What Does Medigap Plan G Cover? Costs, Exclusions, and Fit

Medigap Plan G covers nearly every out-of-pocket cost that Original Medicare leaves behind. It pays the Part A hospital deductible, hospital and skilled nursing coinsurance, the 20% Part B coinsurance, Part B excess charges, the first three pints of blood, hospice coinsurance, and emergency care during foreign travel. The one standard Medicare gap it does not fill is the annual Part B deductible, which is $283 in 2026.¹ For anyone who became eligible for Medicare on or after January 1, 2020, Plan G is the most comprehensive Medigap policy available.

Medigap benefits are standardized by federal law, so a Plan G policy from one insurer covers exactly the same services as a Plan G policy from any other insurer in the same state. Insurers differ on price and service, not benefits.

What Plan G Pays For

Plan G covers the following Medicare cost-sharing amounts in full, with the exception of foreign travel, which has its own limits.

The Part A hospital deductible. Original Medicare charges this deductible each benefit period before it starts paying for inpatient hospital care. In 2026 it is $1,736. Plan G pays all of it.²³

Hospital coinsurance and extra inpatient days. After the first 60 days of a hospital stay, Medicare charges daily coinsurance: $434 for days 61 through 90, and $868 per day for lifetime reserve days (days 91 through 150). Plan G covers all of it. Once Medicare’s hospital benefits run out, Plan G adds up to 365 more days of inpatient coverage.¹⁴

Part B coinsurance. Medicare Part B typically pays 80% of the approved amount for outpatient care. Plan G pays the remaining 20%, with no cap.³ That includes the Part B coinsurance on medications administered in a clinical setting, such as chemotherapy infusions or injections given at a doctor’s office.

Skilled nursing facility coinsurance. Medicare pays in full for the first 20 days of a qualifying skilled nursing stay, then charges $217 per day for days 21 through 100. Plan G pays that daily coinsurance.³

Hospice coinsurance. Plan G pays the Part A coinsurance and copayments for hospice care in full.³

Part B excess charges. A doctor who does not accept Medicare’s approved payment amount can legally charge up to 15% more. Plan G pays that difference, so you are not billed for it.³ More on how often this actually comes up below.

Blood. Plan G covers the first three pints of blood needed for a medical procedure.³

Foreign travel emergency care. Plan G pays 80% of medically necessary emergency care received outside the United States during the first 60 days of a trip, after a $250 annual deductible, up to a $50,000 lifetime maximum.⁵⁶ This is the one Plan G benefit with a dollar ceiling.

What Plan G Does Not Pay For

The one standard Medicare cost-sharing gap Plan G leaves open is the annual Part B deductible, which is $283 in 2026. You pay that once a year before Medicare begins paying for outpatient services.¹ After that, a standard Plan G enrollee generally has no further out-of-pocket cost for Medicare-covered services for the rest of the year.

Plan G also does not cover services that Original Medicare itself does not cover. The common ones:

Prescription drugs. No Medigap plan sold after 2005 includes drug coverage. You need a separate Medicare Part D plan for outpatient prescriptions.⁷
Routine dental care, including cleanings, fillings, extractions, and dentures.⁸
Routine vision care, including eye exams, glasses, and contact lenses.⁹
Hearing aids.⁹
Long-term custodial care in a nursing home or assisted living facility.¹⁰
Private-duty nursing.⁹
Cosmetic surgery, unless medically necessary.⁸

How Often the Excess-Charges Benefit Actually Matters

Plan G’s excess-charges benefit is one of the features often used to sell it. In practice, those charges are rare. As of 2022, 98% of physicians and practitioners billing Medicare were participating providers who accept Medicare’s approved amount as full payment and cannot bill the extra 15%.¹¹ Only non-participating providers who do not accept assignment on a given claim can impose excess charges.¹²

Eight states ban or limit Part B excess charges outright: Connecticut, Massachusetts, Minnesota, New York, Ohio, Pennsylvania, Rhode Island, and Vermont.¹³ If you live in one of those states and rarely seek care elsewhere, that part of Plan G is of little practical value to you. Where excess charges are most likely to appear is in certain specialties. Psychiatrists have the highest Medicare opt-out rate at 8.1%, followed by plastic surgeons at 4.5% and neurologists at 3.2%.¹¹

The High-Deductible Version Covers the Same Things

Some states offer a high-deductible version of Plan G. Coverage is identical to standard Plan G. The difference is that you must first pay $2,950 out of pocket in 2026 for Medicare-covered costs — coinsurance, copayments, and deductibles — before the plan begins paying anything.¹⁴

In exchange, premiums are substantially lower. Reported averages show high-deductible Plan G running about $80 less per month than standard Plan G in Michigan and Texas, and roughly $130 less per month in Florida.¹⁵ High-deductible Plan G is available only to people who became eligible for Medicare on or after January 1, 2020, and only in states that offer it.¹⁴

Where Plan G Is Not Sold at All

Standard Plan G is sold in 47 states and the District of Columbia. Massachusetts, Minnesota, and Wisconsin use their own non-standardized Medigap systems and do not sell the lettered plans.¹⁶ In Wisconsin, for example, you build comparable coverage by starting with the state’s mandatory Basic Plan and adding optional riders for the Part A deductible, excess charges, and foreign travel emergency coverage.¹⁷

Who the Coverage Fits

Plan G is built for predictable medical expenses. Once you pay the $283 Part B deductible each year, a standard Plan G enrollee generally has no further cost-sharing on Medicare-covered services. That predictability is what the higher premium buys. If you see doctors often, have specialists who may not accept Medicare assignment, or simply want to stop tracking coinsurance and copays, Plan G delivers that. If you are healthier, go to the doctor less, and want a lower premium, the high-deductible version of Plan G keeps the same coverage behind a $2,950 threshold, and other Medigap letters trade some benefits for a lower monthly cost.¹⁰

1
CMS. 2026 Medicare Parts B Premiums and Deductibles
2
Medicare Advocacy. 2026 Medicare Rates
3
Medicare.gov. Compare Medigap Plan Benefits
4
Medicare.gov. Inpatient Hospital Care
5
Medicare.gov. Medicare Coverage Outside the United States
6
AARP. Does Medicare Cover Me Outside the US
7
Medicare.gov. How Medigap Works
8
AARP. Services Not Covered by Medicare
9
Medicare.gov. Medigap Coverage
10
NerdWallet. Medigap Plan G
11
KFF. How Many Physicians Have Opted Out of the Medicare Program
12
CMS. Medicare Participation
13
Healthline. Medicare Part B Excess Charges
14
CMS. CY2026 Medigap High Deductible Options
15
GMedicareTeam. High Deductible Plan G
16
GoodRx. Medigap Plan G Pros and Cons
17
TheBig65. Medigap Plans in Wisconsin