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.

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.

Medicare Supplement Plan N – A Lower Cost Alternative

Medicare Supplement Plan N is a relatively newer choice among the 10 Federally-standardized Medigap plans. Many people are unfamiliar with what it covers and how it works because it was added to the portfolio of Medigap plans in June 2010. However, despite it’s “newness” as an option, it is growing in popularity and may be a viable option for some people.

Plan N comes in at a lower premium than more common plans, such as Plan F and Plan G. Plan F has the majority of the market share, around 50% according to recent studies. Plan N, typically, is priced about $30-50 (depending on zip code) lower per month than ‘F’.

Coverage-wise, Plan N provides almost identical coverage to ‘F’ at the hospital/inpatient (Medicare Part A). The differences are found under Medicare Part B coverage – Part B is outpatient or doctor’s office coverage.

First of all, Plan N does not cover the Medicare Part B deductible, which currently is $147/year. After that deductible is met, you are responsible for an up to $20 doctor’s office co-pay (can be 20% if that amount is less) and a $50 ER co-pay. Lastly, Plan N does not cover the “Medicare Part B Excess charges”. Because this is terminology that most people are not familiar with, it scares many people away from this plan. “Excess charges”, though, are when a doctor does not accept the Medicare fee schedule as payment in full. They are permitted to charge up to 15% above that – these are called “Excess charges”. By recent studies, this occurs in 2-3% of instances nationally. And, there are some states (PA and OH in particular) that have prohibited the charging of “excess charges”. Because it is rare and limited to 15% of Part B charges, which are generally smaller than Part A charges anyway, the loss of this benefit on ‘N’ (as compared to plans that cover it) is not that significant, in my experience.

So, is Plan N the right choice for you? This depends on several factors. First of all, what is your current health like? Are you going to the doctor many times a year? Or, are you only going 3-4 (or less) times on average?

Also, do you have any known, upcoming surgeries or procedures which will require rehab or multiple follow-up visits? This can be a major deciding factor, as you would pay the up to $20 co-pay each visit, regardless of whether it is for the same type of visit.

For many people, particularly those in good health or those who do not go to the doctor often, the savings on Plan N can be significant enough to warrant looking at this option instead of Plan F. Much of what you will hear from insurance companies themselves and people you know who have it is certainly advocating Plan F. And, that is a great option. But if you can save $400/year in exchange for paying the $147 deductible and $20 a couple of times, it just makes sense to consider Plan N as an option.

On the flipside, most analysts agree that the Plan N model will be the way of the future for Medigap plans, because it incorporates cost-sharing. That can be a factor in favor of Plan F, because frankly, this type of “full coverage” that Plan F offers may not be around forever. But if you purchase a plan now, it is “guaranteed renewable” and cannot be cancelled (unless you don’t pay the premium).

If you have questions about Plan N or how it works, please feel free to contact us on our website – http://medicare-supplement.us or call us at 877.506.3378.

 

CIGNA Medicare Supplements – A New Option for Medigap Plans

CIGNA Medicare Supplements are a new option on the Medigap
plan landscape. Currently, CIGNA’s plans, sold CIGNA Medicare Supplementsunder the name American Retirement Life Insurance Company (ARLIC), are approved for sale in 39 states. Where they are offered, they have been a well-priced, stable alternative to some of the existing options in the Medigap sphere.

Medigap plans are Federally-standardized. That is, the coverage is the same regardless of which company sells you the plan. To see the standardized plans chart, visit this link. For example, a Plan F with CIGNA (ARLIC) would be the same as a Plan F through AARP, Blue Cross Blue Shield, Mutual of Omaha, Aetna or any of the other companies that offer Medigap plans. In addition to coverage being standardized, claim payments are also uniform from one company to the next. Claims are processed through the Medicare “crossover” system, meaning that the provider and Medicare handle claim payments electronically and on a set-by-Medicare timetable that doesn’t vary from one company to the next. Lastly, doctor acceptance of Medigap plans is not a factor, as doctors that take Medicare are required to accept the standardized Medigap plans, regardless of which company sold you the plan.

With all this in mind, it is crucial to look at premium rates and company rating when comparing Medigap plans. These are the two primary factors, and really, the only things that will vary from one company to the next. CIGNA Medigap plans have an ‘A’ A.M. Best rating and have consistently been priced competitively in the areas in which they are offered.

In most of their markets, CIGNA offers Plans F, G and N. While Plan F is the most comprehensive and common plan, Plan G is sometimes a better “deal”. The only difference between ‘G’ and ‘F’ is the coverage of the Medicare Part B deductible ($147/year for 2013). Otherwise, the two plans are identical. Often, the premium savings on Plan G more than offsets that deductible amount.

One major obstacle to many people changing plans is the simple misunderstanding about when changes can be made, a good article about it is written here at kratomcrazy.com. As we’ve addressed previously, this misconception, which is perpetuated by the annual enrollment period (the only time that you can change Part D coverage but has nothing to do with Medigap plans), causes many people to feel “locked in” to their plans for the year even if that plan has mid-year rate increases as many companies do. On the contrary, you can change Medigap plans at any time, and when your rates go up, particularly if it is a significant increases, it is advisable to at least compare what else is available to you.

Medicare-Supplement.US is an independent agency that provides Medigap comparisons by email. These comparisons can include CIGNA, where available, as well as other competitive companies in your marketplace. To request a Medicare supplement comparison and Medigap quotes, simply fill out this form. If you prefer to speak to someone directly and by phone, you can reach us at 877.506.3378.

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.

Forethought Medicare Supplement Plan Quotes – A Great Option

Forethought is not as “household” of a name as some of the other companies in the Medicare Supplement sphere. However, it is a highly rated company, has been in business for 25+ years, and their Medicare Supplement plans are often very competitively priced when compared to other options.

As you may already know, Medigap plans (another name for Medicare Supplements) are Federally-standardized. This means that all companies are required to offer the same coverage plans. A Plan F with one company, for example, is the exact same as a Plan F with another company. Because of this plan standardization, it is essential to compare plans on the primary basis of price. And, price can vary considerably.

Forethought typically offers Plans F, G and N, which are the three most commonly held plans. Plan F is the most comprehensive plan – it pays everything that Medicare A & B do not cover at the doctor or hospital. Plan G is secondary to Plan F – it pays everything that Medicare doesn’t cover with the exception of the Medicare Part B deductible. For 2013, this deductible is $147/year. Forethought often has the most competitively priced Plan G in areas where their plans are offered. Lastly, they also offer Plan N. Plan N is a good option for people in relatively good health. It is the same as ‘F’ at the hospital (Part A) but it does not cover the Medicare Part B deductible. Also, after the deductible is met, you have an up to $20 co-pay for doctor visits.

Forethought offers Medicare Supplements in many states and is always expanding their offerings. Here are a few states in which they are competitively priced currently – in these states, they are one of the, if not the very, lowest priced option on Plan F, G, and/or N. The states are: KY, SC, IN, OH, VA, AZ, TX, NJ, and OK.

If you are going on Medicare, it is highly advisable that you do a full comparison of the available options. The last thing that you want to do is choose a plan that is $140/month, when you can get equal coverage for $100/month. The differences in premium can be that large sometimes. Even if Forethought is not the company that has the lowest price in your area, it is wise to find out who is. The best way to do this is through an independent brokerage or agency. Whether it is us or someone else, we recommend that this is the first step you take when comparing Medicare Supplement plans.

If you have any questions about this information or would like to get specific quotes for Forethought Medicare Supplement (and other companies’ plans) for your age and zip code, please contact us by phone at 877.506.3378 or on our website at Medicare-Supplement.US.

Now that the Medicare Enrollment Period is Over, What Changes Can I Make?

The Medicare enrollment period lasts from October 15 through December 7. This is also called the Annual Election Period, during which you can elect which Part D plan you are going to have for the following year. The enrollment period also applies to Medicare Advantage plans. It does not, however, apply to Medigap or Medicare Supplement plans contrary to popular misconception.

Now that the enrollment period has come and gone, what changes can you make to your coverage? If you have a Medigap plan, you can easily change into another Medigap plan, as long as you are in relatively good health. If you are on a Medicare replacement plan now (i.e. Medicare Advantage), you have until February 14 to “get out” of that plan and return to Medicare with a Part D prescription drug plan. In doing so, you can also pick up a Medicare Supplement plan to fill in the gaps in Medicare.

After February 14, you will be locked in, if you have a Medicare Advantage plan, to whatever plan you have for the remainder of the calendar year.

If, however, you have a Medicare Supplement plan, you can change plans at any time, for any reason, as long as you can meet the new plans medical criteria. There are some exceptions to this if you are still within your initial open enrollment period (6 months from the time you go on Medicare Part B or turn 65) or in some states, which mandate additional open enrollment periods. But generally speaking, as long as you can qualify medically, you can change Medicare Supplement plans.

Additionally, all Medicare Supplement plans are standardized, so they all provide the same coverage. It is easy to compare based on the rates of the various plans. For example, if you have a Plan F, you can switch to any other Plan F and expect the plan to work the exact same way and provide the exact same coverage. Rates for Medicare Supplement plans do vary greatly so this is essential to do on at least a bi-annual basis.

If you have any questions about this information or wish to compare the Medigap plans in an unbiased and centralized way, please call us at 877.506.3378 or contact us on our Medigap quotes page.

Medigap Rates – Who Determines Them and Why Do They Go Up?

Medigap rates change over time. That is, quite simply, a fact. Some companies will be more stable than others – some plans are more stable than others. But overall, all rates, regardless of the company, plan or where you live will change. The important thing is understanding how those rate changes work, when they occur and why they occur. This allows you to minimize the effect rate increases have on your pocketbook and know when to make changes to your plan if necessary.

First of all, rate increases are always approved by the state departments of insurance. Your state is responsible for screening both the increase itself, as well as the size and administration of that increase (i.e. when it occurs). You cannot be singled out for an increase. One of the most common questions that we receive is… “I have not been to the doctor’s office but once all year, so why is my rate going up?” Unfortunately, that is not the way insurance works. Your rate goes up based on the claims experiences of everyone who has that company in your geographical area (usually in your state). So, your rate, when it goes up (not IF, but WHEN) will go up based on a percentage. For example, if your Plan F rate is $100 and the company has a 6% increase on Plan F rates, your new rate will be $106. The company is required to give you advance notice of any rate changes – 30 days in most states.

There are many things that differentiate the increases that companies will have. Besides geographical and claims experience factors, there is also the factor of which plan you have. In other words, most companies have different size increases on different plans. In general, a plan that is not Federally-required to be offered on a “guaranteed issue” basis in certain situations will be more stable over time. The plans that are required to be offered in “guaranteed issue” situations (i.e. losing employer coverage or Advantage plan coverage) are A, B, C, F, K and L. The other four plans would be, historically speaking, more stable over time due to NOT having to be offered in “guaranteed issue” situations.

Now, when your rate is going to go up, you do have some recourse, particularly if you are in relatively good health and are getting a significant increase. There are NO enrollment periods for Medigap plans (When is the Medigap enrollment period?) so you can change plans any time that your rate goes up. It is always advisable to re-evaluate your rates against those of other plan options when your rate goes up.

If you have questions about this or would like a rate quote comparison for the plans available for your age and zip code, please call us at 877.506.3378 or contact us on our website at Medigap quotes from Medicare-Supplement.US.