Plan G in Pennsylvania
2024 Medicare Supplement Insurance Plan (Medigap)

Monthly Premium

$0-$821

Covered Benefits

Skilled nursing facility
Part A deductible
Part B deductible

Part B excess charges
Foreign travel emergency

*Monthly costs shown do not include the standard Part B premium. 2024 Medicare Part B premium is $174.70 per month.

Coverage Overview

Part A - Hospital - Deductible

$0

(what you pay)

Part B - Medical - Deductible

$240

(what you pay)

Part B - Medical - Coinsurance

$0

(what you pay)

Coverage Details

Part A Coinsurance

(what you pay)

Hospital stays

Days 1-60: $0

Days 61-90: $0

Days 91-150: $0 while using your 60 lifetime reserve days

Additional 365 days: $0 for Medicare-eligible services

After the additional 365 days: All costs

Skilled nursing facility (for Medicare-covered stays)

Day 1-20: $0

Days 21-100: $0

After 100 days: All costs

Blood (during a hospital stay)

First 3 pints: $0

After 3 pints: $0

Hospice care

$0

Part B Coinsurance

(what you pay)

Covered Part B services

First: $240 (Part B deductible)

Then: $0

Preventive services

$0 Generally for most preventive services Medicare covers

Part B excess charges

$0

Blood (outside a hospital stay)

First 3 pints: $0

After 3 pints: $240 (Part B deductible), then $0

Tests for diagnostic services

$0

Home Healthcare - Part A & B Services

(what you pay)

Home health care (for Medicare-approved services)

$0

Durable medical equipment (covered by Medicare)

First: $240 (Part B deductible)

Then: $0

Extra Benefits

(what you pay)

Foreign travel emergency

First: $250

Then: 20% and amounts over the $50,000 lifetime maximum

Insurance Companies Offering This Plan

GPM Health and Life Insurance Company

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