All About the High-Deductible Plan G Medicare Supplement
This article provides an overview of Plan G Medicare Supplement (MediGap) insurance with the high-deductible feature. This article will refer to the high-deductible Plan G as HDG. The article will explain:
Why there is a lot of interest in HDG in the past couple of years
How the HDG plan works, including who pays what and when
How to determine if HDG is a good fit for your medical and financial situation
As with all things Medicare, the more you explain, the more questions arise. For more information and those inevitable questions, contact me here. If you don't know anything at all about Medicare supplement (Medigap) plans, you should first read my overview article here: All About Medicare Supplement Insurance
Why the Recent Interest in HDG?
Dissatisfaction with Medicare Advantage plans, due to provider network restrictions and prior authorization denials, is driving interest in HDG. Many seek alternatives to managed care plans (Medicare Advantage, Part C), but the full coverage Plan G supplement's monthly premium is often unaffordable. HDG offers a more affordable option, making Original Medicare accessible to more people.
First Things First: Gaps in Original Medicare
When we're talking about Medicare supplements, your primary insurance is Original Medicare (OM) and your supplement is your secondary insurance. The purpose of a Medicare supplement plan is to plug the gaps in OM and have those gap costs paid by the supplement. Except for preventative screenings, Original Medicare does not pay 100% for anything. In fact, there are six coverage gaps in Original Medicare, three in Part A and three in Part B. (See graphic below: Gaps in Original Medicare)
Without any additional coverage, you would be responsible for covering those gaps out of your own pocket, and you would have no maximum out-of-pocket protection. That's where Medicare Supplement plans come in. They cover the gaps in OM and protect you from burdensome medical costs.
Gaps Covered by Plan G
Medicare supplement Plan G covers five of the six gaps in Original Medicare. (See chart below.)
How HDG Differs from Plan G
The same gap coverage shown in the chart above is provided by both Plan G and HDG. The difference is that HDG adds an annual deductible, which we call the HDG deductible to differentiate it from the annual Part B deductible.
IMPORTANT: Do not confuse the annual Part B deductible with the HDG deductible. For 2026 the annual Part B deductible is $283. The HDG deductible is $2,950. The annual Part B deductible counts toward (accrues toward) the HDG deductible.
An HDG supplement does not pay anything toward your care until you have reached the annual HDG deductible in out-of-pocket costs. Below is a table showing who pays what and when on HDG. It's important to note that once you've paid your annual Part B deductible, OM pays your claims as they normally would. You are not left to pay the full cost of what Medicare allows. You pay only your usual copays and coinsurance until your HDG annual deductible is met.
Let's Look at Some Actual Numbers
Let's take a couple of examples of what you may have to pay for medical care once your annual Part B deductible is met. Refer to the chart above: Gaps in Original Medicare
Primary care office visit: Medicare allows approximately $200 for a primary care office visit. You would pay 20% of that, or around $40.
Specialist office visit: Medicare allows approximately $300 for a primary care office visit. You would pay 20% of that, or around $60.
Inpatient hospital stay: You would pay the full hospital admission deductible of $1,736.
You will continue to pay your usual OM copays and coinsurance until your HDG annual deductible is met. Once your HDG annual deductible is met, HDG pays exactly like a full Plan G with no deductible. Many people won’t meet the high deductible in a routine-care year, but hospitalization or substantial outpatient treatment could bring them to it.
Is HDG Right for Me?
HDG may be right for you if you can answer "Yes" to the following questions:
In the event of an expensive health year, I have the expendable cash to cover BOTH the HDG premiums, AND the HDG deductible.
I don't mind monitoring and paying bills for medical care to ensure that my bills are paid and that my out-of-pocket costs are being counted toward the HDG deductible.
I am financially able to cover costs for dental, vision, hearing and medical transportation over and above my medical costs. (OM does not cover these expenses. Your Medicare Advantage plan may have had benefits that helped with such expenses.)
In general, HDG is not a good fit for those who get medical care frequently or who have complex medical conditions requiring a lot of medical attention. Working with many clients as I have, I often find that if you compare the annual premium costs of a Plan N Medicare supplement to the combined annual costs of HDG premiums plus the HDG deductible, the total annual out-of-pocket costs are lower on Plan N. On HDG, you may be counting on saving the monthly premium costs, but that only happens in a routine-care year, not in a year with costs that meet the HDG deductible.
Concluding Thoughts
As with all things Medicare, there's a lot to consider and I can help. Please don't hesitate to contact me for Medicare Supplement quotes or to answer any questions you may have: contact me here
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