Does Plan G Cover Copays? Plan N Differences and HDG Notes

Medicare Supplement Plan G does cover copays. Once you’ve paid the Part B annual deductible—$283 in 2026—Plan G pays 100% of the copays and coinsurance that Original Medicare leaves to you, so a Medicare-approved doctor visit, specialist appointment, emergency room trip, or hospital stay costs you nothing more out of pocket for the rest of the calendar year.¹²

How Plan G Treats Copays and Coinsurance

People use “copay” and “coinsurance” interchangeably, and Plan G treats them the same: it pays both in full. Under Original Medicare, Part B generally covers 80% of outpatient services and leaves you the remaining 20%, which Medicare labels as coinsurance or copayment.¹ Plan G covers that entire 20% share.

The one cost it does not absorb is the Part B deductible itself. You pay the first $283 of Part B-covered services each year. After that, Plan G steps in and your additional out-of-pocket cost for Medicare-approved care drops to zero.³

Plan G benefits are standardized by federal law, so every insurer sells the identical coverage. Only the premium differs between carriers.⁴⁵ On the inpatient side, Plan G also pays the Part A hospital deductible of $1,736 per benefit period in 2026, the daily Part A coinsurance for extended hospital stays, the skilled nursing facility coinsurance for days 21 through 100, the Part A hospice coinsurance or copayment, and the first three pints of blood each year.⁶¹ It covers Part B excess charges in full, and it pays 80% of medically necessary emergency care during the first 60 days of foreign travel, subject to a $250 annual deductible and a $50,000 lifetime cap.⁷

What You’ll Pay for Common Visits

For the services most beneficiaries actually use, Plan G’s copay math is simple once the $283 Part B deductible is met:

Doctor office visits: $0. Plan G pays the full Part B coinsurance.⁸
Specialist visits: $0.⁹
Emergency room visits: $0, whether or not you’re admitted.¹⁰
Part B drugs such as chemotherapy and clinician-administered injections: $0. Plan G pays the 20% coinsurance for medications given in a clinical or outpatient setting under Part B.¹¹
Durable medical equipment: $0 after the deductible for Medicare-approved items like glucose meters and test strips.¹²
Ambulance and outpatient surgery: $0. Both fall under the Part B coinsurance Plan G covers in full.¹

Costs Plan G Won’t Pay

Plan G fills gaps in Original Medicare, so it only pays cost-sharing on services Medicare already approves. A few categories fall outside that scope:

The $283 annual Part B deductible is yours to pay.¹
Retail prescription drugs. Medigap policies sold after 2005 cannot include drug coverage, so you need a separate Part D plan.¹³
Routine dental, vision, and hearing care, including eyeglasses and hearing aids.¹⁴
Long-term care, including private-duty nursing and non-skilled nursing home care.¹⁴
Anything Medicare itself denies. If Original Medicare won’t pay, Plan G won’t either.¹¹

Where the Copay Confusion Comes From: Plan G vs. Plan N

Much of the uncertainty about whether a Medigap plan charges copays traces back to Plan N, the other popular option. Plan N does charge copays: up to $20 for certain office visits and up to $50 for emergency room visits that don’t lead to a hospital admission.¹⁵ Plan G does not.¹⁶

Plan N also skips Part B excess charges, which Plan G pays. In exchange, Plan N premiums are generally lower. If you rarely see doctors and live in one of the eight states that ban excess charges—Connecticut, Massachusetts, Minnesota, New York, Ohio, Pennsylvania, Rhode Island, or Vermont—Plan N can come out cheaper.¹⁷ If you want to know your copay in advance for every visit, Plan G removes the question.

High-Deductible Plan G Changes the Copay Picture

Some states offer a high-deductible version of Plan G with the same benefits as the standard plan, but only after you pay $2,950 in Medicare-covered costs out of pocket during the calendar year.¹⁸ Until you hit that threshold, you pay all the copays, coinsurance, and deductibles yourself. After it, the plan pays in full for the rest of the year.

The trade-off is a lower monthly premium. For a 65-year-old nonsmoker in Atlanta, standard Plan G runs roughly $129 to $405 per month, while the high-deductible version runs about $44 to $88.³ The $2,950 deductible is indexed to inflation and has risen 34% over the past six years, and switching from high-deductible to standard Plan G later typically requires medical underwriting, so a health condition can make the switch difficult or more expensive.¹⁹ The high-deductible option is available only to people who became eligible for Medicare on or after January 1, 2020.¹⁸

One geography note: Medigap plans in Massachusetts, Minnesota, and Wisconsin are standardized differently from the lettered plans sold elsewhere, so the Plan G rules described here don’t map directly onto policies in those states.⁴

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