楼顶第一个视频里也说有。但第二个没提起。
Asking DeepSeek: "Does Medigap Plan G have out-of-pocket limit or deductible?"
DeepSeek answers:
Excellent question. This is a common point of confusion because Plan G is known for its comprehensive coverage, but it does have one key cost-sharing element.
Here’s the detailed breakdown for Medigap Plan G:
1. The Part B Deductible (The Only Deductible)
Yes, Plan G has an annual deductible. However, it's specifically for Medicare Part B services.
For 2024, the Medicare Part B deductible is $240. (This amount changes annually).
How it works: You must pay this $240 out-of-pocket for covered Part B services (like doctor visits, outpatient care) once per calendar year. After you meet this deductible, Plan G pays 100% of the Medicare-approved amount for covered Part B services for the rest of the year.
Important: This is the only deductible you pay with Plan G. There is no separate deductible for Plan G itself, and it does not cover the Part B deductible.
2. The Part A Deductible (Fully Covered)
Plan G covers the Medicare Part A deductible in full ($1,632 per benefit period in 2024). This is the deductible for hospital stays.
3. Out-of-Pocket Limit (The Key Difference from Medicare Advantage)
No, traditional Medigap Plan G does NOT have an annual out-of-pocket maximum like Medicare Advantage plans or other types of health insurance.
Once you pay the annual Part B deductible ($240), Plan G covers 100% of the Medicare-approved costs for the services it covers for the rest of the year. Your out-of-pocket costs for covered services are effectively capped at that $240 deductible, plus any excess charges (see below).
Crucial Clarifications and Exceptions:
Excess Charges: Plan G covers Part B excess charges (when a doctor charges up to 15% more than the Medicare-approved amount and does not accept Medicare assignment). This is a major advantage. After your deductible, you would pay nothing for these excess charges.
What You Always Pay: You are always responsible for your monthly Medicare Part B premium (standard premium is $174.70 for 2024) and your monthly Plan G premium to the insurance company. These are not considered out-of-pocket costs for services.
Non-Covered Services: If Medicare does not cover a service (like routine dental, vision, hearing aids, or long-term care), Plan G does not cover it either, and you pay 100%.
Plan G High-Deductible Version: There is a High-Deductible Plan G option available in some states. For 2024, you must pay a deductible of $2,800 for covered services before the plan begins to pay. After you meet that high deductible, the plan pays 100% of covered services for the rest of the year. This version does have an out-of-pocket limit—that high deductible amount.
Summary:
Standard Medigap Plan G:
Has one deductible: The Medicare Part B deductible (e.g., $240 in 2024).
No annual out-of-pocket maximum in the traditional sense, but your costs for covered services are extremely predictable and limited after the deductible.
You pay: Part B deductible, Part B premium, Plan G premium, and any costs for services Medicare doesn't cover.
High-Deductible Plan G:
Has a high deductible ($2,800 in 2024). You pay all Medicare-covered costs up to this amount.
This deductible acts as your out-of-pocket maximum for covered services for the year.
Premiums are significantly lower than standard Plan G.
In essence, with standard Plan G, after you pay the relatively small annual Part B deductible, you should have $0 in additional out-of-pocket costs for Medicare-approved services for the rest of the year. This makes it one of the most comprehensive plans available.
