Medigap Plans, Medicare Advantage, and Part D

*This is Part 3 in a 3-part series designed for people going on Medicare or turning 65. Please
medigapcontact us if you have any questions about this information or fill out a quotes request if you want to get Medigap quotes.*

Medigap plans, Medicare Advantage and Part D are additional coverages that you should be considering if you are going on Medicare. Each of these has their own unique designs and advantages/disadvantages. This article is intended to introduce you to each and give you more information to consider about what is right for you.

First of all, let’s take a look at Medigap plans. Medigap plans are sold through private insurance companies, but they are Federally-standardized. What this means is that each company has to offer one of the standardized plan designs. The chart that shows these standardized plans can be seen here. As you can see, Plan F is the most comprehensive plan – it pays what Medicare Parts A & B do not cover at the doctor and hospital, so you should not have any out of pocket expenses. It is, of course, the most expensive. Other common lower-premium, less-coverage options include Plan G and Plan N. Plan G, in particular, is often a better value than Plan F (Read more about Why Plan G is often better than Plan F).

In addition to the coverage being standardized with Medigap plans, the claim payments and doctor acceptance are also standardized. That is, if a doctor/hospital takes Medicare, he or she will take the standardized Medigap plan that you have, regardless of which company sells you the plan. Additionally, claim payments are processed through the Medicare “crossover” system, so the plans, essentially, “follow” Medicare as a supplement and claims are all handled electronically. For these reasons, it is important to compare the Medigap plans on the basis primarily of cost and company rating. These are the two variables that can differ from one company to the next. You can get a Medigap quotes comparison for you area sent to you by email.

Medicare Advantage is entirely different from Medigap. Many people mistakenly lump them in together or call Medicare Advantage plans “Medicare Supplements”. This is not accurate, as Medicare Advantage plans do not supplement Medicare, but rather take its place in paying claims. These plans have networks, and most are either PPOs or HMOs. Often, premiums are lower than the premiums of Medigap plans, but the coverage is typically also lower. They, in most cases, work more like traditional employer/group type plans. There are some distinct drawbacks to this type of plan, in our experience, and we do not recommend them in most instances. Some of the particular downsides are the network restrictions (which are often based on your county or state) and future plan change issues. If you take a Medicare Advantage plan when first eligible for Medicare, you do have to qualify medically to switch to a Medigap plan at a later time.

Medicare Part D is a part of Medicare, but it is sold through private insurance companies. Part D covers prescription drugs. There are typically 20-40 plans in each county, so it is crucial to compare the plans based on how well they cover your current medications. Co-pays and plan premiums can vary greatly. You can do this on Medicare’s website at: Compare Part D plans.

It is important to sign up for Part D when first eligible unless you have creditable coverage. Medicare imposes a 1% per month penalty if you do not sign up for a Part D plan when you are first eligible (you are exempt from this penalty if you have creditable coverage through an employer-type plan). Premiums for Part D typically range from $15/month to $100/month so it is vital to choose a plan that covers your medications and is the appropriate coverage level for your current medication usage. You can change Part D plans during the annual enrollment period which runs October 15-December 7 each year.

This article explains some of the other coverages that go with Medicare, such as Medigap, Medicare Advantage and Part D. If you still have questions or want to discuss further, please feel free to contact us.

Medigap-Quote.com is one of the nation’s leading independent brokers of Medigap plans. We work with 30+ companies in 40+ states and work exclusively with this type of insurance. As a result, we can provide unbiased, experienced expertise to those going on Medicare and turning 65. Feel free to contact us or request Medigap quotes online.

Best Medigap Plans – What are the Best Medigap Plans in my Area?

The best Medigap plans are, quite simply, the least expensive ones. Sure, service and coverage are always a consideration, but with Medigap plans you can be assured that these factors are standardized. Let’s take a look at what is alike with all Medigap plans:

  1. First of all, Medigap plans all go by the standardized coverage chart (Medigap coverage chart). So all Medigap plans provide the same coverage for “like” plans. In other words, one Plan F is the same as another Plan F from a different company.
  2. Secondly, Medigap plans all pay claims through the Medicare “crossover” system. This system is designed to ensure that all companies are paying claims automatically as secondary to Medicare, without the insured having to file claims or being involved in the process.
  3. Next, all Medigap plans are required to be accepted by anywhere that takes Medicare as primary coverage. So if your doctor takes Medicare, they will, by extension, take any of the standardized Medigap plans.

So if all those things are the same, how do you know which plan in your area would be the best Medigap plan.Well, very simply, you can compare the plans based on premium and company rating. Those are the only two factors that differ from one company to another.

Premium is certainly the most important factor to compare. Since all of the above factors are the same, premium is the primary differentiating factor from one company to another. And, premiums can vary considerably. It is always essential to compare the plans, first and foremost, based on the premiums they charge. The premiums are based on your age and zip code, so they will vary from one person to another, depending on those two factors.

The second comparison factor that you should use when comparing Medigap plans is company rating. A.M. Best is the independent organization that rates insurance companies and that is who many people use to compare the plans. One thing to keep in mind is that these ratings are based on financial stability of the insurance company, and in no way, reflect customer service ratings, etc. That said, A.M. Best ratings can be a good indicator of a company’s financial track record and a good secondary comparison mechanism for Medigap plans.

If you would like to get a Medigap comparison or quotes, please call us at 877.506.3378 or visit us online at http://medigap-quote.com/get-quotes.

Online Medigap Quotes – What You Can Get Online and How To Get It

Getting online Medigap quotes is increasingly easy to do. Many people choose this method for comparing and selecting plans, and it is, in most cases, the most advantageous way to “shop around” in an unbiased and low-hassle way. Many insurance companies in the Medicare Supplement marketplace do not allow their rates to be publicly-published online, so the way to see quotes for all of the options in your area is to receive them by email. There are companies out there that promise to offer the rates online; however, keep in mind that you will not be seeing all of the options as many companies have strict regulations against publication of their rates on public-facing computer systems.

So, what are the steps to getting a Medigap quote online? It’s pretty easy to do really. Here are the steps to follow:

  1. The first step is to understand what you are looking for and what the plans cover. There are 10 standardized Medigap plans. All companies are required to offer from this standardized list of plans, although they don’t have to offer all 10. So, comparing plans is relatively easy – an ‘F’ plan with one company is the same as an ‘F’ plan with another. Two important things to note that are common misconceptions and relate to understanding the plans:
    • There is NOT an annual enrollment period for Medigap. You can enroll in, change or disenroll from your Medicare Advantage plan at any time.
    • Medicare Advantage plans are NOT Medicare Supplements. These plans cannot be compared to Medigap plans because they are completely different in how they work, what they cover, etc. (Difference Between Medigap and Medicare Advantage).
  2. After you have a basic understanding of the plans, how they work, etc. you should request the information from an independent brokerage. Whether it is us or someone else, we would strongly recommend using an independent broker. The advantage to doing this versus using a “captive” agent is that you can compare in an unbiased way and make a full comparison of all of the options. To request information, go to a brokerage website and enter accurate information. If the site is asking for information that you do not want to give, simply don’t give it. Keep looking. The only information needed to run and send a quote is date of birth, zip code, gender, and email. Request a quote comparison from us.
  3. Once you have the information, you can compare the plans that are available and make a wise choice from the plans that are offered. Always base your decision primarily on rates and secondarily on other factors such as the rating of the company.

If you have any questions about this information or if we can assist in any way, please contact us by email or call us at 877.506.3378. Alternatively, you can request information on our website at Medigap-Quote.com.

Medigap Plans FAQ: What Do the Different Standardized Plans Cover?

Medigap plans are standardized – each company has to offer the same coverage plans that come from the standardized plans chart. See: Standardized plans coverage chart. All of the plans have some basic tenets and characteristics that apply to all plans from all companies. Below, we’ve listed a few of those, essential to a basic understanding of the similarities before endeavoring to understand the differences:

  • First and foremost, all of the plans can be used at anywhere that takes Medicare nationwide. Medigap plans are non-network plans.
  • All plans work with Medicare – they do not replace Medicare (i.e. Medicare Advantage). And, claims are all paid, regardless of the plan or company, through the Medicare “Crossover” system (automated).
  • There are four total benefits that all Medigap plans contain some form of coverage for (most plans account for full coverage of all of these benefits – see chart for full details). Those four benefits are: Medicare Part A coinsurance hospital benefits, Hospice care coinsurance, Blood, and Preventive Care coinsurance

So, now that we understand what all of the Medigap plans have in common – how are they different?

First of all, let’s divide the plans into three groups:

The Common Plans

It makes sense to start with the top level of coverage, Plan F. Up until 2010, there was a plan called Plan J, which was the top level of Medigap coverage. In 2010, Medicare enveloped some of the benefits that differentiated ‘J’ and ‘F’. So, ‘J’ was eliminated and ‘F’ stood pat as the most comprehensive plan. Some ‘J’ policyholders still exist but the plan can no longer be sold to new applicants. Plan F pays everything that Medicare A & B do not cover so that you have no out of pocket costs at the doctor/hospital – no co-pays, deductibles or coinsurance.

One level down from that is Plan G. Plan G is the same as ‘F’ in every way except that it does not cover the Part B deductible. For 2012, that deductible is $140/year. Plan N is considered the next most commonly held plan and is a lower-cost alternative to ‘F’ and ‘G’. Plan N does not cover the Medicare Part B deductible (just like ‘G’). Also, it has a co-pay structure – $20 at the doctor’s office and $50 at the ER. Additionally, it does not cover the Medicare Part B excess charges.

The Similar Plans

By similar, I mean that these plans are similar to the plans that are mentioned above. In this category, I would put Plans C, D, and M. These plans are not offered by nearly as many companies as the three plans listed above, and thus, are not nearly as popular. Plan C is very similar to Plan F – the only difference is that it doesn’t cover the Part B Excess charges. Plan D is very similar to Plan G for the same reason – it does not cover the Part B excess charges (in addition to not cover the Medicare Part B deductible). Lastly, Plan M is similar to Plan N. It is a tradeoff – on ‘N’, you have the co-pay structure mentioned above, but on ‘M’, you don’t have the co-pays. In their place, you have coverage of only 50% of the Medicare Part A (hospital) deductible.

The Leftover Plans

Of the 10 total plans, that leaves 4 other plans that have not been discussed. The plans have, between the four of them, less than 10% market share, so they are not very commonly offered and not very often used. These plans are: A, B, K and L. These benefits on these plans speak for themselves on the Medigap coverage chart. And, even if you decide one of these plans is for you, you are relatively hard pressed to find any companies that offer it or any competitive pricing.

Do you have questions about what the plans cover? Or, questions about how they work? Medigap-Quote.com is a leading, independent brokerage that can help you compare all of the plans for your age and zip code in an unbiased way, without having to meet with anyone or talk to an agent. If you have questions or do wish to speak with someone, please call us at 877.506.3378. Or, you can visit us online at: Medigap-Quote.com.

The Three Step Process to Changing Medigap Plans

Changing Medigap plans is relatively easy to do. More importantly, it is essential to do – or at the least, to compare the options – on an ongoing basis every few years. Medigap plans are completely standardized by the Federal government – this means that all plans are the same, regardless of which company sells it to you. For example, a Plan F with one company is the exact same as a Plan F with another company. Often, though, rates can vary widely, as much as $100/month for the same coverage. So, comparing the options, and changing if necessary, is a vital part of your sound financial plan once on Medicare.

So, what is the process for changing plans, if you elect to do so? It is very easy to do:

  1. First and foremost, understand what you have, what the plans are and how to compare them. So many people that we speak with every day do not realize or understand what plan they have or how the plans work. The plans are standardized, as mentioned above, so that means YOUR Plan G is not any different from a different Plan G. Also, all plans pay the same way, can be used anywhere that takes Medicare and use the Medicare “Crossover” system to pay claims. Next, you should understand how to compare plans. Once you understand that the plans are standardized, understand that you can compare plans to see if there is equal coverage for a lower price.
  2. Compare the options from an unbiased source. Unbiased is the key word here. There are many sources out there for comparing/purchasing a Medigap plan. But it is important to use an independent agent, primarily for their expertise and ability to compare all plans in a centralized place. An agent that sells one company is, obviously, going to tout their company, but it is more advantageous for you to compare using an independent agent.
  3. Make the move – apply for a new plan for a future effective date, then once approved, cancel the old plan, effective the same date the new plan starts. Once you have compared the plans available in your zip code, based on monthly premiums and company reliability, you can simply choose a plan and apply. You will apply for a future effective date – usually, at least 2-3 weeks in advance. Then, once it is approved, you will cancel your “old” plan effective the same date that the new plan starts. This way there is no lapse or overlap in coverage.

Medigap-Quote.com and Secure Medicare Solutions help hundreds of people change to lower cost plans each year. Our job is to provide a full comparison of all the plans for your age and zip code, as well as providing information about which companies have been most reliable/stable over time. Once you have that information, we can work with you to help you decide on a plan and reduce your costs. If you would like to reduce your premium and have had your current plan over 12 months, you can easily do so. Contact us at 877.506.3378 or Medigap-Quote.com Quotes.

Medigap Enrollment Period – When Can I Change My Plan?

One of the most commonly held misconceptions about Medicare and Medigap plans is that there is an annual enrollment period for Medigap plans. This misconception holds that you can change plans only during this period, and you do not have to answer medical questions or “qualify” to do so. Put simply, that is just not the case. On the contrary, there is NO annual enrollment period – you can change plans at any time. Whenever you change Medigap plans, you DO have to answer medical questions (in most states).

So, how does this misconception get perpetuated and repeated to new generations of Medicare-eligible people? The main reason is because there IS an annual enrollment period, it just does not apply to Medigap plans. This annual enrollment period, which occurs from October 15 through December 7 in 2012, is for Medicare Part D (the drug coverage part of Medicare) and Medicare Advantage plans (the plans that replace Medicare). During this “AEP” (Annual Election Period), you can change your Part D plan, with the changeover taking effect on January 1. You can do this with no hassle, underwriting or penalty. This leads many people to believe that this is a Medicare annual enrollment period that applies to all plans, when in reality, it does not apply to the Medigap plans.

Changing Medigap plans is certainly possible, though. You can change plans at any time of the year. In most states and with most companies, there are underwriting criteria that determine if/when you are eligible to change. These criteria do vary from company to company. In general, you have to be in relatively good health to make a change; however, there are exceptions. A few of those are:

  • If you are losing employer coverage or an Advantage plan, you have “guaranteed issue” to get a Medigap plan
  • You have six months from the time that you sign up for Medicare Part B to get a Medigap plan with no underwriting
  • Some companies extend a limited underwriting period past that required six month period
  • There are some states in which underwriting is not used/allowed on Medigap plans – for example, WA and NY

Overall, it can seem daunting to many people to change their Medigap plans. However, it should not be that way – it is a very easy process that can be done with limited hassle or paperwork. Basically, you apply for the new plan; then, once approved, you cancel the old plan effective the same date that the new plan takes effect. There is no overlap and no gap in coverage. This can save you hundreds, if not thousands, of dollars a year.

If you have questions about the process for doing this or want to find out what your savings would be, contact us online or call us at 877.506.3378.

 

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