Medicare Supplement plans only help pay for services covered by Original Medicare, which is Parts A and B.
In short, no, Medicare Supplement Plan G does not cover prescription medications. A Medicare Supplement plan will only pay for services that are covered by Original Medicare (Part A and Part B).
Supplement plans do, however, cover the 20% co-insurance for provider-administered drugs that Part B covers, such as injections given in a healthcare setting.
What is Medicare Supplement Insurance?
Medicare Supplement Insurance, often called Medigap, is a private insurance policy that helps to cover the costs Medicare doesn't. This usually means co-insurance, co-pays, and deductibles. The way it works is Medicare pays the Medicare-approved healthcare costs it covers, then your Medigap policy pays its portion. Anything remaining is an out-of-pocket cost for you.
The best time to sign up for a Medigap policy is during the first six months you have Medicare Part B, as this is one of the only times your application does not have to undergo medical underwriting.
Medical underwriting is the process of deciding whether to sell you a policy based on your medical history. It starts with you answering a series of health-related questions, such as age, weight, any pre-existing conditions you have, and any history of smoking, alcohol, or drug use.
As with Medicare Advantage (MA) plans, all Medicare Supplement plans must adhere to federal guidelines and are provided by private insurance companies. But the similarity ends there.
Medicare Advantage plans mimic the health insurance most of us had through an employer. They cover everything Parts A and B do, with most (99%) providing additional benefits like prescriptions, dental, and vision.
Medigap plans, on the other hand, simply help pay for the services you get with Parts A and B. They do not provide additional coverage. For example, you cannot use your Medigap plan to pay for vision services, dental care, or prescriptions, because those things are not covered by Original Medicare.
There are 10 basic Medigap plans, each represented by a letter: A, B, C, D, F, G, K, L, M, and N. Every Plan A offers the same benefits, no matter which insurance company you choose.
Every plan "A", "B", etc. has the same. There are 10 different plans insurers can offer, but all must offer at least Medigap Plan A.
It is important to note the following about Medigap:
● Policies do not cover services not included with Original Medicare
● Policies only cover one person, so if you have a spouse, they will need their own Medigap plan (although many insurers offer discounts for multiple policies)
● It is illegal for any insurer to sell you a Medigap policy if you already have a Medicare Advantage plan
● You cannot have a Medicare Advantage plan and a Medigap plan at the same time
Three states – Massachusetts, Minnesota, and Wisconsin – standardize Supplement coverage differently. You can learn more about Medicare Supplement Insurance with our Ultimate Guide to Medigap.
What does Medigap Plan G cover?
One of the most popular Medigap policies available, Plan G offers comprehensive coverage and pays 100% of several healthcare costs, such as:
● Part A co-insurance and deductible
● Part A hospice care (co-insurance or co-pay)
● Part A hospital costs up to an additional year after your standard Medicare benefit ends
● Part B co-insurance and co-pay
● Part B excess charges, if applicable
● Skilled nursing facility (SNF) care co-insurance
● Three pints of blood per year for medical procedures
Plan G basically covers your portion of anything covered by Original Medicare, with the exception of your Part B deductible, including ambulances, lab work, X-rays, and more. Medigap Plan G does not cover the following:
● Part B deductible
● Dental care
● Eye care
● Hearing aids
● Long-term care
● Prescription drugs
● Private-duty nursing
As stated above, though Plan G does not cover prescription medications, it does cover the co-insurance on any medications covered by Part B.
What happened to Medigap Plans C and F?
As of January 1, 2020, Medigap plans sold to new beneficiaries are not allowed to cover the Part B deductible, which means Medigap Plans C and F cannot be sold to people new to Medicare. If you turned 65 on or after January 1, 2020, these plans are unavailable to you.
If, however, you meet the following criteria, you can still have Plan C or Plan F:
● You already have one of these plans
● Are a new Medicare enrollee, but have been eligible since before 2020
● You turned 65 before 2020
● You have had Medicare coverage for at least 20 years and never had a Medigap plan
Outside of this, you would need to purchase one of the other eight policy options.
Other Medigap plans
All in all, there are 10 possible Medigap plans to choose from. The plan you pick should be based on your specific medical needs and lifestyle. We already went into detail about Medigap Plan G above, but here we will discuss the remaining Medigap plan options.
Medigap Plan A
A basic service coverage option, Medigap Plan A comes with the advantage that you might not have to pay for benefits you don't expect to use. However, this can result in extra costs if you wind up needing additional services. Plan A is a good choice if you only need basic coverage and can assume any potential remaining risk yourself. This policy covers:
● Part A co-insurance (both hospitalization and hospice care)
● Part B co-insurance and co-pay
● 365 hospital reserve days
● Three pints of blood per year
Plan A does not cover:
● Part A or Part B deductible
● Benefits for travel outside the U.S.
● SNF co-insurance
● Part B excess charges
Medigap Plan B
Similar to Plan A, Medigap Plan B is a good option for basic service coverage, but offers a little bit more. Plan B covers:
● Part A deductible
● Part A co-insurance (both hospitalization and hospice care)
● Part B co-insurance and co-pay
● 365 hospital reserve days
● Three pints of blood per year
Plan B does not cover:
● Part B deductible
● Benefits for travel outside the U.S.
● SNF co-insurance
● Part B excess charges
As you can see, the big difference between Plans A and B is that Plan B covers your Part A deductible.
Medigap Plan C
While new Medicare beneficiaries are ineligible for Medigap Plan C, those who qualified for Medicare before January 1, 2020 may still be able to purchase a Plan C policy. Medigap Plan C offers more coverage than the first two options, including:
● Part A and Part B deductible
● Part A co-insurance (both hospitalization and hospice care)
● Part B co-insurance and co-pay
● 365 hospital reserve days
● SNF co-insurance
● Three pints of blood per year
● 80% of your foreign travel benefit
Plan C does not cover any Part B excess charges, coverage is limited to Medicare-approved costs.
Medigap Plan D
Designed to cover the higher-risk gaps not covered by Original Medicare, Medigap Plan D is one of the only plans that offers preventative care coverage. It also offers lower premiums than some of the more comprehensive plans. Plan D covers:
● Part A deductible
● Part A co-insurance (both hospitalization and hospice care)
● Part B co-insurance and co-pay
● 365 hospital reserve days
● SNF co-insurance
● Three pints of blood per year
● 80% of your foreign travel benefit
Medigap Plan D does not cover the Part B deductible or any Part B excess charges.
Medigap Plan F
As with Plan C, we've already discussed that Medigap Plan F is not available to new Medicare beneficiaries, but it is still an option for those that qualified before 2020. Plan F is, historically, the most popular Medigap plan and covers:
● Part A and Part B deductible
● Part A co-insurance (both hospitalization and hospice care)
● Part B co-insurance and co-pay
● 365 hospital reserve days
● SNF co-insurance
● Three pints of blood per year
● 80% of your foreign travel benefit
● Part B excess charges, if applicable
Plan F does not cover home recovery or preventative care.
Medigap Plan K
Using a cost-sharing method different from other Medigap plans, Medigap Plan K pays a percentage of costs until you meet your yearly out-of-pocket spending limit, and then covers 100% of Medicare-approved costs. In 2023, the limit is $6,940. Plan K covers:
● Part A co-insurance for hospitalization
● 50% of the Part A deductible
● 50% of co-insurance for hospice care
● 50% of the Part B co-insurance and co-pay
● 365 hospital reserve days
● 50% of SNF co-insurance
● 50% of the blood benefit (three pints per year)
Once you have reached your maximum out-of-pocket limit, 50% becomes 100%. Medigap Plan K does not cover:
● Part B deductible
● Foreign travel benefit
● Part B excess charges
Medigap Plan L
Though a similar cost-sharing method to Plan K, Medigap Plan L offers a higher percentage of coverage from the start and has a lower out-of-pocket limit. In 2023, the limit is $3,470. Medigap Plan L covers:
● Part A co-insurance for hospitalization
● 75% of the Part A deductible
● 75% of co-insurance for hospice care
● 75% of the Part B co-insurance and co-pay
● 365 hospital reserve days
● 75% of SNF co-insurance
● 75% of the blood benefit (three pints per year)
Once you have reached your out-of-pocket limit, 75% becomes 100%. Plan L does not cover:
● Part B deductible
● Foreign travel benefit
● Part B excess charges
Medigap Plan M
Medigap Plan M is very similar to Medigap Plan D, but only covers half of the Part A deductible. Plan M covers:
● Part A co-insurance (both hospitalization and hospice care)
● 50% of the Part A deductible
● Part B co-insurance and co-pay
● 365 hospital reserve days
● SNF co-insurance
● Three pints of blood per year
● 80% of your foreign travel benefit
Like Plan D, Plan M does not cover your Part B deductible or any Part B excess charges.
Medigap Plan N
Though also similar to Plan D, Plan N does have its differences. For instance, some office visits may still come with a $20 co-pay, and you may have to pay up to $50 for emergency room visits that do not result in admission. Medigap Plan N covers:
● Part A deductible
● Part A co-insurance (both hospitalization and hospice care)
● Part B co-insurance and co-pay
● 365 hospital reserve days
● SNF co-insurance
● Three pints of blood per year
● 80% of your foreign travel benefit
Plan N does not cover your Part B deductible or Part B excess charges.
How much does Medicare supplement insurance cost?
The cost of a Medigap plan depends on a variety of factors, including when you purchase the policy. If you purchase during your first six months of being enrolled in Part B, you don't have to undergo medical underwriting, and that changes some of the contributing factors. Costs are usually based on:
● Age
● When you enroll
● Gender
● Whether you smoke
● Where you live
● The insurance company you choose
Since costs can vary widely, the most important things to consider are whether the plan appropriately meets your healthcare needs and that it is affordable.
Our Find a Plan tool makes it easy to compare Medicare Supplement plans in your area. Just enter your zip code to get started.
