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.

Medigap vs. Medicare Advantage – What Are the Differences?

Medigap vs. Medicare Advantage – which option is right for you? This is certainly a topic that
has been covered extensively before, but with medigap vs. medicare advantagethe end-of-year annual election period coming up, it is a good time to revisit the distinguishing characteristics of these plans. To do that, we’ve broken it down into four overarching areas in which the two types of plans are different.

If you aren’t familiar with the terminology, Medigap plans, or Medicare Supplements as many people call them, are plans sold by private insurance companies that fill in the ‘gaps’ in Medicare. They act secondary to Medicare’s primary coverage.

Medicare Advantage, on the other hand, are not Medicare supplements. They do not supplement Medicare; on the contrary, they take the place of Medicare as primary coverage. They are sold through private insurance companies, but they are regulated by and approved (annually) by the Centers for Medicare and Medicaid Services (CMS).

So, how do these two types of Medicare cover differ?

Usability
Plan usability is, and should be, at the forefront of any decision you make about a Medicare plan. Some doctors/hospitals have chosen to not participate in either Medicare or Medicare Advantage plans (or in some cases, both). That said, Medicare can be used anywhere nationally that takes Medicare, so there is not an actual network. Whereas with Medicare Advantage plans, there is a contractual network in most cases, and the networks are regionally based typically. Overall, there are significantly fewer problems using a Medigap plan in terms of doctors taking the plan or where you can use the plan. If your doctor takes Medicare, they are required to take the Medigap plan that you have.

Coverage
Moving on to coverage, Medigap plans are considerably more comprehensive than Medicare Advantage plans, as far as coverage goes. The top level of Medigap plan pays everything that Medicare A & B do not cover. Medicare Advantage plans use a system of co-pays and deductibles.

Premium
That brings us to premium. Medicare Advantage plans, while they are lower coverage, do also have lower premiums. In some cases, the premiums are even $0 (they use the Medicare Part B premium, which you still have to pay, to offset the costs for the private insurance company). Medigap premiums range widely, depending on your age, zip code, and in some cases, health status.

Future
The future of Medicare plans, in general, is something that has caused much anxiety for people who are over 65 or will be on Medicare soon. While there has been much debated in the last several years regarding Medicare and Medicare supplement plans, the majority of aspects of Medicare/supplement plans have not changed. Medigap really has not been touched at all, other than a 2010 restructuring of the standardized plans. Medicare Advantage, on the other hand, was involved in the PPACA, cuts to the Medicare Advantage program helped fund health care reform. As of now, though, both program still exist and are going strong. With 11,000 Medicare-eligibles aging in to Medicare every day, there is a constant influx of new people onto these plans.

One additional consideration related to the future, particularly if you are comparing the two plan types, is that you do have to qualify medically to get a Medigap plan outside of your initial 6-month open enrollment window. In other words, if you choose a Medicare Advantage plan initially, then wish to return to Medicare with a supplement, you do have to qualify to get the Medigap plan. So, this is certainly something to consider when you take the long view of your health and medical coverage.

If you have any questions about this information or would like to discuss your specific situation, you can reach us at 877.506.3378 or online at Medicare-Supplement.us.

2014 Medigap Plans

2014 Medigap plans will be the same, coverage-wise, as 2013 Medigap plans. With Medigap, coverage is Federally-standardized and all plans go by the Medigap coverage chart. This has been changed in recent years – effective June 1, 2010 – but since that point there have been no changes to the coverage chart. The Federal government – CMS, really – is the one that sets forth this chart and determines what Medigap plans will cover. Although the prices for the plans from different companies can vary considerably, this ensures that the coverage is the same for “like” plans. In other words, a Plan F with one company is the same as a Plan F with another.

So, although the coverage on the 2014 Medigap plans is the same as the 2013 plans, there are other factors to consider. First of all, many people mistakenly think that there is an annual enrollment period for Medigap plans – this is not the case. The annual enrollment period that runs October 15-December 7 is actually for the Part D Rx plans and the Medicare Advantage plans, which take the place of Medicare. For Medigap plans, you can sign up for, leave, or change plans at any time of the year.

As far as companies and rates go, there are always changes going on with Medigap. Over the past year or two, there have been several new companies to enter the marketplace, including CIGNA, AFLAC, Stonebridge Life, and Central States Indemnity, that have very competitive rates in many states and are striving to become market leaders due to price competitiveness and financial stability.

Just like there is not an annual enrollment period for the plans, Medigap rates do not change with the calendar year necessarily. So while your Medigap company may change rates 1/1/14, it is more common that your plan will change rates on your policy anniversary date.

Moving into 2014, it looks like the aforementioned companies, as well as some old “stand-bys”, such as Mutual of Omaha, AARP/United Healthcare, Aetna, etc will continue to be prominent players in the national Medigap market. The rates, of course, depend on what state you are in, your age, gender, and sometimes, other factors. So, it is important, if you are comparing plans, to get an accurate depiction of what is available in your area and what the actual rates would be.

Medicare-Supplement.US is a leading, independent Medigap brokerage that works with 35+ companies in 39 states. If you want a comparison for your specific situation, contact us online or call us at 877.506.3378.

 

Supplemental Medicare Plans – What Are They and Who Needs Them?

Supplemental Medicare plans are plans that “follow” behind Medicare and fill in the gaps in coverage in Medicare. These plans are also called Medicare supplements or Medigap plans, and they are sold through private insurance companies. There are a handful of these options out there and they vary by state, so it is important to be apprised of what’s available in your area if you are trying to determine if this type of a plan is a good idea for you. Here are a few considerations:

  • First, you should understand what you have. Are you on an employer group plan now? If so, will that plan continue even after you go on Medicare? And, at what cost to you? If you do not have other coverage, such as a employer-based plan or retiree plan, will you plan to have only Medicare coverage?
  • Next, it is essential to understand what Medicare does and does not cover. Medicare is relatively comprehensive coverage; however, it does “leave out” an unlimited 20% of medical costs at the doctor/hospital. In other words, if you have only Medicare – with no supplemental Medicare plan – you would be responsible for an unlimited 20% of costs at the doctor/hospital.
  • Last, you should understand what a supplemental Medicare plan would do for you in order to decide if it would be a good idea. There are two types of plans available to those on Medicare – actual supplement plans and Medicare Advantage plans. It is important not to confuse the two. Medicare Advantage plans take the place of Medicare – they do not supplement it. The coverage is at a lower level, and although premiums are also lower, there are some things to consider such as network restrictions, future portability and long-term viability.

Your health is very important to your all-around well-being, particularly when you are of Medicare age. Because of that, it is wise to consider whether a supplemental Medicare plan makes sense for you. It can give you financial peace of mind as well as providing for good, long-term health.

 

Effects of “Obamacare” on Medicare & Medicare Supplements

“Obamacare”, or the PPACA, was signed into law in March 2010. Many of its provisions have been slowly becoming integrated into our health care system. And, in 2014, many of the individual health provisions take effect. For people on Medicare, many are wondering how “Obamacare” will affect them. As a Medicare Supplement brokerage, this is a question we receive almost daily.

If you have Medicare, regardless of what type of supplement coverage you also have (if any), you will be affected by the PPACA. First of all, there have been some relatively significant changes to how the “donut hole” is administered on Part D (Rx coverage). If you have not “felt” these changes yet, it is because they are being rolled out little-by-little over the next few years, culminating in 2020.

On Medicare itself, although there were many significant changes discussed, the coverage on Parts A and B (hospital and doctor’s office, respectively) were not overhauled or changed in prolific ways. Some things were changed, however. These include more preventive care being covered (i.e. wellness checks) and more protection against fraud and abuse of the system.

Now, as you no doubt know, this legislation did not come without a price tag. Some of the PPACA was paid for through reductions in funding to privatized Medicare plans called Medicare Advantage. These plans, although they still exist, may experience reduced funding and thereby not be able to deliver benefits that are as “rich” as they have been in the past.

For Medicare Supplement policyholders, the changes are non-existent to your current policy. Nothing changes about your plan or coverage. The PPACA did not even change the standardized plans chart, although this was a part of some of the discussions and may happen in the future. Medicare Supplements remain one of the few relatively stable things about the current state of affairs in our healthcare system.

If you have questions about this or how your coverage has been, or will be, affected, feel free to contact us online or call 877.506.3378.

Secure Medicare Solutions June 2013 Agency News

Secure Medicare Solutions has had a great start to 2013 with many new, happy clients and lots of competitively priced plans. There have been several new companies to come into the Medigap marketplace, including CIGNA and AFLAC (two big names now offered in some states), which we’ve added to our portfolio. Also, we’ve been able to help many spouses of current clients move onto Medicare with ease and confidence.

Spouse Turning 65?

If your spouse is turning 65 soon, make sure you contact us 2-3 months in advance of their birthday. Some companies offer a husband-wife discount that would apply to your policy, as well as your spouse’s policy (assuming you are with the same company). This is certainly worth taking advantage of and can mean hundreds of dollars of savings in a year.

Term-Life-Comparison.com – A New Venture

Secure Medicare Solutions, Inc. has a new venture that we are working on – http://term-life-comparison.com. This site is designed to serve those looking for term life insurance quotes or information. It is a work in progress.

On the site, a consumer can compare term life insurance quotes all online without having to speak to, or meet with, an agent. And, if they so choose, they can even sign up for a plan online. If you are in the market for life insurance, visit the site and see what you think. You can compare multiple options in one place so you can choose the plan that is the most competitively priced for the option you are looking for.

If you have any questions or want to speak to us, give me a call at 877.506.3378 or email me.

Medigap or Medicare Supplement: A Call for More Precise Terminology

There are many examples of when something, because it is not worded correctly, means something different than what was intended. As a former aspiring journalist, I have an interest in, maybe even a passion for, making sure words are clear. Say what you mean, and mean what you say, as the saying goes.

In the Medicare insurance field, we have our very own example of confusing terminology. As if Medicare and Medicare insurance is not confusing enough, we have allowed the term “Medicare Supplement” to mean many things, all of which are actually different. To clarify, when someone says “Medicare Supplement”, it is not clear what they are talking about because of the overuse and misuse of that term.

Some people use that term to refer to an employer plan for retired workers. In many cases, the insurance plan is actually primary to Medicare. So, it is Medicare that is actually the “supplement” in those cases.

In still other cases, people refer to Medicare Advantage plans as Medicare Supplements, when in reality, these plans do not supplement Medicare at all. On the contrary, they take the place of Medicare and Medicare does not pay claims at all if you have a Medicare Advantage plan.

The last type of plan that is sometimes called a Medicare supplement actually does supplement Medicare. The words actually ring true to what the plan does. However, because of all the confusion around the terminology, I think it makes the most sense to call Medigap plans exactly what they are – Medigap plans – not Medicare Supplements. Medigap plans are the standardized plans, sold through private companies, that fill in the gaps in Medicare. They do, in all cases, act as a supplement to Medicare.

So, for the sake of clarity and for the purpose of reducing further confusion among those on Medicare, I propose using the terminology Medigap exclusively for this type of plan instead of calling them Medicare Supplements. Now, if I could just change the name of my website…

Garrett Ball is the owner of Medicare-Supplement.US, a leading, independent Medigap agency. You can get more information about Medigap plans online at Medicare-Supplement.US or by calling 877.506.3378.

Effects of Sequestration on Medicare

The March 1 deadline to strike a deal to avoid the sequestration cuts has come and gone without a compromise. Medicare cuts are, obviously, a large part of the deficit-reduction cuts in the sequestration. So, what does that mean for those on Medicare?

The sequestration, unless an alternate deficit-reduction deal is enacted, will cut a total of $85.4 billion from the Federal budget. Reductions to Medicare represent about $9.9 billion of this (12%). The bulk of these cuts will come in the form of payments to providers for Medicare patients – these will be cut by 2% effective April 1, 2013.

Overall, assuming these 2% cuts occur, it is estimated that Medicare providers will see $11.085 billion in reimbursement cuts in 2013 .The American Medical Association is urging Congress to adopt new legislation that would prevent the cuts from taking effect on 4/1/13. However, at this point, those cuts are still on schedule.

While it is difficult, maybe impossible, to predict the long-term effects that sequestration will have on the “end-user” (the Medicare patients), most people agree that, ultimately, cuts to the reimbursement rates will reduce the number of providers willing to participate in Medicare.

This is a number that many claim has already been reduced in recent years. Since 2001, the reimbursement rates for providers have gone up 4%. During that time, the cost of giving care to seniors on Medicare has gone up over 20%. The sequestration cuts only serve to further widen this gap and would be likely to cause some physicians to stop accepting Medicare patients.

If you have any questions about this or want to discuss further, please contact us on our website – http://medicare-supplement.us – or at 877.506.3378.

Medicare-Supplement.US is a website owned by Secure Medicare Solutions, Inc., a leading, independent Medicare insurance brokerage. Secure Medicare Solutions sells Medicare Supplement plans in 36 states through 25 different insurance companies. Contact us online at Medicare-Supplement.US or toll-free at 877.506.3378.

February 2013 Updates for Secure Medicare Solutions

Now that the annual enrollment period has come and gone (and I’ve had a month to recover from the 80 hour work weeks), I am busy serving existing clients and helping spouses and referrals for people turning 65 soon. Here are a few things going on with me and Secure Medicare Solutions:

  • As mentioned in our February 2013 newsletter, we switched to a new client management interface. This should make communication easier with clients, including a better format for newsletters and easier file keeping for current clients. This was a much larger undertaking that previously anticipated!
  • Did you know that Secure Medicare Solutions owns and operates several different web sites? The corporation operates Medicare-Supplement.US (this site), as well as Medigap-Quote.com and Medicare-Supplement-Comparison.com. The different sites each contain information regarding Medicare and Medicare Supplements and are focused on both client acquisition and information disbursement.
  • After six years in this business, referrals are now making up 70% of our business. That’s both nice for me, and I like to view it as a compliment. If you have a spouse or friend turning 65 or just paying too much for their current plan, send them my way!
  • Are you on Twitter or Facebook? Or LinkedIn? If you are, I’d love to connect with you that way. There are links to those connections in our newsletter (top right corner) or you can search me out on there. My twitter handle is MedigapIns. The SMS Facebook page is SMS Facebook. And, lastly, you can see me on LinkedIn at: Garrett Ball on LinkedIn.
  • Personally, I am staying busy with my girls – almost 4 and 20 months. They keep me and my wife on our toes and are a lot of fun.

Thanks for reading. Let me know what’s going on with you!