Medicare Supplement

Does Every Plan G Really Cover the Same Things?

GARDNER, Kan. — Shopping for a Medicare Supplement policy can feel like reading a menu in a language you don't speak. Plan G. Plan N. High-deductible G. Plan K. Plan L. The good news for Gardner residents: those letters aren't marketing labels invented by insurance companies. They're federal standards, which means a Plan G sold by one carrier covers the exact same gaps as a Plan G sold by another.

That single fact changes how you shop.

Why the letters are standardized

Medigap policies — also called Medicare Supplement Insurance — help pay some of the costs Original Medicare leaves behind, like coinsurance and hospital deductibles. Since 1992, federal law has required most states to sell Medigap policies using standardized letters. That means the benefit chart for Plan G is identical whether you buy it in Gardner or in Kansas City, and whether the name on the card is one national carrier or another.

Three states — Massachusetts, Minnesota and Wisconsin — standardize their Medigap plans differently. If you move to or from one of those states, the chart works differently and you'll want to compare carefully.

What Plan G covers (and what it doesn't)

Plan G is one of the most comprehensive letters available to people newly eligible for Medicare today. It covers the Part A hospital deductible, Part A and Part B coinsurance, the first three pints of blood, skilled nursing coinsurance, hospice coinsurance, and Part B excess charges. It also includes limited foreign travel emergency coverage.

What Plan G does not cover: the annual Part B deductible. You pay that yourself before Plan G starts filling in the gaps. Plan G also does not cover prescription drugs, dental, vision, hearing aids, or long-term custodial care.

High-deductible Plan G

High-deductible Plan G covers the same benefits as regular Plan G, but only after you meet a separate, higher deductible each year. Until you hit that deductible, you pay Medicare-covered costs yourself. The trade-off is a lower monthly premium in exchange for more up-front risk. It's the same coverage on paper — just structured differently.

What Plan N covers

Plan N covers most of what Plan G covers, with two differences. First, Plan N does not cover Part B excess charges — the extra amount a provider can bill if they don't accept Medicare's approved payment as full payment. Second, Plan N asks you to pay a small copay for some office visits and emergency room visits that don't lead to an admission.

How Plans K and L are different

Plans K and L work on a cost-sharing model. Instead of covering 100% of most gaps, Plan K pays 50% and Plan L pays 75% of certain services — including the Part A hospital deductible, Part B coinsurance, and skilled nursing coinsurance — until you reach an annual out-of-pocket limit set by Medicare each year. After that limit, and after you've paid the Part B deductible, the plan pays 100% of Medicare-covered services for the rest of the year.

That yearly cap is the appeal: predictable protection against a very expensive year. The catch is that in an average or low-use year, you carry more of the day-to-day cost yourself.

Plans C and F — closed to newer enrollees

If you look at an older Medigap chart, you'll see Plan C and Plan F, which cover the Part B deductible. Under federal law, those plans are closed to anyone who became eligible for Medicare on or after January 1, 2020. If you were eligible before that date, you may still be able to buy them; if you weren't, they're off the table.

What Gardner shoppers should do with this

Because the letters are standardized, comparing Medigap policies is not about hunting for a "better" Plan G. Every Plan G covers the same things. Shoppers in Johnson County generally focus on the insurer's premium, its history of rate increases, its customer service, and how it handles billing with providers.

One more thing worth knowing: your strongest consumer protection to buy a Medigap policy is the six-month Medigap Open Enrollment Period that starts the month you're 65 or older and enrolled in Part B. During that window, insurers generally can't turn you down or charge more because of health history. Outside that window, medical underwriting rules vary.