If you’re researching Medicare Supplement Plan G in Missouri, you’re probably looking for a way to make the out-of-pocket costs of Original Medicare more predictable.
Plan G is one of the most comprehensive Medicare Supplement options available to people who are new to Medicare.
It works alongside Original Medicare Parts A and B and helps pay many of the deductibles, coinsurance and copayments that Medicare leaves behind.
At TCG Insurance Solutions, we help Missouri residents understand how Plan G works, compare premiums from available insurance companies and determine whether Plan G—or another Medicare Supplement option—fits their needs and budget.
What Is Medicare Supplement Plan G?
Medicare Supplement Plan G, also known as Medigap Plan G, is private insurance designed to supplement Original Medicare.
Medicare generally pays its share of a Medicare-covered service first. Your Medicare Supplement policy then helps pay eligible remaining expenses according to the standardized benefits of Plan G.
Plan G does not replace Medicare.
To have a Medicare Supplement policy, you generally must be enrolled in:
- Medicare Part A
- Medicare Part B
You also continue paying your Medicare Part B premium.
Plan G does not include outpatient prescription drug coverage. If you want drug coverage, you can generally enroll separately in a Medicare Part D prescription drug plan.
What Does Medicare Supplement Plan G Cover?
Medicare Supplement Plan G provides broad coverage for many of the out-of-pocket costs left by Original Medicare.
Standardized Plan G benefits include coverage for:
- Medicare Part A hospital coinsurance and additional hospital costs after Medicare benefits are used
- Medicare Part A deductible
- Medicare Part B coinsurance or copayments
- Skilled nursing facility care coinsurance
- Medicare Part A hospice care coinsurance or copayments
- The first three pints of blood used in an approved medical procedure
- Medicare Part B excess charges
- A portion of qualifying foreign travel emergency expenses, subject to plan limits
For Medicare-covered services, Plan G can significantly reduce the number of bills and cost-sharing amounts you would otherwise be responsible for paying yourself.
What Doesn’t Medicare Supplement Plan G Cover?
The most important expense Plan G does not cover is the annual Medicare Part B deductible.
The Part B deductible is established by Medicare and can change from year to year.
Once you have satisfied the Part B deductible, Plan G generally pays the remaining Medicare-approved Part A and Part B cost-sharing included within Plan G’s standardized benefits.
Plan G also does not generally provide routine coverage for services such as:
- Outpatient prescription drugs
- Routine dental care
- Routine vision care
- Hearing aids
- Long-term custodial care
- Private-duty nursing
Separate coverage may be available for some of these needs.
Why Do People Choose Plan G?
There isn’t one Medicare Supplement plan that’s best for everyone.
However, Plan G may appeal to someone who values predictability and broad supplemental coverage.
Rather than having several different copayments and coinsurance amounts throughout the year, a Plan G policyholder generally knows that the Medicare Part B deductible is the primary Medicare cost-sharing amount they’ll be responsible for before Plan G’s applicable Part B benefits begin.
Plan G can be particularly attractive to someone who:
- Wants broad Medicare Supplement coverage
- Prefers predictable healthcare expenses
- Travels within the United States
- Wants flexibility in choosing Medicare providers
- Doesn’t want to worry about office visit copayments
- Wants coverage for Medicare Part B excess charges
- Is comfortable paying the annual Part B deductible
The tradeoff is that Plan G premiums may be higher than Medicare Supplement options that require more cost sharing, such as Plan N.
Does Plan G Have a Doctor Network?
A standard Medicare Supplement Plan G policy works with Original Medicare.
It does not generally create a separate network of doctors and hospitals.
With Original Medicare, you can generally receive Medicare-covered care from doctors and hospitals throughout the United States that accept Medicare.
This can be particularly useful for people who:
- Travel frequently
- Spend part of the year in another state
- Have doctors in different parts of the country
- Want flexibility when choosing Medicare providers
This is different from many Medicare Advantage plans, which may use provider networks as part of the plan.
Are All Plan G Policies the Same?
The standardized medical benefits of Plan G are the same regardless of which insurance company issues the policy.
If Company A offers Plan G and Company B offers Plan G, the standardized Plan G benefits are the same.
However, that does not mean the policies are identical in every respect.
Insurance companies can differ in areas such as:
- Premium
- Available discounts
- Rate history
- Financial strength
- Customer service
- Length of time in the Medicare Supplement market
- Underwriting requirements when applicable
This is one reason it can make sense to compare multiple insurance companies instead of choosing solely because you recognize a company name.
How Much Does Medicare Supplement Plan G Cost in Missouri?
There isn’t one Missouri Plan G premium.
The price can vary significantly from one insurance company to another even though the standardized Plan G medical benefits are the same.
Factors that may affect the premium offered to you can include:
- Your age
- ZIP code or area of residence
- Tobacco use
- Gender, where applicable
- Insurance company
- Rating method
- Available household or other discounts
- When you apply
- Underwriting eligibility, when applicable
Because rates can change over time, publishing a single Plan G price can quickly become misleading.
A more useful approach is to compare the Plan G premiums currently available based on your individual circumstances.
Don’t Compare Plan G on Price Alone
The lowest premium today isn’t necessarily the only factor worth considering.
When comparing Medicare Supplement Plan G insurance companies, consider looking at:
- Current premium
- Recent rate history
- Financial strength
- Experience in the Medicare Supplement market
- Available discounts
- Customer service
- Your long-term budget
Sometimes the lowest-priced carrier may be an appropriate choice.
Other times, another insurer may make more sense based on the overall picture.
The goal is to understand what you’re buying rather than simply selecting the first premium you see.
Plan G vs Plan N in Missouri
Plan G and Plan N are frequently compared because both provide substantial Medicare Supplement coverage.
The major difference is the amount of cost sharing you’re willing to accept in exchange for the premium.
Plan G
Plan G generally provides more comprehensive coverage.
After satisfying the Medicare Part B deductible, Plan G covers the applicable Part B coinsurance included in its standardized benefits and also covers Medicare Part B excess charges.
Plan N
Plan N generally requires more cost sharing.
With Plan N:
- Certain office visits may involve a copayment
- Certain emergency room visits may involve a copayment
- Medicare Part B excess charges are not covered
In exchange for accepting these additional out-of-pocket expenses, Plan N may be available at a lower premium than Plan G from some insurance companies.
Which One Is Better?
Neither one is automatically better.
Someone who wants maximum predictability may prefer Plan G.
Someone who doesn’t mind occasional copayments in exchange for potentially lower premiums may prefer Plan N.
The right comparison is not simply:
Which plan costs less per month?
Premium wise? Plan N usually
Which combination of premium and potential out-of-pocket expenses am I more comfortable with?
When Is the Best Time to Enroll in Plan G?
For many people, the most favorable time to purchase Medicare Supplement Plan G is during their Medigap Open Enrollment Period.
This is a one-time six-month period that begins when you are:
- Age 65 or older, and
- Enrolled in Medicare Part B
During this period, an insurance company generally cannot deny you a Medicare Supplement policy it offers because of your health or charge you more because of your medical history.
This is different from Medicare’s Annual Open Enrollment Period.
Your Medigap Open Enrollment Period does not occur every fall.
What If I’m Working Past Age 65?
Turning 65 doesn’t necessarily mean you have to enroll in Plan G immediately.
Some people continue working beyond age 65 and remain covered through an employer or union health plan.
Depending on the type of employer coverage you have, you may be able to delay Medicare Part B without a late enrollment penalty.
If you later enroll in Medicare Part B after qualifying employer coverage ends, your six-month Medigap Open Enrollment Period may begin at that time.
Before delaying Medicare or dropping employer coverage, it’s important to understand how your particular employer coverage coordinates with Medicare.
Can I Change My Plan G Company Later?
Yes, you can apply for a Plan G policy from another insurance company.
However, outside of your Medigap Open Enrollment Period or another guaranteed-issue situation, an insurance company may be permitted to use medical underwriting.
That can mean answering health questions and qualifying medically before a new policy is approved.
Missouri provides an additional protection that can be particularly useful for existing Plan G policyholders.
Missouri’s Medicare Supplement Anniversary Rule
Missouri has a provision commonly known as the Medicare Supplement Anniversary Rule.
Under qualifying circumstances, an existing Missouri Medicare Supplement policyholder may have an annual guaranteed-issue opportunity associated with the anniversary of their current policy.
For a Plan G policyholder, this can create an opportunity to compare Plan G with another insurance company without the normal medical underwriting that might otherwise apply.
For example:
You currently have Plan G with Company A.
Your premium has increased.
Around your policy anniversary, you may qualify to apply for Plan G with Company B under Missouri’s Anniversary Rule.
Specific timing, eligibility and replacement requirements apply.
Before cancelling an existing Medicare Supplement policy, make sure the new coverage has been approved and you understand the effective date.
Missouri’s Anniversary Rule is based on your policy anniversary, not your birthday and not Medicare’s fall Annual Open Enrollment Period.
Should I Review My Plan G Rate Every Year?
For Missouri Plan G policyholders, an annual review can make sense.
Because standardized Plan G benefits are the same from one insurer to another, a premium increase may be a reason to see how your current rate compares with other available Plan G policies.
That doesn’t mean you should change insurance companies every year.
A review simply answers:
- Has my premium changed?
- How does it compare with other Plan G premiums?
- Am I receiving a discount that could change?
- Am I satisfied with my current insurer?
- Would changing companies actually provide enough benefit to justify doing so?
Sometimes the right answer is to change.
Sometimes the right answer is to keep exactly what you have.
The purpose of a review is to know the difference. The state of Missouri also provides a Medigap Rate Shoppers Tool for your use in research
Does Plan G Include Prescription Drug Coverage?
No.
Medicare Supplement Plan G does not include outpatient prescription drug coverage.
If you want prescription drug coverage, you can generally purchase a separate Medicare Part D prescription drug plan.
Part D plans can differ in:
- Premiums
- Formularies
- Pharmacy networks
- Deductibles
- Copayments and coinsurance
Your prescription drug needs should therefore be evaluated separately from your Medicare Supplement Plan G decision.
Plan G and Travel
One advantage of having Original Medicare with a Medicare Supplement policy is the ability to use Medicare providers throughout the United States.
Plan G also includes a standardized benefit for certain medically necessary emergency care received during foreign travel, subject to the policy’s deductible, percentage and lifetime limits.
If international travel is important to you, review the specific foreign travel emergency provisions before relying on Plan G as your only source of international medical protection.
Frequently Asked Questions About Medicare Supplement Plan G in Missouri
Is Plan G the most comprehensive Medicare Supplement plan available to someone new to Medicare?
Plan G is among the most comprehensive standardized Medicare Supplement options available to people who became newly eligible for Medicare after Plan F eligibility rules changed.
Plan G covers most of the major gaps in Original Medicare but does not cover the Medicare Part B deductible.
Does Plan G pay the Medicare Part B deductible?
No.
You are responsible for the annual Medicare Part B deductible.
The amount is established by Medicare and can change each year.
Does Plan G have copays for doctor visits?
For Medicare-approved services covered by Plan G, Plan G generally covers the applicable Part B coinsurance after the Part B deductible has been satisfied.
This is one of the differences frequently considered when comparing Plan G with Plan N.
Does Plan G cover Part B excess charges?
Yes.
Standard Medicare Supplement Plan G includes coverage for Medicare Part B excess charges.
Can I go to any doctor with Plan G?
Plan G works with Original Medicare rather than establishing a typical Medicare Advantage-style provider network.
You can generally use providers throughout the United States that accept Medicare.
Are Plan G benefits different between insurance companies?
The standardized Plan G medical benefits are the same regardless of the insurance company offering the plan.
Premiums, discounts, customer service and company characteristics can differ.
Can my Plan G premium increase?
Yes.
Medicare Supplement premiums can change over time.
A Plan G policy having standardized benefits does not mean its premium is permanently fixed.
Can I switch from one Plan G company to another in Missouri?
Yes, although medical underwriting may apply depending on when and why you are changing policies.
Missouri’s Medicare Supplement Anniversary Rule may provide qualifying existing Plan G policyholders with an annual opportunity to move to another company’s Plan G without ordinary medical underwriting.
Is Plan G the same as Medicare Advantage?
No.
Plan G is Medicare Supplement insurance that works alongside Original Medicare.
Medicare Advantage is an alternative way to receive Medicare Part A and Part B benefits through a private Medicare-approved insurance plan.
You cannot use a Medicare Supplement policy to pay Medicare Advantage plan copayments or other cost sharing.
Do I still need Medicare Part D if I have Plan G?
Plan G does not include outpatient prescription drug coverage.
If you want drug coverage, you can generally enroll in a separate Medicare Part D plan.
Is Medicare Supplement Plan G Right for You?
Plan G can be a strong option for someone who wants broad supplemental coverage and predictable out-of-pocket medical expenses while remaining with Original Medicare.
But choosing Plan G is only the first decision.
The next question is:
Which Plan G insurance company makes the most sense for you?
Because the standardized benefits are the same, comparing premiums, company characteristics, rate history and your long-term budget can be worthwhile.
Compare Medicare Supplement Plan G Options in Missouri
My name is Paul Carrigan, and I’m a licensed insurance agent helping Missouri and Kansas residents understand their Medicare coverage options.
As an independent agent, I can help you:
- Compare Medicare Supplement Plan G options from multiple insurance companies
- Understand how Plan G differs from Plan N
- Review premiums available in your area
- Understand Missouri’s Medicare Supplement Anniversary Rule
- Review an existing Plan G policy
- Answer questions about transitioning from employer coverage to Medicare
The goal isn’t to push you toward a particular company.
It’s to give you enough information to make a decision you understand and are comfortable with.
We also provide you with the Medicare and You handbook
Call TCG Insurance Solutions at 913-837-0434 or use the form below to ask a Medicare question.
Have a Medicare Question?
If there is one Medicare question I can answer for you, feel free to ask.
By submitting the form, you authorize TCG Insurance Solutions to contact you using the information you provide solely for the purpose of responding to your question or inquiry. Your information will not be used for unrelated marketing purposes or sold to third parties. You are under no obligation to purchase any product or service.
Important Information
This information is provided for educational purposes and is not a complete description of Medicare benefits, Medicare Supplement policies, eligibility requirements or enrollment rules.
Medicare Supplement plan availability, premiums, underwriting requirements and eligibility can vary by insurance company and individual circumstances.
TCG Insurance Solutions is not connected with or endorsed by the U.S. government or the federal Medicare program.
For official Medicare information, visit Medicare.gov or call 1-800-MEDICARE.