Medigap Plan G – What It Covers and Why It Makes Sense

Medigap Plan G is one of the often-overlooked Medicare Supplement plans. Most agent and consumers look to Plan F, which is the most common and comprehensive plan, first. However, Plan G is a great plan and is very similar to Medigap Plan F (only one benefit difference). For that reason, I believe Plan G to be, in most cases, the most advantageous Medigap choice.

So, what does Plan G cover? Well, in short, it covers everything that Plan F covers with one exception. The exception is the Medicare Part B deductible. For 2017, this deductible is $183/year. Other than not covering that deductible, Plan G is absolutely identical to Medicare Supplement Plan F.

The benefits that G includes are: Basic Benefits (20% coinsurance, hospice coverage and blood), skilled nursing facility coinsurance, Part A deductible, Part B excess charges, and foreign travel emergency. These benefits are part of every Plan G because Medigap plans are standardized.

Since the coverage of the Part B deductible is the only difference, it is very easy to compare Plan F and Plan G. If you divide the deductible amount by 12 months, you get the figure $15.25/month. This is the “benefit difference” between the two plans, since all other benefits are identical. So if a Plan G is $20 less than a Plan F, it just makes sense.

Also, and this is something that many people do not realize, Plan G has historically been more rate-stable than Plan F. The primary reasons for this is Plan F is required to be offered on a “guaranteed issue” basis in several situations (i.e. losing employer coverage, losing Advantage plan coverage, etc.). Plan G, on the contrary, is not required to be “guaranteed issue” in these situations. What this means is that Plan F must accept people, regardless of pre-existing conditions, that fall into one of these situations. So on average, the people on Plan F could be less healthier than the people on Plan G, because to get Plan G (unless you are in open enrollment), you would have had to qualify medically. Less healthy people can lead to more claims, and rate increases are based on claims in a certain geographic area.

Lastly, in 2014, legislation passed that set an “end date” to the full coverage Medigap plans, including Plan F. These plans will no longer be available after 2020. At that point, the plans that are no longer available to new members will very likely be less stable over time than other options, including Plan G.

Altogether, Plan G is a great option. While many agents “push” Plan F, doing some simple math can show you that Plan G is more advantageous to you in most cases. If you have questions about Medicare Supplement plans or want to get Medicare supplement quotes, please contact us via our website.

Five Advantages of Using an Independent Medigap Broker

Independent Medigap brokerThere are many advantages to using an independent Medigap broker. These may not be readily apparent to someone who does not fully understand how the back end of the insurance “business” works, but these advantages are significant and they can mean more money in your pocket.

First of all, let’s establish that there are two basic ways to sign up for a Medigap plan. Unlike Part D, you cannot sign up for a Medigap plan directly through Medicare or on Medicare’s website. The two ways to sign up for a Medigap are directly through an insurance company or through an independent agent who represents that company (among others). Signing up directly through the company is certainly an option, and either way, you’ll receive the same rate, same benefits, same claims processing, etc. However, here are five advantages of using an independent Medigap broker that may make that option more advantageous for you.

1. The independent broker is just that, independent, so they can assist in compiling and comparing all options in a centralized place. While this seems like it would be easy for a consumer to do on their own, anyone that has attempted it can tell you, it is a tiresome task. First, all rates are not published online – some may be, but there are questions about whether the website is up to date and whether all options are reflected. What an independent broker can do is compile and present all options in a centralized place.

2. An independent broker can also provide virtually unlimited and unbiased expertise from their dealings with the various Medigap plans. For us, we represent 30+ companies in 40+ states, so we have clients with many different companies. We have seen how stable companies rates have been over time, what problems/issues clients have had and which companies have maintained a strong position in the marketplace.

3. Once you have the rates and information, an independent broker assists by answering questions that you have about how the plans work and what they cover. Again, this is information that can be obtained by thorough reading of Medicare’s materials, but anyone who has done it can tell you, that again, that is not an easy task.

4. After you have understood the plans and chosen one, an independent broker can provide service after the sale. This can take many forms, but the certainty is that, because agents are compensated on an ongoing basis, it is to their advantage to consistently “service” you and your policy. Many other brokers, including us, also offer added services for clients. For example, we offer annual Part D plan reviews, Medicare informational newsletters, and periodic rate snapshots of Medigap rates.

5. The fifth advantage of using an independent Medigap broker is one many people do not realize… You are already paying for a broker, whether you use one or not – it doesn’t cost you anything to use one – so why not capitalize on your premium dollars and use a broker’s expertise. In other words, companies build in the broker’s pay into their premiums, so all policyholders “pay” agents as part of their premiums.

Whether it is us or someone else, it is unquestionable that using an independent broker has many advantages and facilitates and more informed decision. Signing up directly through an insurance company is an option, but by doing so, you would not have access to the unbiased comparative functions offered by an independent broker. Additionally, in most cases, you would be dealing with someone who is not as qualified/experienced specifically in this market. And, lastly, the likelihood that you would deal with the same person over time is not nearly as high (higher turnover and usually you’re calling an 800 to a call room somewhere for service/questions).

If you have questions about this or how using an independent Medigap broker works, please contact us at 877.506.3378 or on our website.

Comparing Part D Plans – A Step-by-Step Guide to Using Medicare.gov

This article is re-posted (with revised dates and updated information) from a previous blog post in 2013.

Comparing Part D plans is an essential task for those on Medicare. Part D is the part of Medicare that covers prescription medications, and frankly, is often the most confusing and complex part of Medicare. It can also be the most expensive, particularly if you have chosen the “wrong” Part D plan.

Part D has an annual enrollment period (contrary to Medicare Supplement plans, which do not). This year, the Part D annual enrollment period, or AEP, runs from October 15 through December 7. Any changes made to your coverage during this time period will take effect on 1/1/16.

So, why do you have to compare plans each year? Can you not just choose a plan and stay with it? Yes, you certainly can stick with the plan that you have now. If you take no action during AEP, your plan will carry you into the next year (as long as it is not being discontinued). But, this is not always a wise strategy. Many things about the plans change from year to year.

Each year, insurance companies have to have their plan outlines/designs approved by the Centers for Medicare and Medicaid Services (CMS). Medicare/CMS sets forth minimum guidelines that they must maintain, but they can expand on those as they see fit. Typically, premiums, deductibles and co-pays on each plan change each year. Also, there is the variable of your actual medications, which may have changed and may make a different plan a better option.

So, how to do you compare the Part D plans. Fortunately, Medicare has put all of the plan information on their website (2016 information will be available around 10/1/15). However, the site is not always very user-friendly. Here are the steps to follow to compare the Part D plans:

  1. Point your web browser to http://medicare.gov.
  2. Click the green button named “Find health and drug plans” (mid-way down, left hand side).
  3. Enter your zip code and click “Find plans”. You may be prompted to enter your county (if your zip code spans multiple counties) – if so, select your county and click “Continue”.
  4. Answer the next two questions and click “Continue”.
  5. This will take you to the drug entry screen. You should enter your medication names exactly as they are listed on the label (in other words, don’t list the brand name if you take a generic equivalent). Then, select the dosage and frequency when prompted. Once you have entered them all, select “My Drug List is Complete” (below the drug names).
  6. Next, select your preferred pharmacy. This is important as co-pays etc can vary on some plans from one pharmacy to the next. Choose the pharmacy that you use now or would most likely use and click “Add Pharmacy” below the pharmacy name. Then, click “Continue to plan results” at the bottom of the screen.
  7. Under “Summary of search results”, select ONLY the checkbox beside “Prescription Drug Plans”. Then, click “Continue to plan results”.
  8. This brings up all the plans for your area and the results are sorted by “lowest estimated annual retail drug costs”. In other words, the plans are listed in order of which plan would cost the least to you over the course of an entire year, taking into account premiums, deductibles, and co-pays for your specific medications (that you entered).

This is truly the best way to compare Part D plans. You can even sign up for the plan you want right there on the Medicare website, or you can get information about contacting to company to enroll. It is a little cumbersome and time-consuming, but the savings that can result are significant. Each year for the last 10 years, I have had a client save $2000+ on Part D costs simply by changing plans to one that fits their medication profile better.

We perform the Part D comparisons at no cost for our Medicare clients, as most independent agencies do (or should do). If you want more information or have questions, please contact me online or call us at 877.506.3378.

How to Make the Right Medigap Choice

logo-collage-smallChoosing the right Medigap plan can be a time-consuming and overwhelming process if you allow it to be. While there is a lot of information out there and a lot of people and companies vying for your “attention”, choosing a Medigap policy does not have to be difficult. Follow this three-step guide to narrowing the choices, reducing the clutter and selecting the plan that is right for you.

  1. Understand the plans. First of all, you must have an understanding of the plans – what they cover, how they work and what is important in the decision-making process. The first thing to know is that the plans are Federally-standardized. That is, all companies provide the same coverage plans – a Plan F with one company is the same as a Plan F with another company. Additionally, the plans all work the same way. Claims are automated (paid electronically without involvement from the patient), and they are done through the Medicare “crossover” system. Lastly, all plans can be used at any doctor or hospital that takes Medicare. In other words, as long as a physician takes your primary coverage (Medicare), they will take your Medigap plan regardless of what Medigap company sold you the plan.In summary, and the main thing to understand when it comes to Medigap plans, is that there are no differences to compare as far as coverage, reliability, how the plan works, where you can use it, etc. The two factors to compare when it comes to Medigap are price (first and foremost) and company rating/reputation. The Federal standardization of plans has made the other variables non-existent or irrelevant.
  2. Compare the rates. Once you understand “what” to compare, it is time to actual do the comparing. There are a couple of ways to do this. The “old-fashioned” way is to get the phone numbers of all companies offering Medigap plans in your area and call them and ask their rates. Some companies will give you this information over the phone; some will require that an agent come to your house to meet with you prior to giving you the information. For most people, this way of doing it is not appealing. However, it is an option.The other way of going about it – which I believe most people would find preferable – is to use an independent agent, or broker, to compare the plans. An independent agent does not work specifically for one particular insurance company, so they are not going to try to “sell” you on their company. Instead, they can give you unbiased information of what company’s offer competitively priced plans in your area. Additionally, they can provide other information such as company rating, past rate stability and reputations, which may help you narrow down the choices and make an informed decision.Keep in mind that the main thing to compare when it comes to Medigap (Medicare Supplement) plans is the rates, as plan coverage is completely standardized by the Federal government. A good independent agent can provide a full breakdown of the companies that offer companies in your zip code, as well as what the rates would be for someone at your age.
  3. Choose wisely. Once you have the information that pertains to premium rates and company rating/reputation, you can easily narrow the choices to which reputable companies are competitively priced for your area. While many people know about Plan F, which is the most common plan, it is not always the most wise choice. It is the most comprehensive but also the most expensive. Plan G is an alternative that typically would provide a savings when compared to Plan F – under Plan G, you have to pay a $147/year deductible but that’s the only difference between ‘F’ and ‘G’ and the premium savings is often $300+/year resulting in a significant net savings.Once you choose a plan, it is easy to enroll, particularly if you are in an “open enrollment” period (i.e. turning 65 or just going on Medicare). Simply complete an application, which the independent agent can facilitate either online or by phone, then the application will be processed by the insurance company. You’ll receive an insurance card and policy in the mail.

While signing up for a Medigap plan is an overwhelming charge for many people, it does not have to be. The standardization of Medigap plans and the proliferation of information available online has made comparing and choosing a Medigap plan much easier than choosing most other types of insurance.

If you would like a listing of the companies/rates in your area or have other questions, you can contact us online or call 877.506.3378.

Rescue Medicare Now – Help Stop Changes to Medicare and Medigap Plans

Dear Valued Clients and Seasoned Citizens:

I wanted to let you know that I’ve joined an organization that is very involved in getting the word out about various policy changes to Medicare that are being discussed as part of budget talks.

These are going to come up again in 2014, and I think it’s imperative that we all assist in making people aware of the possibilities and implications. These changes have been discussed (and proposed in the past) by Congressional members and leaders on both sides of the aisle. You can choose to get involved by contacting your Congressional representative.

I’ve inserted a video below. If you can, do watch it – it is 7 minutes long, but it does talk about some of the ideas that have been discussed and their possible implications. Most of them are directed at consumers “over utilizing” services because they “have good insurance”. This is not actually based in fact and has been disproven by several independent reports over the last few years. In reality, Medigap (Medicare Supplement) plans don’t drive “over utilization” since they do not pay until Medicare approves a service. In other words, Medicare dictates whether it is “medically necessary” and whether the Medigap plan will pay.

This video gives a good overview of what may be proposed – it’s been talked about in previous years with little traction, but many think there will be a greater “push” for changes this year. This would fundamentally change Medicare and Medigap plans.

If you are interested in doing something to make your thoughts known, one thing you can do is sign the petition at: http://rescuemedicarenow.com/petition.

Also, I would suggest that you can call your Congressional representatives as well. See: http://www.ahipcoverage.com/contact-congress/

I am sending this message to all my clients – not as a way to generate fear or false concern – but simply to make you aware of something that has been discussed and may be a part of upcoming budget talks. Feel free to share this information with friends or families – the more we can get this in the “open” the better. Regardless of what happens, if anything, I think we can all agree that the discussions and decisions need to involve the stakeholders who have a vested interest in Medicare and Medigap insurance – you, me and the millions of other seasoned citizens that rely on this valuable coverage.

Thank you for taking the time to read this and please do not hesitate to contact me at any time that you have questions. Email me here.

The Partnership to Protect Medigap – Help Preserve Medigap Plans

Medigap plans protect you against financial catastrophe – why not take some small actions to help protect Medigap plans, with the goal being to preserve Medigap plans’ existence in current form for yourselves and future Medicare-eligible individuals. There has been discussion off and on over the last 2-3 years about reforming Medigap plans. These discussions have ranged from eliminating first-dollar coverage (i.e. Plan F) to overhauling the plans completely to creating a Medicare deductible that cannot be insured against. While none of these plans became a part of PPACA (“Obamacare”) and none have been enacted, it is still important to be apprised of the fact that they have been discussed and likely will be discussed again soon.

Visit the PPM (Partnership to Protect Medigap) web site.

Visit the PPM (Partnership to Protect Medigap) web site.

First of all, to reiterate, nothing HAS changed with Medigap plans and the way they work as a result of PPACA

(“Obamacare”). On the contrary, Medicare Advantage plans were affected considerably, with reductions in funding and new regulations/restrictions. For Medigap plans, there were discussions that included changes to these plans, specifically the Kerry-Stark bill which would have forced Medigap plans to abide by the Medical Loss Ratios that the PPACA included for “under 65” plans. This would have made it difficult for most Medigap companies to compete and, most analysts agree, would have had a detrimental effect on Medigap rates. This and other ideas got pushed to the “backburner” during the PPACA talks and health care reform went forward without including them.

Now, however, is not the time for people who care about having the ability to purchase Medigap plans to fall silent and relax. The Partnership to Protect Medigap is one organization that is non-partisan and works to protect the Medigap plans that so many rely on. You can find out more here: Partnership to Protect Medigap. On their site, you can find out more about protecting Medigap plans and their viability into the future, as well as get information on contacting your Congressional representative and other ways to be involved in these efforts.

Medigap plans provide many benefits for those on Medicare, supplementing Medicare’s sometimes-insufficient coverage and “capping” (or eliminating, in the cases of Plan F) the total out-of-pocket expenses someone would have, regardless of the amount of care needed. Additionally, they provide the security of automated billing (i.e. no paperwork) and flexibility (can go to any doctor that takes Medicare). An independent American Viewpoint independent study found that over 90% of seniors were satisfied with their Medigap coverage. This is one of, if not the, highest among various insurance niches. For these reasons and more, those who have vested interest in Medigap should make the minimal efforts required to protect the future viability of these plans.

If you have questions about this or want to discuss in more detail, contact me online or call 877.506.3378.

Three Reasons the Name of Your Medigap Company Is Not Important

One of the most common thoughts, and understandably so, for many people “shopping” seniors looking at computer
for a Medigap plan is what company or companies have I heard the most about. This leads to people looking, primarily, at the companies that do the most marketing or the company that a neighbor or family member has. While this can lead to some good results – personal testimonials are often a great predictor of future performance – it can also lead to some “tunnel vision” and a lack of understanding of how the plans actually work and what factors should truly go into your decision-making process.

Put simply, the name of your company – even the rating of the company – is not ultimately very important when it comes to choosing a Medigap policy. This does not hold true with other types of insurance, where there are more variables and less standardization. But for Medigap insurance, the name of the company is virtually irrelevant. Here is why:

  1. First of all, the plans are Federally-standardized. This means that the coverage with one company is the same as the coverage with another company. For example, a Plan F with one company is the same as a Plan F with another. This means that price is, or should be, the primary differentiating comparison factor.
  2. Claim payments are paid through the Medicare “crossover” system. This is the same system used by all Medigap companies – it links your “original” Medicare Parts A and B up with your Medigap and insures that claims are paid on the same time schedule and in the same amount regardless of who your Medigap company is.
  3. You can use any doctor or hospital that takes Medicare regardless of which company you have. Different plans are not more or less widely accepted. As long as your doctor takes Medicare, he/she is required to take any of the standardized Medigap plans. Note that doctors offices, and particularly those that work in the insurance/billing offices, are not always well-versed on the different types of plans. And, some companies offer both Medigap and Medicare replacement plans like Medicare Advantage. Very often, someone in the billing department will say that they do not “accept” a certain Medigap plan, when in reality, they don’t have a choice as all claims are paid through the Medicare “crossover” (see point #2 above) and they are not filing specifically to the individual companies anyway.

It is important not to make a decision on a Medigap plan simply because you’ve heard the plan pays well or someone else is “happy with it”. Frankly, everyone is (or atleast should be) happy with their Medigap plan’s claim-paying performance because it is the very same from company to company. It is prudent to have an understanding of the above three points and compare Medigap plans on what really matters – price – before selecting a plan based on imagined or superficial differences. Otherwise, you could, like many others, end up paying “extra” every month for the exact same products that works the exact same way.

If you have questions about this or want to further discuss, you can contact me online or call 877.506.3378.

How Are Medigap Plans Affected by Obamacare?

healthcare.gov websiteThis is one of the most frequently asked questions that we receive from clients and people that we talk to on a daily basis about Medicare and Medigap insurance. So, how are Medigap plans affected by “Obamacare”?

The answer is a short and easy one – simply, they are not directly affected, or impacted, by the PPACA, or “Obamacare”, legislation, due to the fact that the plans are supplemental in nature and not “full-blown” medical plans. As such, Medigap plans are not subject to the requirements and restrictions on individual plans for people under age 65.

For people that have a Medigap plan, Medicare is, of course, still the primary coverage. Medicare covers, in general, 80% of the total, overall medical costs after doctor’s office (Part B) and hospital (Part A) deductibles. The Medigap plans step in to pay the Medicare deductibles (in most cases, depending on which Medigap plan you have) and the 20% after Medicare pays. The way this works – and the type of coverage that Medigap plans provide – has not been changed or impacted by the passage of the “Obamacare” legislation.

On the contrary, Medigap plans have historically been one of the more stable types of insurance since they became standardized in 1992. The actual plan designs have changed a couple of times since then, the last change occurring June 1, 2010; however, the way that the plan works and the overall outline of what they do has not changed.

Additionally, because of the standardization of plans (i.e. one company offers the same coverage plans as another, although rates may differ), the plans are relatively easy to understand, not nearly as complex as “under-65” individual insurance plans, and can be easily compared to one another.

Overall, many analysts project that “Obamacare” will cause some strain on the financial health of insurance companies that have elected to continue to offer individual plans. Learn more about Kratom which can help you to Increase focus and give you many benefits. This may cause some trickle-down to the portions of those companies that do Medigap insurance. However, this is uncertain at best, and for now, Medigap plans look like a safe bet to remain the same post-“Obamacare” as they were before the law was enacted.

If you have any questions about this or would like to compare Medigap plans for your area, please call us at 877.506.3378 or visit our website at http://medicare-supplement.us.

Medicare Annual Election Period Ends – Medigap Enrollment Still Open

The Medicare annual election period ended December 7. This is the time of year that you can change Medicare Part D plans or Medicare Advantage plans, if you are on one of those plans in place of traditional Medicare.Although the AEP is over, you can still make any changes you want to make to your Medigap coverage. Medigap plans do not have an annual enrollment period – you can change plans at any time for any reason, contrary to popular misconception.

If you are on a Medicare Advantage plan, you are locked in to that plan for the year now, unless you disenroll during the short Medicare Advantage Disenrollment Period (MADP), which runs January 1 through February 14. If you do choose to disenroll from your Medicare Advantage plan during this period, you can do so and return to “regular” Medicare A & B and pick up a Medigap plan to fill in the ‘gaps’ in Medicare.

For those on Medigap plans already, it is advisable to compare your Medigap plan to other options on an annual or bi-annual basis. With Medigap plans, rates change annually in many cases. While coverage does not change from year to year, it can make sense to “shop” your rate to make sure you are still getting a good deal.

Fortunately, this is very easy to do when it comes to Medigap plans, as the plans are Federally-standardized. In other words, if you have a Plan F now, you can “shop” other Plan F’s on the basis of rate, with the security that the coverage itself is going to be the same. Additionally, the plans all work in the same way – i.e. you can use them anywhere that takes Medicare, and claims are processed automatically through the Medicare “crossover” system.

If you have not compared your Medigap rates against other options in the last year or more, it is advisable to do so now. Also, if you have a Plan F, now is the time to consider Plan G. Plan G is a better “deal” in almost all cases and will provide annual savings and more rate stability.

If you have questions or want to compare your current rate against what is available, you can request a comparison on our Medicare-Supplement.US website or call us at 877.506.3378.