What Does Medicare Plan G Cover in Texas?

Medicare Supplement Plan G is one of the most comprehensive and predictable Medigap options available to Texans enrolled in Original Medicare. As a supplement, not a replacement, it works alongside Medicare Parts A and B to reduce the out-of-pocket expenses you would otherwise pay on your own. Unlike Medicare Advantage plans, which operate through networks and private insurance rules, Plan G maintains the full provider freedom of Original Medicare, making it especially appealing to those who want nationwide access without referrals or restrictions.

Because Plan G is a Medicare supplement policy and is designed for people who value stability, predictable yearly costs, and strong protection from unexpected medical bills. Many Texans choose Plan G because it offers broad coverage without the higher premiums sometimes associated with other Medigap plans.

What Medicare Plan G Covers

When people ask, “What does Medicare Plan G cover?”, they are usually trying to understand how much financial protection the plan provides beyond Original Medicare. Plan G is designed to fill many of the most common out-of-pocket gaps in Medicare Part A (hospital) and Part B (medical) so that healthcare costs feel more predictable throughout the year. By covering major hospital expenses, routine outpatient copays, and important ancillary services, Plan G helps Texans reduce the burden of unexpected medical bills and maintain consistent access to care.

Hospital and Skilled Nursing Coverage

• Part A coinsurance and hospital costs for up to 365 additional days after Medicare ends. This added protection helps safeguard against long hospital stays, which can be very expensive without supplemental coverage.
• Part A hospice care coinsurance or copay, ensuring comfort-focused services remain accessible throughout end-of-life care.
• Skilled nursing facility coinsurance, which can significantly reduce costs during rehabilitation or recovery periods.
• Medicare Part A deductible, a sizable amount that Plan G absorbs so members do not face large upfront hospital bills.

Medical and Outpatient Coverage

• Part B coinsurance and copays, which apply to doctor visits, outpatient procedures, specialist appointments, and durable medical equipment.
• Coverage for the first three pints of blood each year, an important benefit for surgeries or medical treatment involving transfusions.
• Part B excess charges in states where they may be billed, offering added protection if providers do not accept Medicare assignment.

Additional Benefits

Foreign travel emergency coverage, up to plan limits, which can help pay for urgent care while traveling outside the United States.

These Medicare Supplement Plan G benefits are standardized across insurers, meaning the coverage is the same no matter which company issues the policy. Premiums and customer service can differ, but the core protections remain identical. Many Texans find that Plan G delivers an ideal balance of comprehensive coverage and simplicity, providing strong financial protection without confusing copay structures or fluctuating out-of-pocket expenses.

What Medicare Plan G Does Not Cover

To make an informed decision, it is equally important to understand what Plan G does not cover. The most notable exclusion is the Medicare Part B deductible, which must be paid out of pocket before Medicare and Plan G begin covering outpatient services. Although this deductible is relatively modest, it represents the one cost Medicare Supplement Plan G does not absorb, which is why premiums are often lower than those for Plan F.

Beyond the deductible, Plan G does not include coverage for services that fall outside the scope of Original Medicare. These gaps are not unique to Plan G; they apply to all Medigap plans because supplemental policies are designed only to work alongside Medicare Parts A and B, not replace or expand them.

Plan G also does not include:

• Prescription drug coverage (Part D is purchased separately)
• Routine dental, hearing, or vision care
• Long-term custodial care or assisted living
• Extended foreign travel benefits beyond the limits of the policy

If you need coverage for prescriptions, dental cleanings, eyeglasses, or hearing aids, you can explore supplemental insurance options to round out your benefits. Many Texans pair Plan G with a Part D prescription plan and stand-alone dental or vision coverage to create a more complete and predictable healthcare package.

Medicare Plan G vs. Plan F and Plan N

Texans comparing Medigap plans often want to understand the differences between Medicare Plan G vs Plan F and Medicare Plan G vs Plan N, especially when balancing premium costs with out-of-pocket responsibility. Although each plan is standardized, the financial experience can vary widely depending on your medical usage, provider preferences, and comfort level with cost sharing.

Plan G

• Covers all Medigap benefits except the Medicare Part B deductible
• Offers strong cost protection and wide provider choice nationwide
• Popular among those who want predictable yearly expenses with minimal surprises

Plan G appeals to people who prefer stable, predictable healthcare spending. Because the only out-of-pocket medical cost is the annual Part B deductible, it provides simplicity without the higher premiums associated with Plan F.

Plan F

• Covers the Part B deductible, the one benefit Plan G does not include
• Only available to people who became Medicare eligible before January 1, 2020
• Typically has higher premiums due to its more comprehensive benefit structure

Many long-time Medicare beneficiaries still keep Plan F, but new enrollees cannot purchase it. Even for those who can, the premium difference often makes Plan G the more cost-effective option.

Plan N

• Lower monthly premiums than Plan G
• Copays for office visits and potential copays for emergency room visits
• Does not cover Part B excess charges

Plan N is designed for people who want to lower their premiums and do not mind occasional copays. However, those who visit specialists often or want protection from excess charges may prefer Plan G instead.

Takeaway:

Plan G often provides the strongest blend of affordability and coverage for Texans seeking predictable out-of-pocket expenses. Plan N may appeal to cost-conscious individuals willing to trade small copays for a lower premium, while Plan F remains an option only for those who qualified before 2020. If you need help comparing these plans, Selected Benefits can walk you through the options and explain how to choose a Medicare supplement that fits your needs.

Costs, Premiums & How Plan G Is Priced in Texas

Understanding Medicare supplement costs in Texas is essential because even though Plan G benefits are standardized, premiums vary widely by insurer. Companies use different pricing formulas, known as rating methods, such as:

• Community-rated: Everyone pays the same premium
• Issue-age-rated: Premium is based on your age when the policy is issued
• Attained-age-rated: Premium increases as you age

Premiums are also influenced by:

• ZIP code and county of residence
• Age at enrollment
• Tobacco use
• Household discounts

In Texas, premiums can differ significantly between rural and metropolitan areas because insurers evaluate healthcare usage patterns, medical costs, and provider access differently across the state. A policy in Dallas or Houston may be priced very differently from one in West Texas, even with identical benefits. Some insurers also offer introductory rates that rise more quickly, while others focus on long-term stability.

Because insurers may price the same standardized benefits very differently, comparing options is essential. A Texas-based advisor can help review rates and show how Plan G fits alongside individual and family health insurance needs if multiple members of a household are exploring coverage.

When to Enroll

Timing matters when enrolling in Medigap. Your best opportunity is the Medigap Open Enrollment Period, which lasts six months starting the first month you are both 65 or older and enrolled in Medicare Part B. During this window, you cannot be denied coverage or charged more due to health conditions.

Outside this period, approval may require medical underwriting unless you qualify for a guaranteed-issue scenario, such as losing other credible coverage.

Here’s a simple enrollment roadmap based on common Medicare enrollment periods:

1. Enroll in Medicare Parts A and B. Plan Medigap Plan G in Texas requires active enrollment in Original Medicare.
2. Check your Medigap Open Enrollment start date. This is your most flexible window for securing coverage.
3. Evaluate guaranteed-issue protections if applicable. These situations allow you to enroll without underwriting.
4. Compare plans early. Reviewing options before your 65th birthday ensures no gaps.

If you still have questions about eligibility, pricing, or timing, view our Medicare and health insurance FAQ for straightforward guidance.

Is Medicare Plan G Right for You?

Whether Plan G is the best fit depends on your healthcare needs, travel habits, budget, and comfort with unpredictable expenses. Plan G is widely chosen by Texans who:

• Want broad provider access
• Prefer predictable annual costs
• Travel frequently within the U.S.
• Want to limit surprise medical bills
• Prefer comprehensive protection without high premiums

Ultimately, comparing premiums, out-of-pocket exposure, and long-term value is the best way to determine whether Plan G meets your goals. If you'd like personalized help reviewing your options, you can learn more about our team or request guidance directly.

For tailored advice and plan comparisons, you can always contact Selected Benefits to review Medigap options side-by-side and ensure the coverage you choose fits your needs today and into the future.