There’s no doubt Medicare is popular among older Americans: In a 2024 Gallup poll, 87% of adults over 65 believe the federal health insurance program will be important or extremely important to them in their later years.
However, Medicare isn’t perfect. Original Medicare, which consists of Part A (hospital insurance) and Part B (medical insurance) — has some gaps in coverage that can end up costing huge amounts if you become chronically ill or have a major medical event, such as a heart attack. Original Medicare also has no cap on out-of-pocket spending, so you could spend endless amounts on deductibles, coinsurance and copayments.
To address this, adults over 65 also have the option of buying an additional insurance policy called Medigap. There are 10 different Medigap plans available, but the most notable is Medigap Plan G.
“Plan G is the most comprehensive nationally standardized Medigap policy available to new Medicare enrollees,” says Melanie Lambert, senior Medicare advocate at the Center for Medicare Advocacy.
That means Medigap Plan G covers the most “gaps” in coverage of any supplemental insurance plan.
The choices among Medicare parts, plans and options, though, can be confusing. Here’s how to decide if Plan G is right for you.
[READ: How Medicare Might Change for 2026 and How It Will Affect Your Coverage]
What Medigap Plan G Covers
Medigap Plan G is supplemental insurance sold by private companies that is designed to cover deductibles, copayments and other out-of-pocket expenses not covered by original Medicare.
In addition, Plan G has additional covered benefits, such as more hospital days.
The full list of federally regulated benefits are:
— Part A deductibles
— Part A coinsurance and hospital costs (up to an additional 365 days after Medicare benefits are used)
— Part A hospice care coinsurance or copayment
— Part B coinsurance or copayment
— Blood benefit (first 3 pints)
— Skilled nursing facility care coinsurance
— Part B excess charge (if a doctor charges more than the allowed Medicare amount)
— Foreign travel emergency benefits
This is more coverage than is offered by the other Medigap plans available to new enrollees (A, B, D, K, L, M and N).
The discontinued Plan F had one additional covered benefit — Plan B’s deductible, which is $257 in 2025 — but that plan is no longer available for people who became eligible for Medicare after January 1, 2020.
Even so, Plan G’s coverage is still very broad: You’ll pay no more than $257 for covered medical services for the year, and zero for covered hospital services.
[READ Medigap vs. Medicare Advantage: Which Should You Buy?]
What Medigap Plan G Doesn’t Cover
Medigap Plan G’s covered services are the same as those of original Medicare.
Conversely, Plan G doesn’t cover what original Medicare doesn’t, such as:
— Vision care, including glasses
In addition, Plan G doesn’t cover:
— Prescriptions. Medigap Plan G doesn’t offer prescription benefits, so you’ll still need to buy the Medicare Part D prescription plan. Plan G also doesn’t offer gap coverage for Part D.
— Part B deductible. As mentioned, Medigap Plan G doesn’t cover the Part B deductible of $257 (2025 rate).
— Parts A and B premiums. Medigap plans help with costs associated with care, but don’t cover your Part B premium (generally $185 per month) or your Part A premium if you have one.
Most people do not have a Part A premium if they’ve been paying into Medicare taxes through their employer.
[READ: When and How to Change Your Medicare Plan]
Medigap Plan G Deductibles
Medicare Plan G tends to be an expensive option, but you get what you pay for: More upfront cost generally means more coverage if and when you need it.
Different insurance companies may charge different premiums, but they usually range around $200 to $250, according to Amy O’Rourke, past president of the Aging Life Care Association and author of the book “The Fragile Years.”
If that’s too high for you to afford, a high-deductible Plan G is a cost-effective alternative. It requires a high upfront out-of-pocket expense before your Medigap Plan G kicks in, but in return, it offers lower premiums.
Medicare Part C (Medicare Advantage) vs. Medigap Plan G
Just when you thought picking a supplemental plan couldn’t get any more confusing, there’s another major option to consider: Medicare Part C, also called Medicare Advantage.
Medicare Advantage is an alternative to original Medicare that’s offered by private insurance companies. In addition to the benefits of original Medicare, Medicare Advantage offers more coverage, such as vision, hearing, dental and prescription drug coverage.
Although the amounts of Medicare Advantage premiums can vary per plan, they are generally low — or even zero.
You will still have to pay the Part B premium of $185 per month in 2025, but the additional benefits often make up for that.
“On a month to month basis, Medicare (Advantage) is the most inexpensive,” O’Rourke says. “If you don’t have $200 to $300 per month every month for (Medigap) insurance, then (Medicare Advantage) is the choice to be made.”
Although Medicare Advantage may seem like a better deal, it isn’t always.
“The difficulty with Medicare (Advantage) plans is the unpredictability of copay costs when a medical event occurs,” O’Rourke says.
These can add up quickly: For example, both Medicare Advantage and Plan G offer 20 free days of skilled nursing coverage. After the 20 days, you pay nothing additional if you have Plan G, but with Medicare Advantage, you have a copay of $206 per day.
“The biggest disadvantage with a Plan G is that you will likely pay more up front in premiums than you would with Medicare Advantage,” Lambert says. “However, the biggest advantage with a Plan G is you have the peace of mind that you know exactly how much cost-sharing you will be responsible for. With Medicare Advantage, it’s harder to estimate what your out-of-pocket liability will be for the year, and you can end up paying more in cost-sharing if you use a lot of services.”
In addition, a Medicare Advantage plan may require you to go to an in-network doctor; whereas Plan G, as with original Medicare, allows you to go to any doctor who takes Medicare.
Medicare Advantage does have a maximum for out-of-pocket cost-sharing for covered, in-network services, which is currently $9,350, so you do know the top limit you could end up spending.
Choosing a Medigap Plan G
Once you’ve decided to go with Medigap Plan G, the next decision is which private insurance company to buy it from.
Two factors to take into consideration:
1. Premium amounts
The coverage and benefits of Medigap plans are the same everywhere because coverage is mandated by the federal government. The only difference will be in the cost of the premium.
“That means that every Plan G offers the same benefits, regardless of premium, which makes it easier to compare options apples-to-apples and shop by lowest premium,” Lambert says.
Some companies may have different premium amounts based on age, health, tobacco use and other factors, which may be regulated by state.
2. Deductible amount
As discussed earlier, you can offset the cost of Medigap Plan G by choosing a high or low deductible.
If you’re in relatively good health now, you might want to choose a high deductible plan to save money on your premium.
In your later years, however, you may want to switch to a low deductible plan — as long as your company will let you.
“I need to make sure that the company I purchase supplemental insurance from will allow me to change my supplemental plan, either to low deducible G or another plan,” O’Rourke says.
When to Enroll in Medigap in Plan G
No matter what company you choose, you should enroll in Plan G as soon as you become eligible to enroll in Medicare, which for most people is the six months after turning 65. During this period, you are guaranteed to be accepted by law.
“In the first six months, there is no risk of medically being ineligible,” O’Rourke says. “After that, you may not be eligible to purchase a supplemental plan because of a medical condition.”
Without a supplemental plan, original Medicare will likely end up costing you much more over time.
“Having traditional Medicare with no supplemental insurance leaves the financial liability huge. There is no cap to the medical out-of-pocket costs or copays,” O’Rourke says.
Resources for Choosing a Medigap Plan
If you’re confused, it’s understandable: Medigap plans can be complicated. There is help available:
State Health Insurance Assistance Program (SHIP)
This no-cost state program should be your first go-to for questions.
“I highly recommend anyone who is trying to decide to call their SHIP for free, unbiased counseling on Medicare options for their specific situation, budget, needs and priorities,” Lambert says.
You can find your local SHIP’s contact information at shiphelp.org.
Aging Life Care Managers
Care managers charge a fee, but you can trust that they will also give an unbiased opinion, if the one you choose is knowledgeable about Medicare.
“Some CMs, like myself, are well versed in the Medicare plans, and can give advice objectively because we do not sell any products or services,” O’Rourke says. “Not all CMs know the Medicare market.”
Medicare brokers
Many older adults use Medicare brokers, but because they work on commission, they might not always have your best interests at heart.
“Buyer beware — some brokers have no objectivity and will sell the Advantage plans hard because the commissions on selling Advantage plans are higher than supplemental plan commissions,” O’Rourke says. “In some instances, it is predatory.”
However, if you find a broker who appears objective, they may be able to explain all of the plans and help you decide.
Medicare.gov
Medicare.gov is the official government website explains everything in plain language, so you can print it out and refer back to it.
Their guide to Medigap policies is comprehensive and includes a chart comparing the different Medigap plans.
Bottom Line
When you become eligible for Medicare, it’s worth deciding on Medigap insurance or Medicare Advantage, which can end up saving you money in the long run.
Taking into account your current health, financial situation and what problems may arise in the future, you can work with a trusted advisor to decide which plan is right for you.
More from U.S. News
How Medicare Might Change for 2026 and How It Will Affect Your Coverage
What Is Medicare’s Chronic Care Management Program?
What Is the Medicare Part D Penalty?
What Is Medigap Plan G? originally appeared on usnews.com
