Original Medicare (Part A & B) + Medigap Plan G (+ Part D)
Highest clinical freedom and most predictable medical cost exposure for progressive Parkinson's: direct self-referral to UCSF, Stanford, and Sutter movement-disorder centers, $0 out-of-pocket for Medicare-covered DBS surgery and LSVT therapy after the $257 Part B deductible, and no commercial prior authorization for routine Part B services.
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Eligibility & Enrollment Windows for Parkinson's Patients
Adults 65+ or SSDI recipients after 24-month Medicare waiting period; Medigap guaranteed-issue during initial 6-month Part B window or annually under the CA Medigap Birthday Rule (for existing Medigap holders).
How Original Medicare + Medigap Plan G Performs Across the Parkinson's Care Pathway
Accepted by virtually all U.S. neurologists and movement-disorder centers (UCSF, Stanford, Sutter CPMC, UCLA, Mayo Clinic) with zero primary-care referral required.
Covered under CMS NCD 160.24 without commercial insurer prior-authorization delays; Medigap Plan G pays the full $1,648 Part A hospital deductible and 20% Part B neurosurgeon/programming coinsurance.
Covers LSVT BIG (PT/OT) and LSVT LOUD (Speech) beyond the $2,480 CY 2026 threshold when the therapist appends the KX modifier for medical necessity; covers maintenance therapy under Jimmo v. Sebelius.
Covered under Medicare LCD L35396 when ordered to differentiate Parkinsonian syndromes from Essential Tremor; Plan G covers the 20% Part B coinsurance (~$262) in full.
Paired with a standalone Medicare Part D plan. Generic carbidopa/levodopa, pramipexole, ropinirole, and rasagiline are Tier 1/2; brand specialty drugs (Rytary, Neupro, Gocovri, Nuplazid, Vyalev) require Part D prior auth, but total annual Part D out-of-pocket costs are capped at $2,100 in 2026.
Covers up to 100 days of skilled nursing facility (SNF) rehab after a qualifying 3-day inpatient stay (Plan G pays days 21–100 coinsurance) and intermittent skilled home health, but does NOT cover non-medical custodial caregiving or assisted living.
- ✓Direct access to UCSF, Stanford, and Sutter movement-disorder specialists without HMO gatekeeper referrals.
- ✓Medigap Plan G eliminates the 20% Part B coinsurance that can otherwise cost $6,000+ on outpatient DBS generator replacements or repeat therapies.
- ✓No 10-visit Medicare Advantage re-authorization pauses mid-way through a 16-session LSVT BIG or LSVT LOUD protocol.
- !Higher fixed monthly premiums (Part B + Medigap Plan G + standalone Part D).
- !Switching from Medicare Advantage into Medigap later in Parkinson's usually triggers medical underwriting in California, where Parkinson's is typically an automatic decline (unless qualifying for a federal/state guaranteed-issue event).
- !Does not cover long-term custodial home care unless the patient also qualifies for Medi-Cal IHSS.
Compare Other California Parkinson's Coverage Types
Source: CMS 2026 Choosing a Medigap Policy Guide, CMS NCD 160.24 & CA Dept. of Insurance Medigap Rate Survey (Oct 2026)