Plan G Part B Deductible: What You Pay Out of Pocket

When you buy a Medicare Supplement plan, you want peace of mind. You want to know exactly what your healthcare will cost so you can budget for retirement. For most people, Medigap Plan G is the gold standard for that exact reason. But every January, thousands of new Plan G enrollees are caught off guard when they visit the doctor and receive a bill in the mail a few weeks later. They call their insurance agent, confused and frustrated, asking, "I thought Plan G covered everything. Why am I getting a bill?" The answer comes down to one specific rule: the Plan G Part B deductible.

Understanding how the Plan G Part B deductible works is the single most important part of managing your Medigap policy. It is not a hidden fee, and it is not a mistake by your doctor. It is a standard part of how Medicare works for everyone. In this guide, we will break down exactly what this deductible is, how it is billed, what happens after you pay it, and the common mistakes you need to avoid to protect your wallet in 2026.

What Is the Part B Deductible on Medigap Plan G?

In the world of health insurance, a deductible is the amount of money you must pay out of your own pocket for healthcare services before your insurance company starts paying its share. Medicare is divided into different parts, and each part has its own rules and costs. Medicare Part B covers outpatient services, which includes doctor visits, lab tests, medical equipment, and outpatient surgeries.

For the year 2026, the official Medicare Part B deductible is $283 per year. This is an increase from $257 in 2025. This $283 is set by the federal government, not by your Medigap insurance company. It applies to everyone on Medicare Part B, regardless of which company they buy their supplemental insurance from.

Here is the most important thing to know: Medigap Plan G does not cover this $283 deductible. By law, you are responsible for paying this amount out of pocket. Your Plan G policy will sit quietly on the sidelines until you have paid exactly $283 toward your Medicare-approved medical bills for the year. Once you cross that finish line, Plan G activates and becomes one of the most powerful insurance policies you can own.

How the $283 Deductible Is Billed at the Doctor's Office

The most common confusion around the Plan G Part B deductible is how it actually gets paid. People are used to traditional employer health insurance, where you might pay a copay at the front desk before you even see the doctor. Medicare works completely differently. If you have Original Medicare and a Medigap Plan G policy, the billing process is highly automated, but it requires patience.

Step 1: Your Doctor Visit

Let us say it is January 2026. You go to your cardiologist for a checkup. The total cost of the visit and the tests they run is $400. You walk up to the front desk. The receptionist asks for your Medicare card and your Plan G card. You do not pay anything at this moment. You simply show your cards and go home.

Step 2: The Claim Goes to Medicare

Your doctor's billing department sends a claim for $400 directly to Medicare. Medicare looks at the bill and says, "This is a valid medical expense. However, this patient has not met their $283 Part B deductible for the year yet." Medicare subtracts $283 from the $400 bill. That leaves $117. Medicare then pays 80% of that remaining $117, and sends the remaining 20% to your Medigap company.

Step 3: The Claim Goes to Your Medigap Provider

Because your doctor has your Plan G information on file, Medicare automatically forwards the claim to your Medigap insurance company. This is called the "Medicare crossover" process. Your Medigap company sees that Medicare paid its 80% share of the post-deductible amount. Your Medigap company then pays the remaining 20% coinsurance directly to the doctor.

Step 4: You Receive Your Bill

A few weeks later, you will receive two pieces of mail. The first is a Medicare Summary Notice (MSN) from the government, explaining how they processed the claim and noting that you owe the $283 deductible. The second piece of mail is a bill from your doctor for exactly $283. You write a check or pay online directly to your doctor's office. You have now met your Plan G Part B deductible for the entire year.

What Plan G Pays After You Meet Your Part B Deductible

Once you have paid your $283 out of pocket, you unlock the true value of Medigap Plan G. For the rest of the calendar year, you will experience what is often called "first-dollar coverage" for your Part B services. Here is exactly what Plan G covers once your deductible is met.

100% of Part B Coinsurance

Original Medicare only pays 80% of approved outpatient costs. Without a Medigap plan, you are on the hook for the remaining 20%, and there is no cap on how high that 20% can go. If you need a $100,000 outpatient procedure, you would owe $20,000. But with Plan G, after you meet the $283 deductible, your policy pays that 20% in full. You owe nothing.

Part B Excess Charges

Under federal law, doctors who do not accept Medicare "assignment" (meaning they do not agree to Medicare's standard payment rates) are allowed to charge up to 15% more than the Medicare-approved amount. These are called Part B excess charges. If you have Medigap Plan N, you have to pay these excess charges out of your own pocket. But Plan G covers 100% of Part B excess charges. This gives you the freedom to see almost any doctor in the country who accepts Medicare, without worrying about surprise balance billing.

The Massive Part A Hospital Deductible

While we have focused heavily on Part B (outpatient care), you also have Medicare Part A, which covers inpatient hospital stays. In 2026, the Medicare Part A deductible is a staggering $1,736 per benefit period. Unlike the Part B deductible, Plan G covers the Part A deductible at 100% from day one. If you are rushed to the hospital on January 1st, Plan G pays that $1,736 for you immediately. It also covers your skilled nursing facility coinsurance.

Foreign Travel Emergency Care

If you travel outside the United States, Original Medicare provides zero coverage. Plan G steps in to protect you. After you pay a small $250 deductible, Plan G covers 80% of billed charges for medically necessary emergency care outside the U.S., up to a lifetime limit of $50,000. This is a massive benefit for retirees who love to travel.

High-Deductible Plan G: The 2026 and 2027 Limits

If the standard Plan G premiums feel too expensive, there is an alternative version called High-Deductible Plan G (HDG). This plan offers the exact same medical benefits as standard Plan G, but it operates with a much higher out-of-pocket threshold in exchange for significantly lower monthly premiums.

In 2026, the High-Deductible Plan G limit is $2,950. This means you must pay for all of your Medicare-approved out-of-pocket costs until you hit $2,950 for the year. Once you hit that number, the HDG plan kicks in and pays 100% of your covered costs for the rest of the year.

Here is where the math gets interesting: The $283 Part B deductible counts toward that $2,950 limit. If you pay your $283 Part B deductible, you only have $2,667 left to pay out of pocket before your HDG policy takes over. Any Part A hospital deductibles or Part B coinsurance you pay also count toward this limit.

Breaking News for 2027: As of October 21, 2026, the Centers for Medicare & Medicaid Services (CMS) announced that the High-Deductible Plan G limit will increase to $3,050 in 2027 based on inflation indexing. If you are comparing plans for the long term, you must factor in this rising out-of-pocket limit. While the monthly premiums for HDG are often very low, you are taking on a larger share of the financial risk if you have a bad health year.

Plan G vs. Plan N: How the Deductible and Copays Compare

When shopping for a Medigap policy, the two most popular options are Plan G and Plan N. Both plans require you to pay the $283 Part B deductible out of pocket. The difference lies in what happens after you meet that deductible. To make an informed choice, you have to do the break-even math.

As the table shows, Plan N requires you to pay copays of up to $20 for every doctor visit and up to $50 for emergency room visits, even after you have paid your $283 Part B deductible. Furthermore, Plan N does not cover Part B excess charges. Because of these out-of-pocket risks, Plan N comes with lower monthly premiums than Plan G.

To decide which is better, look at your health habits. If Plan G costs $150 per month and Plan N costs $110 per month, you save $40 a month ($480 a year) in premiums with Plan N. If you only go to the doctor twice a year, you will pay your $283 deductible plus two $20 copays ($40 total). You come out ahead financially with Plan N. However, if you develop a chronic condition and need to see specialists twice a month, those $20 copays add up incredibly fast, wiping out your premium savings. If you want a deeper dive into this math, read our full guide on Medigap Plan G vs Plan N.

How the Standard $202.90 Part B Premium Connects to Plan G

It is very common for people to confuse their deductibles with their premiums. A deductible is what you pay when you actually use medical services. A premium is what you pay every single month just to have the insurance, whether you go to the doctor or not.

To have Medigap Plan G, you must be enrolled in both Medicare Part A and Medicare Part B. For 2026, the standard Medicare Part B premium is $202.90 per month (up from $185.00 in 2025). This money goes directly to the federal government, usually deducted automatically from your Social Security check.

On top of that $202.90, you must pay your Medigap Plan G premium to your private insurance company. Depending on your age, zip code, gender, and tobacco use, standard Plan G premiums typically range from $120 to $250+ per month. Therefore, your baseline fixed cost for healthcare before you even see a doctor is the combination of your Part B premium and your Plan G premium.

You must also be very careful about your initial enrollment timing. If you delay enrolling in Medicare Part B without having creditable health coverage (like insurance from a current employer), you will face a strict Part B late enrollment penalty. The government adds 10% to your Part B premium for every full 12-month period you delayed. This is a lifetime penalty. Your Medigap Plan G policy does not cover, absorb, or forgive this penalty. You will pay it every month for the rest of your life.

Medigap Pricing Methods: Why Your Premium Might Rise

When you budget for your Plan G Part B deductible and your monthly premiums, you also need to understand how your insurance company prices its policies over time. Even though the medical benefits of Plan G are standardized by law, the way companies calculate your premium increases is not. There are three pricing methods allowed by law.

When you are comparing rates, always ask the broker or look at the policy details to see which pricing method the insurer uses. A policy that looks incredibly cheap today might be an attained-age policy that will double in price over the next decade.

Why You Can No Longer Buy a Plan That Covers the Part B Deductible

If paying the $283 Part B deductible is such a hassle, why not just buy a Medigap plan that covers it? The short answer is: you can't, because the federal government made it illegal for new enrollees.

For decades, Medigap Plan F was the most popular supplement plan in America because it offered true 100% first-dollar coverage. It covered the Part A deductible, the Part B coinsurance, and the Part B deductible. You could go to the doctor every day of the year and never pull out your wallet.

However, lawmakers realized that when people have zero out-of-pocket costs, they tend to overuse the healthcare system. People would go to the doctor for a minor sniffle because it was completely free. This drove up costs for the entire Medicare program. To fix this, Congress passed the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).

The MACRA rule stated that anyone who became eligible for Medicare on or after January 1, 2020, is legally prohibited from buying a Medigap plan that covers the Part B deductible. This effectively closed Plan F and Plan C to new enrollees. The government wanted seniors to have some "skin in the game"—even if it is just $283 a year—to make them think twice before seeking unnecessary medical care. Because of this law, Plan G is now the most comprehensive plan available to anyone turning 65 today.

The "One-Way Door" Trap: Medicare Advantage vs. Plan G

When you first turn 65, you have a crucial choice to make: Original Medicare with a Medigap plan (like Plan G), or a private Medicare Advantage plan (Part C). Medicare Advantage plans are heavily advertised on television, often boasting $0 monthly premiums. To a healthy 65-year-old, saving $150 a month on a Plan G premium and avoiding the $283 Part B deductible sounds like a fantastic deal.

But this choice is often a "one-way door" trap. When you first enroll in Medicare Part B, you are granted a 6-month Medigap Open Enrollment Period. During this six-month window, you have a guaranteed issue right to buy any Medigap Plan G policy sold in your state. The insurance company cannot ask you any health questions, they cannot deny you coverage, and they cannot charge you a higher premium because of a pre-existing condition.

If you choose a $0 Medicare Advantage plan instead, you forfeit this golden window. Fast forward five years: you are 70 years old, and you are diagnosed with a serious illness. Your Medicare Advantage plan is hitting you with thousands of dollars in copays for specialists and cancer treatments. You decide you want the predictable, low out-of-pocket costs of Plan G. You apply for a policy.

Because your guaranteed issue window is closed, the Medigap insurance company will subject you to medical underwriting. They will look at your health history, see your serious illness, and legally deny your application. You are trapped in your Medicare Advantage plan. If you want to understand your options and rights in this scenario, read our guide on switching from Medicare Advantage to Medigap. Choosing Plan G and paying the $283 deductible up front is often the safest long-term financial play.

Common Billing Mistakes to Watch Out for on Plan G

Even when you understand the rules, the healthcare billing system can be messy. Many Plan G enrollees end up paying money they do not actually owe because of simple misunderstandings or clerical errors. Here are the most common mistakes to watch out for.

Mistake 1: Paying at the Front Desk

As mentioned earlier, you should never pay a copay or a deductible at the front desk when you have Plan G. Doctors' receptionists are used to dealing with standard commercial insurance and Medicare Advantage plans, which require upfront copays. If a receptionist demands a $20 copay or asks you to pay toward your deductible on the spot, politely decline. Tell them to bill Medicare first. If you pay upfront, and Medicare later determines the service was covered differently, getting a refund from a doctor's office is a notoriously slow and frustrating process.

Mistake 2: Thinking Preventative Care Costs Money

The $283 Part B deductible applies to diagnostic care and treatments, not preventative care. Medicare covers a wide range of preventative services at 100%, with absolutely no deductible and no coinsurance. This includes your annual "Welcome to Medicare" visit, yearly wellness visits, flu shots, mammograms, and colonoscopies. If you only go to the doctor for these free preventative services, you will not pay a dime, and your $283 deductible will remain unpaid for the year. That is perfectly fine.

Mistake 3: Confusing the Part A and Part B Deductibles

If you have an outpatient surgery at a hospital, it is billed under Part B, meaning you owe the $283 deductible. If you are formally admitted to the hospital as an inpatient, it is billed under Part A. Remember, Plan G covers the $1,736 Part A deductible completely. Always check your Medicare Summary Notice to see how your hospital visit was classified. If you were only under "observation status," it falls under Part B.

Mistake 4: Ignoring Provider Coding Errors

Sometimes a doctor's office will use the wrong billing code, classifying a free preventative screening as a diagnostic test. When this happens, Medicare applies the cost to your $283 deductible and you get a bill. Always review your Medicare Summary Notice carefully. If a routine physical is coded as a diagnostic visit because you asked a quick question about a sore knee, you have the right to call your doctor's billing department and ask them to resubmit the claim with the correct coding.

A Quick Checklist for Managing Your Plan G Part B Deductible

To keep your finances organized and ensure you never overpay, follow this simple checklist every year:

• Wait for the MSN: Never pay a medical bill until you have received and reviewed your Medicare Summary Notice (MSN) in the mail.
• Match the amounts: Ensure the amount your doctor is billing you exactly matches the "Maximum You May Be Billed" column on your MSN.
• Track your spending: Keep a running tally of what you have paid toward your $283 deductible starting every January 1st.
• Check for preventative codes: Verify that free preventative services like flu shots and wellness visits were not accidentally applied to your deductible.
• Do not pay upfront: Remind the front desk staff to bill Medicare directly for all services.

How to Compare Medigap Plan G Rates on Rebel Rates

The most important thing to remember about Medigap Plan G is that the coverage is strictly standardized by the federal government. A Plan G policy from a massive, famous insurance company offers the exact same medical benefits, covers the exact same doctors, and follows the exact same $283 Part B deductible rules as a Plan G policy from a small, regional company. The only difference is the price they charge you and their customer service reputation.

Because the benefits are identical, there is no reason to overpay for a brand name. At Rebel Rates, our mission is simple: "No BS, just the lowest rates." We help you cut through the marketing noise so you can see the real numbers for yourself, without being harassed by pushy sales agents. If you are ready to find the most competitive premiums in your zip code, take a moment to compare Medicare quotes today. You can also return to the Rebel Rates home page to explore options for life insurance and final expense coverage.