Should You Get the High-Deductible Medigap Plan G? Pros, Cons, and Cost
Key takeaways:
Plan G is the most generous and costly Medigap plan.
Depending on how much you access healthcare, the high-deductible version of Plan G may be a better deal, but it requires you to pay $2,870 out of pocket in 2025 before Medigap coverage begins. However, almost all of your care and cost-sharing is then covered at 100%.
By law, all plans with the same letter name must offer the same benefits. That’s why it’s important to compare premiums and ask the insurance company for its record of price increases.
Table of contents
Medigap plans are insurance supplement policies that cover out-of-pocket costs that original Medicare doesn’t — including copays, coinsurance and the Part A deductible. You typically need to have Medicare Part A and Part B to buy a Medigap plan.
Medigap plans are organized by letter names: A, B, C, D, F, G, K, L, M, and N. All plans with the same letter name have the same benefits. Some Medigap plans cap your expenses with annual out-of-pocket limits, after which the insurance company pays for 100% of approved services.
Among original Medicare enrollees in 2022, 42% had a Medigap plan. Of Medigap enrollees who had one of the 10 standardized plans in 2023, 39% had Plan G.
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The Medigap plans with the most comprehensive coverage can have the highest premiums. If you access lots of healthcare, one way to make the most of your costs upfront and savings later is to choose a plan with a high deductible, which offers lower premiums. For people in most states, that means choosing Plan G — which is the only high-deductible plan available to new Medicare enrollees. (Plan F also has a high-deductible option in some states, but it is only available to people eligible for Medicare before January 1, 2020. And before June 1, 2010, an older Plan J could be sold with a high-deductible option.)
If you live in Massachusetts, Minnesota, or Wisconsin, it’s important to know that Medigap plans aren’t standardized by letter name, and you have fewer options in those states.
What is Medigap Plan G?
Plan G is the most comprehensive Medigap plan available to enrollees new to Medicare on or after January 1, 2020. It is also the only high-deductible Medigap plan available to enrollees new to Medicare on or after January 1, 2020.
There is no Plan G option in Massachusetts, Minnesota and Wisconsin.
What is High-Deductible Medigap Plan G?
High-deductible Plan G is a lower-premium plan with Plan G benefits that requires you to pay a certain amount out-of-pocket — excluding premiums — before the plan pays benefits. The high-deductible Plan G deductible is $2,870 in 2025. A Plan F high-deductible option is available in some states for enrollees eligible on or before January 1, 2020.
What does Medigap Plan G cover?
Plan G covers all of your out-of-pocket costs for:
Part A coinsurance and hospital costs, up to an additional 365 days after Medicare benefits are used up
Part B coinsurance or copayments
First 3 pints of blood
Part A hospice care coinsurance or copayments
Skilled nursing facility care coinsurance
Part A deductible
Part B excess charge
Comparing Medigap plans: Medigap offers 10 different plans — so how do you choose the best policy? Before enrolling, learn more about the benefits of each plan.
Should you consider Medicare Advantage? For many people, the decision between Medicare Advantage versus Medigap with original Medicare comes down to plan benefits and out-of-pocket costs. Learn about the pros and cons of both here.
Traveling with Medigap coverage: People with original Medicare can travel across the U.S. and its territories and be covered by any healthcare professional that accepts Medicare. But if you want to see the rest of the world? Read about the limitations and coverage before you book your next trip.
Plan G also covers 80% of your out-of-pocket costs for emergency health care during foreign travel, up to your plan’s limits. Typically, you have a $250 annual deductible before this coverage begins.
High-deductible Plan G coverage matches regular Plan G once you meet your deductible.
What doesn’t Plan G cover?
Plan G doesn’t cover the Part B deductible, which is $257 in 2025.
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How much does Medigap Plan G usually cost?
Premiums for regular Plan G and high-deductible Plan G vary based on factors including:
Whether your plan offers discounts for being a non-smoker, paying the yearly cost upfront, or other reasons
Whether you have a guaranteed issue right, which means an insurance company must sell you a Medigap plan that covers all of your pre-existing conditions and can’t charge you more because of past or present health issues
Whether you are subject to medical underwriting, which can consider your health in a decision to deny coverage or charge a higher premium
Whether you choose the high-deductible option
Use this Medigap plan finder tool to look for plans and compare costs in your ZIP code.
Premiums will rise, sometimes annually, based on inflation and other factors. Insurance companies can choose to base your monthly cost on one of three factors:
Community-rated: The same premium is charged to everyone in an area, regardless of age.
Issue-age-rated: These premiums are based on your age when you buy the policy and increase as you get older.
Attained-age-rated: These premiums are based on your current age.
Cost comparison
Let’s look at a sampling of 2025 monthly premiums for a 70-year-old man who doesn’t smoke (preferred rate), which may also include a household discount. It’s important to note that rates for women are typically lower. Each state’s sample rates are from a company that sells a standard and a high-deductible Plan G:
State | Insurance Company | Plan G | High-Deductible Plan G |
Connecticut | $240.54 | $67.35 | |
Iowa | $2,041 (annual rate), which is about $170.08 per month | $627 (annual rate), which is $52.25 monthly | |
Maryland | $222 | $57 | |
New Hampshire | $376 | $71 | |
New York | Globe Life for Rochester ZIP codes | $305 | $60 |
How to choose a Medigap Plan G
How do you choose? Generally, community-rated plans are more expensive in the beginning, but their cost rises more slowly. The other two start out cheaper, and their cost rises steadily. No matter what plan you choose, the only thing you can count on is eventual premium increases.
Before you buy any Medigap plan, ask the salesperson how much the cost of the policy has increased over the last 10 years. If the company’s initial price looks low, consider whether the insurer has a history of low premium price increases. You can get this information from:
Your local nonprofit State Health Insurance Assistance Program, known as SHIP
Your insurance salesperson
What are the pros and cons of Medigap Plan G?
Pros
The biggest advantage of Plan G is its breadth. As long as Medicare covers your conditions and your preferred healthcare professional accepts Medicare, Plan G will pay its share.
Plan G seems expensive compared to other Medigap plans and Medicare Advantage plans. But if you need lots of healthcare or develop a condition that requires extensive medical care, Plan G could be very beneficial to you.
Cons
The downside of high-deductible Plan G can be, of course, your upfront cost before you receive help with out-of-pocket expenses. Assuming you have this high-deductible Medigap plan and receive a Medicare Part B-covered service, you’ll be responsible for the Part B deductible, which is $257 in 2025. Then Medicare will pay 80% of covered services and you will pay 20%. Your out-of-pocket spending in 2025 must reach $2,870 before your Medigap plan covers 100% of your share of Part B charges.
The situation changes if you are hospitalized, because Medicare Part A in 2025 has a $1,676 deductible per benefit period or episode of illness. Just that cost places you more than halfway to the high-deductible Plan G deductible. But you’ll need to have enough money to pay the Part A deductible plus about $1,200 more in out-of-pocket costs before your plan pays 100% of your share of Part A charges.
Another drawback of high-deductible Plan G is the chance that you may be stuck with that plan if your health worsens and you’d prefer to switch to regular Plan G. That’s because in most states, you will be subject to medical underwriting after your initial Medigap open enrollment period. That process can include the insurance company reviewing your medical records and the results of a physical to determine your premium — or opting not to cover you. Even if you’re approved, you could face very high premiums.
How does Medigap Plan G compare to other supplement plans?
When comparing Medigap plans, it’s important to note that Plan A and Plan B have the least-generous benefits. Neither covers skilled nursing home coinsurance or Part B excess charges. Plan A also doesn’t cover the Part A deductible, which is $1,676 for every hospital benefit period. All of these are covered by Plan G, and they can add up quickly if you are seriously ill and hospitalized.
If you are trying to save on monthly premiums, take a look at Plan K and Plan L. Both cover Part A coinsurance and hospital costs like Plan G, but they cover a lower percentage of other benefits. They do, however, have out-of-pocket limits. Plan K limits your costs to $7,220 in 2025. Plan L’s limit is $3,610 in 2025.
Medicare Advantage
You also might consider Medicare Advantage plans to replace your Part A and Part B coverage because their upfront costs are low, although ongoing costs can be much higher. But you can’t cover Medicare Advantage out-of-pocket costs with a Medigap plan.
Medicare Advantage plans also have an out-of-pocket maximum, which in 2025 is $9,350 for in-network services or $14,000 for in-network and out-of-network services combined — but this doesn’t include what you’ve paid for Part D prescription medications.
Other programs
If you have limited income, these programs may be able to help you cover your Medicare out-of-pocket costs:
Medicare Savings Programs, which are run by the states and territories
Program of All-Inclusive Care for the Elderly, known as PACE
If you are a U.S. military veteran, see if you qualify for Veterans Health Administration benefits.
The bottom line
In the long run, a healthy original Medicare enrollee may find a sweet spot for care and affordability with the Medigap high-deductible Plan G. That’s because premiums are significantly lower than with the standard Medigap Plan G option. In 2025, the high-deductible version of Plan G requires you to pay $2,870 out-of-pocket before Medigap coverage begins — but then almost all of your care is covered at 100%.
Where you live makes a difference, too. Medigap Plan G high-deductible plans aren’t available in every state, and premium prices can vary greatly state-to-state and even between regions in a state. You may also consider other programs that can help you afford Medicare out-of-pocket costs.
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References
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