Original Medicare, comprised of Part A (Hospital Insurance) and Part B (Medical Insurance), provides the foundational health coverage for millions of Americans. However, it was never designed to cover 100% of healthcare costs. Instead, it leaves several “gaps” – out-of-pocket expenses that beneficiaries are responsible for. This is precisely where Medicare Supplement Plan G steps in, acting as a powerful safety net that significantly reduces financial exposure for seniors.
Let’s break down the what is a medicare plan g, most common gaps in Original Medicare and how Plan G expertly fills them:
1. The Part A Hospital Deductible
The Gap in Original Medicare: When you’re admitted to a hospital, Medicare Part A requires you to pay a deductible for each “benefit period.” In 2025, this deductible is a significant $1,676. If you have multiple hospital stays in a year, you could potentially face this deductible more than once.
How Plan G Fills It: Plan G covers the Medicare Part A deductible in full. This means that when you’re admitted to the hospital, you won’t have to pay that initial large sum out of your own pocket.
2. Part A Hospital Coinsurance for Extended Stays
The Gap in Original Medicare: While Medicare Part A covers the first 60 days of a hospital stay after the deductible, it then starts charging daily coinsurance amounts:
- Days 61-90: You pay a daily coinsurance ($419 in 2025).
Days 91 and beyond: You use your “lifetime reserve days,” which also have a daily coinsurance ($838 in 2025).
- Beyond lifetime reserve days: Medicare Part A pays nothing, leaving you responsible for 100% of the costs.
How Plan G Fills It: Plan G covers all of these Part A coinsurance amounts. More importantly, if you exhaust your lifetime reserve days, Plan G provides coverage for an additional 365 days of hospital care. This is a critical safety net for very long or catastrophic hospitalizations, preventing potentially ruinous bills.
3. Skilled Nursing Facility (SNF) Coinsurance
The Gap in Original Medicare: If you require a stay in a skilled nursing facility after a qualifying hospital stay, Medicare Part A covers the first 20 days at 100%. However, for days 21-100, you are responsible for a daily coinsurance ($209.50 in 2025). After day 100, Original Medicare pays nothing.
How Plan G Fills It: Plan G covers the daily coinsurance for days 21-100 in a skilled nursing facility, alleviating this significant daily cost during recovery.
4. Part B Coinsurance (the 20% responsibility)
The Gap in Original Medicare: For most Medicare Part B services (like doctor visits, outpatient therapy, lab tests, durable medical equipment, etc.), Original Medicare generally pays 80% of the Medicare-approved amount after you meet your annual Part B deductible. This leaves you responsible for the remaining 20% coinsurance, with no annual limit on how much you might have to pay.
How Plan G Fills It: Once you meet the annual Medicare Part B deductible ($257 in 2025), Plan G covers 100% of that 20% coinsurance. This means that for virtually all Medicare-approved outpatient services, your out-of-pocket cost is $0 once your deductible is met. This provides immense financial predictability.
5. Medicare Part B Excess Charges
The Gap in Original Medicare: This is a less common but potentially very costly gap. Some healthcare providers (who do not “accept Medicare assignment”) can legally charge up to 15% more than the Medicare-approved amount for a Part B service. Original Medicare does not cover these “excess charges.”
How Plan G Fills It: Plan G uniquely covers 100% of Medicare Part B excess charges. This offers invaluable protection, ensuring you won’t face surprise bills if you see a provider who charges more than Medicare’s approved amount. Very few other Medigap plans offer this crucial benefit.
6. Foreign Travel Emergency
The Gap in Original Medicare: Original Medicare generally does not cover medical care received outside the United States.
How Plan G Fills It: Plan G provides coverage for 80% of foreign travel emergency costs, after a small $250 deductible, up to a lifetime maximum of $50,000. This is a valuable benefit for seniors who travel internationally.
The Only Remaining Gap for Standard Plan G
It’s important to note the one significant “gap” in Original Medicare that Plan G does not cover:
- The Medicare Part B Annual Deductible: In 2025, this is $257. You are responsible for paying this amount out-of-pocket each year before Plan G begins to cover your Part B coinsurance.
The Overall Impact
By covering nearly all of Original Medicare’s significant deductibles, coinsurance, and excess charges, Plan G provides unparalleled financial predictability and peace of mind. For most Medicare-approved services, once the small Part B deductible is met, your medical bills are essentially eliminated. This comprehensive coverage is why Plan G has become the preferred choice for a vast number of seniors seeking a robust and secure healthcare experience.
