000
    3. $233 🙂

Let’s Meet!

At Hopper Insurance Services we can help you choose the right supplemental plans for Medicare. We invite you to give us a call and we will go over a variety of supplemental and Advantage plans.

We represent the top two insurance companies in California:

  • Anthem Blue Cross
  • Blue Shield of California

In a one-hour meeting, we will educate you on Medicare and explain all your options. With good education, you will easily be able to choose the plan that offers the best value for your needs and budget.