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Medigap G: A Solution to your Medigap F Problem

by Garrett Ball
written by Garrett Ball

One of the superstars of Medigap plans in the last five years has been Medigap Plan G. This plan is one of the more comprehensive Medigap plans and has been increasing in market share and favorability with Medicare beneficiaries. Medigap G: A Solution to your Medigap F Problem

What Does Medigap Plan G Cover?

Medigap Plan G is one step down from the “Cadillac” Medigap plan, Plan F. Plan G fills in all the gaps in Medicare with the exception of the Medicare Part B deductible. For 2017, that deductible is $183/year.
Plan G pays the Part A (hospital) deductible, as well as the 20% coinsurance that Medicare does not cover under Part A and Part B. So on a Plan G, your only out of pocket costs for Medicare-covered expenses would be the Part B deductible amount.

How Does Medigap Plan G Work?

Plan G works just like Plan F and the other Medigap plans. It is designed to work with Medicare and fill in the remaining gaps after Medicare pays. Medigap G: A Solution to your Medigap F Problem
You can use a Plan G at any medical provider that accepts your primary coverage, Medicare. There are no networks on any Medigap plans, including a Plan G (Does my doctor accept my Medigap plan?).
Different insurance companies sell Plan G. In some states, there are as many as 30-40 companies that sell this plan. Each company may charge a different price for their Plan G, although the coverage is the exact same with each of them.
In addition, all the Plan G’s, regardless of which insurance company sells it, pay claims through the Medicare “crossover. This is Medicare’s automated claims payment system that works for Medigap plans and coordinates payments from your secondary insurance (Medigap). Medigap G: A Solution to your Medigap F Problem

Is Medigap Plan G Right for Me?

That is the “64 million dollar question”. Or, maybe it’s the $183 question! The Part B deductible is the only difference between a Plan F and a Plan G. So if the premium savings on a Plan G is greater than the deductible amount, it certainly makes sense to consider a Plan G.
There are other considerations as well. If you have researched Plan F, you may be aware that Plan F is scheduled to end for new beneficiaries as of 2020. What this means for current beneficiaries in Plan F is uncertain, but most analysts agree that Plan F rates will not be as stable moving forward once no “new” beneficiaries are put into that plan. This makes Plan G an even more viable alternative.
Lastly, historically speaking, Plan G has been more stable over time than Plan F has. Plan F is offered in certain “guaranteed issue” situations whereas ‘G’ is not offered in those situations. Over time, this means the pool of Plan G policyholders is slightly healthier, and this has led to more stability over time for Plan G vs Plan F.

Medigap G: A Solution to your Medigap F Problem

Medigap G: A Solution to your Medigap F Problem Medigap G: A Solution to your Medigap F Problem Medigap G: A Solution to your Medigap F Problem Medigap G: A Solution to your Medigap F Problem Medigap G: A Solution to your Medigap F Problem Medigap G: A Solution to your Medigap F Problem

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3 Steps for Medicare Supplement Comparison
Medicare Plans

3 Steps for Medicare Supplement Comparison

by Garrett Ball
written by Garrett Ball

Doing a Medicare Supplement comparison is a crucial part of a sound financial plan for someone on Medicare. Premium rates and guidelines vary considerably from state to state and from situation to situation. But there is so much information out there, much of it contradictory, how do you know where to start? 3 Steps for Medicare Supplement Comparison

Step 1: Understand Medicare Supplement Standardization

Without a doubt, the first step in doing an effective Medicare Supplement comparison is understanding the most basic aspect of these plans – the plans are Federally-standardized. By this, I mean that the coverage is the exact same no matter what company sells you the plan. A Plan G, for example, is the same with one company as it is with a different company.
Not only is the plan coverage standardized, the claims payment process is also standardized, as all companies pay claims through the Medicare “crossover” system. Because of this plan standardization, “like” plans cover the same things and work the same way. So, once you understand this, you realize that Medicare Supplement plans are actually quite easy to compare.

Step 2: Study the Medicare Supplement Coverage Chart and Choose a Plan

The Medicare Supplement coverage chart shows exactly what each of the standardized Medicare Supplement plans cover.
You will see that Plan F is the most comprehensive plan. It pays everything that Medicare Parts A and B do not cover. On that plan, you have no out-of-pocket costs. Although it is the most comprehensive plan, it may not always make the most financial sense.
Every insurance company does not offer every plan. The three plans that most companies have focused on over the last five years are plans F, G and N. Those three plans represent a top, middle and lower level of coverage, within which most Medicare beneficiaries can find a plan that fits their specific situation and needs.
Once you narrow down a level of coverage that you want, or at least have a good idea of what the different plans cover, you can move to step 3 of the Medicare Supplement comparison.

Step 3: Gather Medicare Supplement Rates and Choose a Company

Now you understand the plan standardization and have a good idea of what the different levels of Medicare Supplement plans are, the next step is to look at some actual premium figures and insurance companies.
There are several options for doing this. Some states maintain online resources containing rates for that state. These can typically be found on the state’s department of insurance website; however, they should be verified for accuracy as rates change over time.
Another option is to use an independent broker or agent. This person can provide rates and information for all your options and answer your questions.
A final option would be to contact each of the companies that sell Medicare Supplement plans in your state to gather the rates and use those to make a comparison of your options.
Medicare Supplement rates are determined by your age, zip code, gender, and in some cases, tobacco usage and/or health. So, make sure you use accurate information when requesting and obtaining the premiums.
Once you have the rates for your zip code, you can compare the reputations and ratings of the insurance companies you are considering and pick a reputable company that has competitive rates. Keep in mind step 1 when you are doing step 3 – the coverage and way that the plans work. 3 Steps for Medicare Supplement Comparison

3 Steps for Medicare Supplement Comparison

3 Steps for Medicare Supplement Comparison 3 Steps for Medicare Supplement Comparison 3 Steps for Medicare Supplement Comparison

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Introduction to new Medigap Plan G
Medigap

Introduction to New Medigap Plan G

by Kimberly Johnson
written by Kimberly Johnson

For many years now, the Plan F Medicare Supplement has been the top selling plan. Because of the Medicare Access and CHIP Reauthorization Act of 2015, the Plan F will no longer be available for sale for people who turn 65 in 2020 and thereafter. People who have a Plan F in force at that time can keep their current plan or switch to another Plan F with a different company, but they may not want to. Here’s why: Introduction to new Medigap Plan G
As history has shown with other plans that have been eliminated in the past, Medigap enrollees can likely expect their premiums to rise significantly if younger and healthier seniors are prevented from enrolling in their plan. That is what exactly what happened when Medicare did away with the Plan J in 2010, and many experts expect the same result with the Plan F. Introduction to Medigap Plan G

Let Me Introduce You to Plan G

Plans F and G are identical with one exception – Plan G does not cover the annual Part B deductible (see the Medicare supplement plan chart on our comparison page). Part B of Medicare is the part that is paid to physicians or outpatient facilities for your care. So with a Plan G, you would be responsible for the annual Part B deductible – which is $183 in 2017.
Today, more and more seniors are finding that they can save on out of pocket costs by choosing Plan G instead of the Plan F. In most areas of the country, the difference in premium between a Plan F and Plan G is $280-360 per year. There is no need to pay the insurance company up to $360 more for the only additional benefit of them paying the $183 deductible for you. If you will pay that deductible yourself, you can pocket the difference. The Part B deductible will get paid to Medicare whether you pay directly with a Plan G or by letting the insurance company pay it through a Plan F with a convenience fee tacked on.

Why The Big Difference In Premium?

There are many theories as to why there is a big difference. Many experts attribute it to the fact that Plan G does not accept Guaranteed Issue enrollees. These are typically enrollees who are leaving an employer plan to go on Medicare. Plan F policies must accept all Guaranteed Issue enrollees without any underwriting, regardless of their current health.
Another school of thought says that many people will be more apt to seek treatment for minor issues as they have no deductibles or co-pays under the Plan F for Part B services. This is what is referred to as “first-dollar coverage.”
Either way, the better option is to go ahead and look at the Plan G (or even Plan N). The good news is that Plan G is already a better value today as I demonstrated above. Making a change could actually be beneficial now instead of waiting to see what possibly happens to Plan F premiums down the road. IIntroduction to new Medigap Plan GG
Keith Murray is an independent agent and the founder of ExpertMedicare.com and Integrity Senior Solutions Inc. Keith has over 21 years of experience working with Seniors on their Medicare insurance needs. He can be reached at 1-888-228-6119 or through the website. Introduction to new Medigap Plan G

Introduction to new Medigap Plan G

Introduction to new Medigap Plan G Introduction to new Medigap Plan G Introduction to new Medigap Plan G Introduction to new Medigap Plan G Introduction to new Medigap Plan G Introduction to new Medigap Plan G Introduction to new Medigap Plan G

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Should You Still Enroll in Medicare Supplement Plan F?
Medicare Plans

Should You Still Enroll in Medicare Supplement Plan F?

by Kimberly Johnson
written by Kimberly Johnson
For years, conventional wisdom in senior insurance said that if you were going to purchase a Medicare Supplement plan, Medigap plan F was the way to go. But is purchasing Plan F now a smart move considering it will no longer be issued to new enrollees as of 2020? Should You Still Enroll in Medicare Supplement Plan F?

What is Medigap?

Medigap is actually a nickname for all of the lettered Medicare Supplement plans. They are designed to pay some or all of the fees not covered under Original Medicare. Medigap pays the fees or “gaps” that Original Medicare typically requires you to pay out of pocket, such as copays, coinsurance and deductibles. These costs can really add up. Should You Still Enroll in Medicare Supplement Plan F?

Difference between Medicare Plan F and G:

Each lettered Medigap plan is designed to pay for different gaps in coverage. Plan F is considered the gold standard because it offers everything that Medigap is legally allowed to cover at a historically great price. Plan G, America’s second most popular plan, covers everything that F does except for the Part B deductible which currently is $183.
There is some speculation that Plan F’s monthly premium will increase after 2020 if new younger members are no longer allowed to enroll. Since no one knows what will take place in the future, how do you choose between the two?
We suggest starting with the current price. Many insurance companies now offer Plan G at such a great price that you can save hundreds of dollars annually over plan F. If you can find a plan G that saves you more than $183 a year over F today, it’s most likely a smart move to go with it now.
If you are unable to find a competitively priced plan G, then go with Medigap plan F. You don’t want to overpay for G just because we are unsure about the future of plan F prices.
One final note: Not all Medigap plan prices are posted online, so check with a licensed insurance agent before you pull the trigger on Medigap to make sure you have the best-priced plan in your area.
About the Author: Amy De Vore
Amy is a licensed independent agent. Senior65 is dedicated to helping seniors understand Medicare and enroll in appropriate senior insurance health plans. Should You Still Enroll in Medicare Supplement Plan F?

Should You Still Enroll in Medicare Supplement Plan F?

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Do All Doctors Accept Medigap
Medigap

Do All Doctors Accept Medigap

by Garrett Ball
written by Garrett Ball

If you are turning 65 and comparing Medicare Supplement or Medigap plans, you will probably ask “do all doctors accept Medigap plans?“. This is one of the most common questions for people turning 65 – it can seem complex, but the answer is actually very straight-forward. Do All Doctors Accept Medigap
Put simply, when it comes to accepting Medigap plans, it all depends on if your doctor accepts Medicare itself. Medigap plans “follow” Medicare. So, if a doctor or hospital takes Medicare, they will accept your Medigap plan. It does not matter which company or plan you have since Medigap plans themselves do NOT have networks. Do All Doctors Accept Medigap
If your doctor is a non-participating provider with Medicare itself (rare), then they will NOT accept your Medigap plan either. If Medicare is not accepted, there is nothing for the Medicare Supplement/Medigap plan to “supplement”.
This is not the case, obviously, with many other types of insurance which rely heavily on network arrangements to determine which doctors you can/can not see. For example, under-65 individual plans, group plans, and Medicare Advantage plans all typically use a PPO or HMO network of providers.

What If My Doctor Does Not Accept Medicare Assignment?

There is a difference in accepting Medicare and accepting Medicare assignment. Medicare “assignment” is the terminology that essentially means whether or not a doctor accepts the Medicare payment as payment in full. Medicare has a pre-defined payment schedule for each service or procedure. This is the amount that they will pay to a provider for a certain service or procedure, and it is based on where you are located (varies by location).
Most providers DO accept Medicare assignment (most estimates show that around 95-96% of doctors do accept assignment nationally). This means they accept the terms and conditions (and amounts) on the Medicare payment schedule.
If a physician does not accept assignment, however, he or she can charge up to 15% above the Medicare payment schedule. This is called a “Part B Excess charge”. This is typically billed to you after the doctor visit. There are a few states that have prohibited the charging of these excess charges, including CT, MA, MN, NY, OH, PA, RI and VT (as of early 2017). In those states, doctors can not charge above the Medicare payment schedule if they are going to accept Medicare patients.
Even when doctors do charge excess charges, many of the standardized Medigap plans cover these Part B Excess charges, including Plans F and G. Plan N is the most common plan among the plans that do not cover Part B excess charges.

Why Won’t My Doctor Accept My Medicare Supplement Plan?

We often get this question in January and February of each year. Inevitably, what has happened is the person is in a Medicare Advantage plan that they are mistakenly calling a Medicare Supplement. The Advantage plans all have networks and are typically PPOs or HMOs. Those networks change each year – sometimes even in the middle of a year – and if your doctor is not in network with the specific plan you have, you may have to find a new doctor.
This is one of many reasons why it is crucial to understand the differences in Medigap plans and Medicare Advantage plans.

Do All Doctors Accept Medigap Plans: The Bottom Line

So in summary, do all doctors accept Medigap plans? The short answer is “No”. However, if a doctor accepts Medicare itself, which is your primary coverage, then they will also accept your Medigap plan, regardless of what company sold you the plan or which Medigap plan you have. The key thing to remember is that Medigap plans “follow” Medicare. Do All Doctors Accept Medigap
Do All Doctors Accept Medigap

Do All Doctors Accept Medigap

Do All Doctors Accept Medigap

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Understanding Medicare Plan N
Medicare Plans

Understanding Medicare Plan N

by Garrett Ball
written by Garrett Ball

Medicare Plan N is one of the 10 standardized Medigap plans that are offered to supplement traditional Medicare. Plan N is one of the options that is typically a lower premium with more cost-sharing. So, it can be a good fit for someone who is in relatively good health or who wants to go with a lower-premium option.
Plan N works just like other Medigap plans. Coverage is Federally-standardized, so one Plan N will be the exact same as any other Plan N in terms of coverage. In addition, you can go to any doctor or hospital that takes Medicare – there are no networks. Also, all claims under Plan N are paid automatically through the Medicare “crossover” system.

What does Plan N cover?

Plan N covers the Medicare Part A (hospital) deductible in full. It also pays in full for the hospital coinsurance, hospice coinsurance, and skilled nursing facility coinsurance (20%). So, it is essentially complete and full coverage under Part A charges, filling in the gaps in Medicare Part A.
The Part B (doctor fees and outpatient) charges are where Plan N differs from other, more comprehensive plans like Plan F, Plan C and Plan G. Plan N does not cover the Medicare Part B deductible, which is $183/year for 2017. Also, after that deductible is met, you have co-pays for doctor visits under Plan N – these co-pays are $20 per visit (primary or specialist) and $50 for a visit to the emergency room. Lastly, Plan N does not cover the Part B Excess charges. In short, Part B excess charges are when a doctor does not accept the Medicare payment schedule as payment in full. Under Plan N, you are responsible for paying these.
You must have Medicare Part A and B in order to purchase any Medigap plan, including Plan N. Rates vary considerably depending on your age and where you live. In some states, Plan N can be a very competitively priced plan and a great value. In other areas, the price difference between Plan N and more comprehensive plans is so small that it may not make sense.
It is advisable to research whether Plan N is right for you and how to choose a Medigap plan prior to turning 65 or selecting a plan. If you are in good health with minimal pre-existing conditions, it may make sense to go with a Plan N. However, it is always a good idea to think about your Medigap selection with a long-term perspective as you may have to “qualify medically” to change plans at a later time.
 
 

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Medicare Plans

Boomers turning 65 face complex healthcare choices

by Jeff Dailey
written by Jeff Dailey

Every day, about 10,000 baby boomers turn 65 and become eligible for Medicare. Not everyone will sign up, but it’s important to understand the importance of early choices when enrolling in Medicare for the first time. Boomers turning 65 face complex healthcare choices
You can enroll in Medicare three months before turning 65, the month you turn 65 or up to three months afterward.
“Turning 65 opens the door to Medicare eligibility, but it brings with it some complex choices,” says Paula Muschler, manager of the Allsup Medicare Advisor, a personalized Medicare plan selection service. “Choices seniors make at this time can impact their healthcare costs over the long term and their entire family.”
Muschler offers the following key steps for Medicare first-timers.
1. Take a look at your existing group health plan coverage and think about how it will coordinate with Medicare. Many people work past age 65. As a result, Medicare-eligible individuals who have health coverage through their employer or their spouse’s employer may be able to wait to enroll in Medicare Part B, which covers outpatient medical care. This is not true in every case, however. This option depends on other factors, such as the size of the employer and how soon you expect to retire after reaching 65. You may want to consider enrolling in Medicare Part A, which includes hospital coverage, even if you defer Part B.
2. Consider the options for first-time enrollment, keeping in mind your current health needs and financial resources. If you choose traditional Medicare, you have an average of 31 Medicare Part D prescription drug plans from which to choose. You can also choose from 10 standard Medigap policies for supplemental coverage, ranging from basic to comprehensive coverage. The price for these plans also can differ from one company to the next.
Adding to the complexity, Medigap plans are not required to accept you after your initial enrollment period. This is one reason first-time choices are crucial. Seniors evaluating Medicare Advantage plans over traditional Medicare also have an array of options – an average of 20 plans, depending on where you live. “We’ve been able to help Allsup customers find plans that cost less and match their specific healthcare needs,” Muschler says.
3. Follow Medicare enrollment rules to avoid costly mistakes. Penalties are in place for decisions related to Part B and Part D coverage. The late-enrollment penalty is 10 percent for each full 12-month period you could have been enrolled in Part B. Likewise, Part D imposes a penalty if you go for more than 63 days without coverage after enrolling in Part B.
“Your first-time Medicare plan choices also are more complicated if you have retirement dates, COBRA coverage or dependent coverage to consider,” Muschler says. “These are good reasons to contact a Medicare specialist, who can help answer the right questions and provide guidance to seniors so they make choices that match their situations.”
4. Understand how higher income and changes in your income affect Medicare costs. Higher-income beneficiaries pay higher premiums for Medicare Part B and prescription drug coverage. For Part B, the 2013 monthly premium is $104.90 for joint filers with income of $170,000 or below ($85,000 for single filers). However, the premium increases to between $146.90 and $335.70 for those with incomes above these thresholds. Likewise, higher-income beneficiaries can expect to pay from $11.60 to $66.40 more each month in prescription drug premiums.
The Social Security Administration uses IRS records when determining premiums. Social Security may reduce an individual’s income-related monthly premium with verification. “Social Security has specific requirements about how you can document changes in your income when you are requesting reduced Medicare premiums,” Muschler explains.
5. Review healthcare coverage for your spouse and dependents to determine how your choices may affect their coverage. If you are nearing Medicare eligibility, you can find yourself at a crossroads when it comes to providing healthcare for your entire family.
Some employers may continue to provide coverage to a worker’s family, or you may need to purchase COBRA coverage or private coverage for family members. “One early step is to talk with your benefits plan administrator to see what options you may have and then plan for your family,” Muschler says.
Seniors turning 65 have seven months during their initial enrollment period to make critical decisions. But you can begin evaluating your options earlier to be better prepared.
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Boomers turning 65 face complex healthcare choices

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Guide to Choosing a Part D Prescription Drug Plan
Medicare Plans

Tips to Avoid Medicare Pitfalls

by Carol Marak
written by Carol Marak

Since over thousands of baby boomers enroll into Medicare every day, it’s important to know the facts about the health care insurance program. If you fail to learn, you remain open to expensive mistakes and catches. Tips to Avoid Medicare Pitfalls
Joe Baker, president of the Medicare Rights Center, says, “Avoiding the most common errors in Medicare is the difference between having good financial and health security — or not.” He warns older consumers to learn the rules to avoid higher premiums.
I enrolled in Medicare last year and found the process overwhelming. With the difficult language and limitless selections to choose, it’s no wonder the enrollment left me puzzled. The continuous flow of promotional mail from insurance carriers made the matters worse, not better regarding gaining knowledge. The marketing letters just added to the confusion. And now I face open enrollment and fear the process will take similar paths.
So, to make it easier for the younger boomer, I’ve researched Medicare myths and truths with the intention to save you time and headaches. Here is my assessment:

  • Medicare is not free, and the program has an annual deductible. Beneficiaries do pay monthly premiums. Your income determines the amount.
  • Never assume you don’t qualify or haven’t earned the necessary credits. You may be eligible for the full benefits for Part A – hospital insurance. Understand that the credits are not mandatory to be eligible for Part B, doctors’ services, outpatient care, medical equipment. It’s a requirement that you enroll in Part D, the prescription drug plan, even if you don’t take medications.
  • You must sign up for Part B unless you are 65 and have health coverage at your job (or spouse job) and the employer has 20 plus workers, then delaying Part B is allowable.
  • Even if you have a retiree health plan or COBRA, Part B check with your plan to understand how it works with Medicare.
  • Never count on a friend, associates, or partner to steer you in the Medicare process. Assess your health needs, medications, treatments, physicians, etc. to learn which plan is best. Seek free consultations here.
  • Enrollment begins when you turn 65. You have eight months to enroll when you have coverage at work (or if a spouse carries you on their plan) when it ends.
  • Select a Part D plan according to the drugs you take. Compare coverage and costs among different plans by using the plan finder program on medicare.gov or by calling Medicare at 800-633-4227.
  • Open enrollment comes up once yearly in the fall about an open season that allows you to switch plans.
  • If you intend to buy Medigap, a supplement that covers some out-of-pocket costs like deductibles and copays, you must do it at the right time.
  • Don’t ignore the Annual Notice of Change that comes in the mail each September if enrolled in a Medicare Advantage plan (HMO or PPO) or a Part D drug plan. It states changes and cost increases. It is your chance to make comparisons.
  • There is help to pay for the Medicare, check the Medicare Savings Program and the Extra Help Program to see if you are eligible.

Tips to Avoid Medicare Pitfalls

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How to Avoid Common Medicare Mistakes
Medicare Plans

How to Avoid Common Medicare Mistakes

by Jeff Dailey
written by Jeff Dailey

Medicare, our national social insurance plan for seniors, has been severely disabled since 1964. Compared to individual health insurance plans for those under 65, it is excellent coverage. But you must take an active role in managing your coverage. How to Avoid Common Medicare Mistakes
When you are approaching your 65th birthday, keep the following advice in mind:

  • Enroll on time How to Avoid Common Medicare Mistakes

    In the months prior to turning 65, you are going to be inundated by junk mail. Somewhere in all that, you will also receive a notice from the Social Security Administration that contains your award letter. It lists effective dates for your Part A and Part B, and your Medicare claim number. You will also receive your Medicare card, with the same information on it. Make a copy of the card, and keep these in a safe place.

  • Don’t assume you are enrolled

    Even if you haven’t received a letter or card, don’t assume you are enrolled. Call 1-800-Medicare and get your enrollment information over the phone. Or, you can even enroll online at www.Medicare.gov.

  • Choose a Medicare Supplement plan

    This is particularly important f you spend a lot of time in another home. One of the most common mistakes we hear is seniors choosing an Advantage plan that narrows their choice of providers, when they spend a great deal of the year out of this area. Advantage plans are Regional HMOs. They expect you to choose a primary care physician from their participating group, and that you only see specialists in their referral network.

  • Choose the best plan you can afford

    It is a lot easier to downgrade coverage later than it is to upgrade. For Medicare Supplements, the F plan is the best coverage available. With this supplement plan added to your Medicare plan, you will have almost no out-of-pocket expenses at all and have the largest choices of providers.

  • Medicare Supplements, review plans every year on your birthday

    You have 30 days after your birthday to change your plan with no underwriting, as long you move to a similar or lesser plan. If you want to improve your coverage, you will need to go through medical underwriting.

  • Prescription Drug Plans (Part D)

    Schedule to review your plan each year during open enrollment, October 15 – December 7. Don’t assume that the premiums and co-pays for your medication will stay the same year to year.

If you receive a bill for any medical service, do not pay it until you receive the explanation of benefits from Medicare and/or your Medicare Supplement. It will explain why a charge was not paid. Often, it is as simple as incorrect coding and a simple phone call to the provider can get the bill resubmitted to Medicare. How to Avoid Common Medicare Mistakes

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