Southern Senior Care Blog

I get this question a lot. What IS the “best” Medigap plan? I think Plan G is the best in about 90% of the cases we see. The exception is if the client lives in a zip code in which they can get a Plan F for less than $134 more than the Plan G. The most significant difference between Plan F and G is coverage for the annual Medicare Part B deductible of $134.

 If, for example, you do not have a Medicare Supplement, you have to pay the first $134 dollars each year when you go to a doctor, before Medicare starts paying anything. This $134 is called the Part B deductible. Medigap Plan F pays this Part B deductible for you. HOWEVER, most companies charge about $250 more in annual premium for a Plan F than a Plan G. So, in essence you are paying $250 to save $134. That doesn’t make much sense does it? That is why I prefer the Plan G most of the time.

The Plan G also covers up to $1,700 in home health care that the Plan F does not cover.

If you examine the plans carefully, you will notice another difference in the “Excess charge column.” Plan F pays 100% of excess charges, Plan G only pays 80%. This doesn’t come into play very often. Let me explain. First doctors can only charge 15% more than Medicare approves if they ever do charge more (which most do not.) So, let’s say you have a $2,000 procedure at a doctors office and Medicare approves $1,000. If the doctor wants to charge more, he/she can only charge 15% more, which in this case is $150. Plan F would pay that $150 for you. Plan G would pay 80% or $120. Which means you would have to pay the $30 left over.

Stay with me for one more minute.

So, you pay $250 more for your plan F to save $150. So you are still out of pocket about $100 more than a Plan G. And you might save another few bucks on the excess charge every several years.

Bottom line: review the Plan F and Plan G premiums. If you can get a plan F for $134 more than a Plan G then get it. If the plan F is going to cost you more than $134 more than a Plan G, then seriously consider going with a G. If none of this makes much sense, then send me a quick note on my contact form and I’ll be happy to go over it with you.