When purchasing Medigap insurance, you are weighing benefits versus cost. At some point, the monthly premiums for more comprehensive coverage (like Plan F) may outweigh the extra benefits.
In our experience, a Plan N Medicare supplement insurance policy can offer good value when compared to supplements that fill in more gaps.
There are several reasons we’ve arrived at this conclusion, but in a nutshell, Plan N has little in additional out-of-pocket exposure when compared to some of the other more comprehensive plans – and the monthly premiums can be $40-$50 less in many cases.
Understanding Plan N Out Of Pocket Gaps and Expenses
First let’s talk about the gaps in Medicare Part A & B that Plan N does not cover. There are three:
- Part B Coinsurance (Plan N has a $20 doctor’s office copay and $50 emergency room copay)
- Plan N does not cover the Part B deductible
- Plan N does not cover Part B Excess Charges
Those are the only three gaps not covered by Plan N that are covered by Plan F. As you can see, your out-of-pocket exposure is low and predictable.
Plan N Has A $20 Office and $50 ER Copay
The first gap is simply an office copay. When you see the doctor or visit the emergency room, you may have a small copay to pay. This is very much like any insurance plan you had before you became eligible for Medicare. If a copay is due, the provider will usually collect it upfront.
The maximum amount for a primary care physician (or specialist) is $20, but it can be less – or none at all. In the event you visit the emergency room, the copay is a maximum of $50 . If you see several doctors every month, Plan N may not be the best value, but these small copays do work for most people.
Plan N Does Not Cover the Part B Deductible
Plan N does not cover the small, one-time per year Part B deductible. In this way Plan G and Plan N are the same. If you are considering Plan G, then Plan N might be a good choice for you as well.
The Part B deductible is $183 for 2018 (same as 2017) and was $166 in 2016. When the officials at Medicare change this number, it affects all plans – both new and old. The Part B deductible is a yearly, one-time amount. It has remained low for several years.
The officials at Medicare (CMS) can raise this deductible each year due to inflation metrics. If this deductible does increase significantly, then plans that do cover this amount (like Plan F) will simply pass that cost on to policyholders. In other words, you are paying for it one way or the other, but Plan N gives your more control.
Plan N Does Not Cover Part B Excess Charges
In our opinion, Part B Excess Charges are the only gap worth further thought. The first two gaps should not be too costly over the long haul. But what about Part B Excess – what is it? Basically, this is the amount above and beyond what a doctor can charge you if s/he doe not accept Medicare assignment. In other words, your doctor does not accept the Medicare reimbursement amounts.
If that’s the case, then your doctor can charge a 15% surcharge on top of your regular bill. There are a couple of things to know. First, it is very rare that doctors do not accept Medicare assignment – it would be hard for them to stay in business. Second, some states (like Ohio for instance) do not allow for Part B Excess charges. Doctors cannot charge this fee even if they wanted to in Ohio.
In a nutshell, it is very, very rare for someone on Medicare who purchased a Plan N to run into Part B Excess charges. And in the rare event that your doctor does not accept Medicare assignment, then you might consider finding a new doctor. Our colleague wrote a very good article posted here about the rarity of Part B Excess charges.
The Argument For A Purchasing Plan N Medicare Supplement
The argument for Plan N is a simple one: You can lower your monthly premiums without adding significant out-of-pocket exposure. The premiums you save in most cases will more than make up for the gaps not covered by this particular supplement.
The copays are small and have not increased since Plan N was released in June of 2010. The Part B deductible is the smaller of the two Medicare deductibles (Part A deductible is much higher and covered by Plan N) and will not break the bank.
Part B Excess charges are very rare and in the event you encounter them, you can always change doctors so that you do not run into that problem again. And if you live in Ohio, it’s a moot point – doctors are not allowed to charge Part B Excess amounts.
The Argument Against Purchasing a Plan N Policy
This may be more of a “peace of mind” argument. Many of our clients simply want the best coverage money can buy. So they buy Plan F – and there is nothing wrong with that idea.
In other cases, some of our clients are visiting various doctors on a regular basis and do not want to pay the Part B deductible or encounter a regular office copay. These are also valid arguments against Plan N. It has a couple of more gaps that need to be filled and some people simply don’t like that idea.
Contact Us for Quotes and Enrollment
At Hyers and Associates, we are your one-stop shop for all things Medicare insurance. We offer traditional supplements, Medicare Advantage plans and Part D drug insurance.
We can help you compare the direct rates from several different Medigap carriers side by side. We can also help you enroll direct – at no additional cost. Contact us today to compare the lowest rates on the supplement of your choice.
Compare Supplemental Plan N Quotes Now →
Category: Medicare Supplements
Many of our clients are curious about what they can expect from the Medicare supplement policies that cover the Foreign Travel Emergency Benefit.
There are only 6 Medicare supplements offered today that fill in this gap, but it’s important to understand this benefit has some limitations.
Plans C, D, F, G, M & N all cover Foreign Travel Emergency. There are no other Medicare supplement plans sold today that fill in this gap. If you travel extensively, then you may want to consider one of these six options or at the very least, High Deductible Plan F as it would cover this gap once the deductible has first been met.
Plans E, H, I & J also cover this benefit, but they are no longer for sale. If you purchased once of these four plans before June 1, 2010, then you are covered. Fortunately, these 10 total plans are the most commonly purchased Medicare supplements, so most people have this gap covered.
What Does Foreign Travel Emergency Actually Cover?
That is a good question. First, you have a $250 deductible. After the deductible has been met, then Plans, C, D, E, F, G, H, I, J M and N pay 80% of medically necessary emergency care received outside of the U.S.
These 10 Medicare supplement plans only cover medical care if it begins during the first 60 days of your trip and if the billed charges weren’t already covered by Medicare. (In other words, Medicare does already cover some planned care received outside of the U.S., but this benefit it strictly for emergencies.)
It is also important to note that their is a $50,000 lifetime limit on the amount this benefit will pay. This limit is something to be mindful of if you travel abroad frequently.
Should I Purchasing Health Insurance For Travel Abroad?
Maybe. If your trip will be longer than 60 days, it might be a good idea. Foreign Travel Emergency does not pay after day 60. You might also consider a separate short term health policy for travel abroad if you live outside of the country for more than a couple of months at a time.
You might also consider a separate policy if you are close to reaching the lifetime $50,000 limit. Or you might consider additional insurance if you travel frequently and just want piece of mind.
On the other hand, if you only take the occasional trip abroad once every year or so, then the above mentioned Medicare supplement plans should be fine. The benefits provided should be enough to get you on the mend and home again where you can receive care in the U.S. if needed.
Contact Us for Medicare Supplement Insurance Coverage
Hyers and Associates is a full service, independent insurance agency. We specialize in plans that supplement Medicare as well as health insurance coverage for those who travel abroad. We can help you find the plans that will best fit your needs and budget. Contact us today for quotes and information.
Category: Medicare Supplements
Recently, I was contacted by a prospective client who had been going without a Medicare supplement insurance policy for a few years. She was in good health and did not feel the urgency to purchase a plan that would help fill in the gaps of Medicare Parts A & B.
In the insurance industry, it is not uncommon for agents to encounter consumers who have gone without different types of insurance for any number of reasons.
Sometimes it’s the cost and other times, it’s a calculated gamble. Some may be able to go their whole lives without doing much insurance planning and be no worse for the ware.
Unfortunately, that was not the case with my client. Her good health had kept her out of the hospital for quite a while until she had a health incident that required her to visit the emergency room. Her doctors ran several tests and she was kept overnight for observation until cleared to go home the next day.
Fortunately, her visit to the emergency room was a false alarm. She had experienced no major health event, but had felt poorly enough to make sure nothing was seriously wrong. It may have been nothing more than too much caffeine in her case.
Medicare Supplement Plan & Out Of Pocket Costs
After she left the hospital the next day, she returned to her normal daily activities and felt fine… until she received the bill for her stay. Medicare covered its portion, but her out-of-pocket costs were several thousand dollars. Several thousand dollars for a one night stay and a battery of tests and exams.
Her gamble to go without Medicare supplement insurance did not pay off. She called our agency and we helped her enroll in a policy so that she would never face these kinds of bills again. If she had owned a good Medicare supplement (like a Plan F, G or N) or even a Medicare Advantage plan, her portion of the hospital bill would have been a couple of hundred dollars at most – or nothing at all.
Buying A Medicare Supplement Insurance Policy
She is now covered and has very little to worry about should she face something like this again, but it was a real eye opener. Sometimes consumers are under the false impression that Medicare pays 80% of all claims and they are only responsible for the remaining 20%.
It does not work this way in all cases as there are several gaps in Medicare that can be more or less than 20% – and in some cases they can add up quickly – even for a brief medical event.
Some gaps in Medicare require the uninsured to cover a certain amount per day. In some cases, these per day costs can be over $500-$600. After only a few days, this can add up to a very large bill. Having some type of supplemental coverage can help to save the insured thousands of dollars if and when a large medical bill is encountered.
Medicare Supplements & Medical Underwriting
The other part of her story that is worth telling is that she was able to buy a Medicare supplement plan even after her health event. That’s because she was still in good health and her stay was a false alarm. If her event was more serious, then she may have not been able to purchase a Medicare supplement from us at all.
If you are not in your open enrollment window (age 65) or experiencing a qualifying event (losing group coverage for instance) then you will very likely have to undergo medical underwriting before you can buy a plan. And if you’re in poor health, then you can be turned down.
It’s important to remember that the times you want insurance the most, it may be hard to get it. Some policies have waiting periods (like dental insurance) and others require medical underwriting (long term care) that can cause an applicant to be turned down.
In other words, you must plan ahead. We have a saying in the insurance industry that really states the obvious, “The best kind of insurance you have is the kind that you don’t use.” No one wants a claim on their home, car, health or finances – but they happen. You buy insurance for the rainy day that you may or may not face down the road. To be sure, if you really need insurance, then it may already be too late.
Insurance: Planning Ahead For The Unknown
Hyers and Associates is an independent insurance agency specializing in Medicare supplement insurance, Medicare Advantage plans, Prescription Part D policies, long term care insurance and annuities.
Contact us today to learn more about the insurance plans that can best fill the gaps in your long term plans.
Compare Medigap Quotes Today →
Category: Medicare Supplements, Retirement Planning
Each year the Centers for Medicare & Medicaid Services (CMS) make changes to Original Medicare that affect all Medicare supplement insurance polices – both old and new. We highlight those changes below.
Purchasing a Medicare supplement insurance policy can be a stressful endeavor. Using our independent insurance brokerage and the information below, you can take the guesswork out of the coverage that will best fit your needs and budget.
Like most years, the changes to Medicare are subtle and incremental. The Part A deductible has increased slightly while the Part B deductible has stayed the same. The chart below highlights the differences between 2013 and 2014.
2014 Medicare Part A and Part B Deductibles
| Medicare Feature |
2013 Amount |
2014 Amount |
$$ Increase |
| Medicare Part B Premiums (for most) |
$104.90 |
$104.90 |
$0 |
| Part A Deductible (Inpatient Hospital) |
$1,184 |
$1,216 |
$32 |
| Part B Deductible (Physician’s Services) |
$147 |
$147 |
$0 |
| Hospital Coinsurance Days 61-90 |
$296 |
$304 |
$8 |
| Hospital Coinsurance Days 91-150 |
$592 |
$608 |
$16 |
| Skilled Nursing Facility Coinsurance |
$148 |
$152 |
$4 |
| High Deductible Plan F |
$2,110 |
$2,140 |
$30 |
The good news is there are no significant changes to Medicare for 2014. Sometimes there are fears that CMS will shift more costs toward seniors, but that is not the case for 2014. This simply means that Original Medicare Parts A & B (when coupled with a good supplemental policy) will cover most if not all Medicare approved out-of-pocket costs.
Medicare Insurance Highlights
Since the changes to Medicare are minimal year over year, there is little cause for concern. Most seniors will be happy to see that their Medicare Part B premiums have not increased. This news is welcome relief for those on a fixed income.
High income earners who are subject to the Income Related Monthly Adjustment Amounts (IRMAA) will continue to pay higher premiums – just as before. There will be no increases to the IRMAA numbers for 2014 and they will still be assessed on a sliding income scale.
Plan G Medicare Supplement Insurance Changes
It is also important to note that the Part B deductible has not changed year over year. In our opinion, this continues to make Plan G a very good choice for Medicare supplement insurance. There are two reasons for this:
- Plan G rates tend to be much lower than Plan F – usually offering annual savings when factoring in the $147 Part B deductible amount
- Plan G is NOT a guaranteed issue plan. This means there are fewer enrollees and smaller rate increases when compared to Plan F
Consumers in good health or who are new to Medicare should continue to ask about Plan G in order to save money on their Medicare supplement insurance premiums.
High Deductible Plan F 2014 Deductible Amount
HD Plan F is a popular plan for those who want a low-priced Medicare supplement policy, but are comfortable with a deductible. As indicated in the chart above, the deductible has only increased by $30 year over year.
Unlike Medicare Advantage plans, High Deductible Plan F has no network restrictions – seniors can see any doctor or hospital that accepts Medicare. Additionally, there is usually less out-of-pocket exposure with HD Plan F when compared to most Medicare Advantage plans.
In Summary
The changes to Medicare were measured and consumer friendly. These adjustments continue to make Plan G and High Deductible Plan F good choices for 2014 Medicare supplement insurance.
If you are in need of assistance with Medicare Supplement, Advantage, or Part D Drug insurance – please contact our agency and we will walk you through your options online, over the phone, and where possible in person.
Category: Medicare Supplements, Retirement Planning
Our independent insurance agency offers Aetna Medicare insurance policies direct – at no additional cost. You can compare the lowest rates available on all Aetna plans in your state. This includes Medicare Supplements, Advantage plans, Part D Drug coverage, as well as dental, vision and hearing insurance.
When purchasing supplemental insurance, it’s important to shop around. You want to compare premiums, benefits and networks where applicable. Oru agency can do the shopping for you. With us, you can compare all of your Medicare options to make sure you enroll in the most suitable coverage for your needs.
Medicare Supplement Insurance Quotes From Aetna
We have represented Aetna’s Medicare offerings for many years. While they may be more well known for individual and group plans, they are very competitive in the Medicare markets as well.
Those who are eligible can choose from a wide array of policies. Their insurance offerings include:
- Medicare Supplement Plans
- Medicare Advantage Policies
- Prescription Part D Plans
- Dental, Vision & Hearing Insurance
- Final Expense Life Insurance
- Accident & Illness Coverage
- Home Health Care & Recovery Plans
- Hospital Indemnity & Flex Coverage
- Cancer, Heart Attack & Stroke Reimbursement
Now that Aetna has merged with CVS health, they offer more plans in more places. Their Medicare Advantage footprint grew significantly when they acquired Coventry and we continue to see them expand into more counties across the U.S.
Their size and scope allows for many of the ancillary plans listed above. Almost all insurance policies have some kinds of gaps. You can plug those gaps and account for the unknown using any number of the coverage options available.
Those who are eligible for Medicare due to disability will have different options depending on the state in which they reside. Aetna offers some of the most popular Medicare Advantage plans in many areas of the country. They are known for low rates and large networks. One such policy is their $0 Value PPO plan. It’s great for those who want comprehensive coverage, but are on a tight budget.
American Continental, Accendo, & Continental Life
Like most large insurance companies specializing in Medicare, Aetna sells under a few different names. There’s American Continental, Continental Life, Aetna Life & Health, and their newest offering Accendo.
Aetna acquired both American Continental and Continental Life from Genworth Life Insurance Company to expand their Medicare supplement offerings. Both Genworth companies have good reputations and good rates in several states. They also sell policies in many states under the Aetna Health and Life name.
Accendo is a newer Medicare supplement line of business that’s part of their CVS merger. While all of these different lines offer spousal discounts, Accendo has the largest one at 14%. This means spouses who both enroll can each save 14% on their premiums.
Medicare Prescription Part D Drug Coverage
As part of the CVS merger, Aetna was required to sell their Part D drug plans to Wellcare. That’s okay. Wellcare is well known for offering affordable drug plans for those on Medicare. In fact, some of their policies are under $14 a month and have $0 copays on many common prescriptions.
Bu to round out their offerings, Aetna partnered with SilverScript so they could continue to provide robust Part D drug offerings. If you purchase a Medicare supplement from Aetna, you are not required to purchase one of their Part D plans, however. You can enroll in any one offered in you area. We can help you compare SilverScript, Wellcare and all others to make sure you’re getting the most value available.
And if you choose a Medicare Advantage plan, you’ll see that Part D drug coverage is included in most cases. Advantage plans can also include dental, vision and hearing coverage too. We can help you compare these all-in-one plans with those that are purchased separately. Their are pros and cons to each path.
In some cases, it may be more cost efficient to have your supplemental coverage with one company and Part D drug policy with another, but it is nice to know that both plans can be purchased from Aetna in order to keep your insurance simple.
Purchasing Medicare Insurance Plans Direct
It is important to note that Medigap insurance prices are controlled by law. Simply put, it does not matter from where or how you choose to purchase your coverage – the price will be the same.
Agents cannot charge you more or less than the going rate with insurance company itself. Having an agent can be helpful when you are ready to comparison shop or if you need assistance with your current policy.
It is always a good idea to talk with someone who works with Medicare insurance policies on a daily basis before submitting an enrollment on your own. You will want to consider future rate increases, company stability and customer service, and claims experiences.
You will also want to inquire about spousal and household discounts. There is a lot to know. The consumers who we see run into the most problems are typically ones who enrolled in a plan with consulting a knowledgeable professional first.
Contact Us For Assistance, Quotes and Enrollment
Hyers and Associates is a full service, independent insurance agency specializing in Medicare insurance policies. We represent Aetna and many others direct to you.
We can help you find suitable supplemental and Part D policies with the carrier(s) of your choice. Call us or contact us today to learn more about your best options.
Request Aetna Medicare Supplement Quotes Here →
Category: Medicare Advantage, Medicare Supplements
If you’re shopping for Medicare supplement insurance, Plan N might be a good option. With all Medigap coverage, you are weighing benefits vs. premiums.
It’s important to know that the gaps uncovered by Plan N are small. Rarely do they expose you to significant out-of-pocket yearly expenses.
Plan N does not cover three gaps. Below, we will explain the out-of-pocket costs and exposure associated with each one.
Understanding The Plan N Out Of Pocket Gaps
First, let’s examine the three gaps in Original Medicare that Plan N does not cover. They are:
- Part B Coinsurance (Plan N has a $20 doctor’s office copay and a $50 emergency room copay)
- Plan N does not cover the Part B deductible
- Plan N does not cover Part B Excess Charges
Those are the only gaps not covered by Plan N. It’s important to know that your out-of-pocket exposure is low and predictable with these three benefits.
Plan N Medicare Supplement Has Doctor’s Office Copays
Plan N is unique because it’s the only Medicare supplement with doctor’s office and emergency room copays. This means you may be responsible for a small copy when you visit your primary care doctor or any specialist. In this way, Plan N is like traditional health plans you see before age 65 that require copays at the doctor’s office.
The Plan N copay is $20 for a doctor’s office visit – and $50 for the emergency room. These fixed amounts have not increased or decreased since the inception of Plan N in 2010. Medicare (CMS) could choose to change these amounts in the future, but it’s unlikely they will. If they do, it will affect all N plans – both new and old.
It’s worth noting that your office copay could be less than $20, but never more. It depends on the billing practices of your doctor’s office. Specialist visits are also $20 – they are not allowed to charge more. You should also know there is no unique copay for Urgent Care. It would be $20 as well.
If you visit several doctors on a monthly/regular basis, then Plan N may not offer significant savings over Plan G or Plan F. However, for most, this supplement can help to keep their monthly premiums lower.
It Does Not Cover The Small Medicare Part B Deductible
Like Plans G and D, Medicare supplement Plan N does not cover the Part B deductible. Of the two Medicare deductibles, it is the much smaller one. Part A is the big one. Part B applies to doctor visits and outpatient procedures. Part A occurrences are for hospital and inpatient procedures.
For 2025, the Part B deductible is $257. It was only $240 in 2024 and $226 in 2023. The increases are usually small. It was $233 in 2022, $203 in 2021, $198 in 2020, $185 in 2019, $183 in 2017-18, and $166 in 2016. As you can see, it does not move much. That’s because it’s tied to inflation. The increases are not arbitrarily set; rather they are tied to inflation metrics which usually move slowly.
If the Part B deductible increases significantly, you should know that Medicare supplements covering this gap will increase their premiums to account for the change. They will not absorb this cost. It will be passed on to you. One way or the other you are paying for it. At least with Plan N, you have some control over it.
And you may know that no new supplements can be sold after 2020 covering the Part B deductible. This ensures consumers have more skin in the game. This change made Plan N more attractive since it only competes with Plan G as a top comprehensive Supplement.
Plan N Does Not Cover Part B Excess Charges
You would only face Part B Excess Charges if you choose to see a doctor who does not accept Medicare Assignment. This could be a doctor who charges more than what is allowed by Medicare. The maximum Part B Excess amount is 15% above what Medicare deems normal and customary.
Plan N does not cover Part B excess charges, but these fees are rarely encountered. In a few states, like Ohio for example, Part B excess charges are not allowed. If you are considering Plan N in a state like Ohio, you don’t need to worry about Part B Excess Charges. Doctors cannot charge them even if they wanted to.
The other states where Part B Excess Charges are not allowed, include: Connecticut, Massachusetts, Minnesota, New York, Ohio, Pennsylvania, Rhode Island, and Vermont. (You can compare the list of what each supplement covers here.)
Most doctors won’t charge Part B Excess – even if they are in a state where they’re allowable. It would be hard for them to stay in business. Consumers would find another doctor. We have several Plan N clients at our independent insurance agency. No one has told us this gap is causing them financial distress.
The Argument For Plan N Medicare Supplements
The argument for Plan N is a simple one: You can lower your monthly premiums without adding significant out-of-pocket exposure.
The premiums you save in most cases can more than account for the gaps not covered by this supplement.
The copays are small and have not increased since Plan N was released in June 2010. It’s unlikely they ever will.
The Part B deductible is the smaller of the two Medicare deductibles (Part A deductible is much higher and covered by Plan N) and will not break the bank.
Part B Excess charges are rare, and if you encounter them, you can always change doctors If you live in a state like Ohio, it’s a moot point – doctors are not allowed to charge Part B Excess amounts.
The Argument Against
This may be more of a “peace of mind” argument. Many of our clients want the best coverage money can buy. So they buy Plan F or Plan G. There is nothing wrong with that idea. We recommend drilling down a little further, however. Peace of mind today can lead to frustration tomorrow.
But in other cases, you may consult with several doctors on a regular basis. You may worry about the copays adding up over time. Or perhaps you have a favored doctor who doesn’t accept Medicare Assignment and you’re running into frequent Part B Excess charges.
These are valid arguments against a Part N plan. It has more gaps you will need to cover than Plan G. In cases like this, you may benefit more from a more comprehensive Supplement.
Contact Us To Learn More About Medicare Supplements
Hyers and Associates is an independent insurance agent specializing in Medicare supplements, Advantage Plans, and Prescription Part D drug coverage. We license directly with all carriers and can help you compare Medigap quotes from several insurance companies.
If you are considering Plan N Medicare Supplement insurance or any other Medigap plan, contact us today. We can help you compare rates, benefits, and out-of-pocket exposure so you can enroll in the plan that best fits your needs and budget.
Compare Plan N Supplement Quotes Today →
Category: Medicare Supplements
Our independent insurance agency (Hyers and Associates) has offered Medicare supplement insurance from Standard Life and Accident Insurance Company for years. We offer this coverage direct to our clients – at no additional cost.
Our clients appreciate that they can shop for new or replacement coverage with us direct. And we appreciate their loyalty and that’s why we are always on the lookout for new carriers that are competitively priced in certain areas.
Standard Life High Deductible Plan F Supplement
Standard Life and Accident (SLAICO) offers several lines of insurance, but their High Deductible Plan F Medicare supplement insurance is very competitively priced in most states. Rates for applicants will vary depending on a number of factors including age, gender, zip code of residence, and tobacco use.
There are a number of reasons you might be considering HD Plan F for your supplemental insurance coverage, but the one we hear most often is low premiums. It does not make good financial sense to enroll in HD Plan F unless there are significant premium savings – and SLAICO’s rates hit the mark.
In many cases, HD Plan F with Standard Life can be more than $100 less per month than a traditional Plan F. For those who are looking to save premium dollars while still insuring against catastrophic claims, HD F can be a very good financial decision.
About Medicare Supplement High Deductible Plan F
HD Plan F works very much like a traditional Plan F save for the fact that is has a yearly deductible. For 2019, the deductible is $2,300 which is a $60 increase over year 2018. Benefits will not be paid until the policyholder has reached his or her deductible, but Medicare will continue to pay its portion first.
The deductible amount can change every year (as mandated by the government run Centers for Medicare and Medicaid Services) and those changes will affect all plans. This simply means that you cannot lock in your deductible based on the year when it was purchased. Once CMS makes changes, those changes affect all plans – both new and old.
It is also important to note that High Deductible Plan F does not have any network restrictions. One of the biggest issues consumers have with Medicare Advantage and Medicare Select plans is navigating their networks.
In many cases, HD Plan is as, if not more, affordable than many Select and Advantage plans, but without any network restrictions. This is an important issue for many Medicare eligible consumers. They like to know they can use any doctor or hospital that accepts Medicare assignment and HD Plan F allows them that freedom.
About Standard Life & Accident Insurance Company
SLAICO has been offering insurance policies in the senior market for over 50 years. They are highly rated with the AM Best ratings agency.
They offer several lines of insurance for those both over and under the age of 65, but providing affordable insurance to seniors is a priority. Other types of insurance offerings from SLAICO include life insurance, annuity policies, health insurance and various ancillary coverages.
SLAICO works with agencies like ours in order to provide insurance direct to consumer. There are no additional fees or commissions to place your business through us. You also get the benefit of working with someone with knowledge of the insurance industry at large.
Hyers And Associates Medicare Insurance Agency
We are an independent insurance agency specializing in the senior market and offering insurance policies in several states. We work extensively with Medicare supplements, Part D prescription drug policies, long term care plans and annuities.
Compare Medicare Supplement Quotes Now →
Category: Medicare Advantage, Medicare Supplements
Every year The Centers for Medicare and Medicaid Services (CMS) make changes to the Medicare program. CMS has posted the numbers for 2013 and there are no alarming changes, but it is important to know what out of pocket expenses to expect going forward.
Deductible and coinsurance amounts will increase January 1 and that will affect the cost sharing provisions of all Medicare supplement plans. Supplemental insurance plans are not “grandfathered-in.” Changes to Medicare by CMS affect all Medigap plans – both new and old.
2013 Medicare Part A and Part B Changes
| Medicare Feature |
2012 Amount |
2013 Amount |
$$$ Increase |
| Part A Deductible (Inpatient Hospital) |
$1,156 |
$1,184 |
$28 |
| Part B Deductible (Physician’s Services & Supplies) |
$140 |
$147 |
$7 |
| Hospital Coinsurance Days 61-90 |
$289 |
$296 |
$7 |
| Hospital Coinsurance Days 91-150 (lifetime reserve) |
$578 |
$592 |
$14 |
| Skilled Nursing Facility Coinsurance |
$144.50 |
$148 |
$3.50 |
At face value, there are no significant changes to the Medicare cost sharing amounts. As in past years, the limits to what certain Medicare supplement insurance and some Medicare Advantage plans must cover have only increased incrementally. However, these new numbers are something to keep in mind when you experience rates increase on your privately insured Medigap coverage.
The Part B Deductible For 2013 Is $147
The good news for those who purchased or are considering purchase of either Plan G or Plan N is the nominal increase in the Part B deductible. The increase was only $7 – moving to $147 for 2013 – up from the current amount of $140 for 2012.
This means that CMS is working to keep the Part B annual deductible low going forward – at least in the short run. Consumers worried about high out of pocket costs with Medicare supplement plans that do not cover the Part B deductible (like Plans G & N) can rest easy. The cost share is low and will continue to remain that way.
Thus, paying more for traditional Plan F is not necessarily the best option for some seniors. If Plan G is more than $12.25 less per month than Plan F, then Plan G can make good financial sense. There may little reason to pay more for Plan F considering that it only covers an extra $147 for 2013. As always, it’s important to keep in mind that the Part B deductible will likely increase going forward.
What Is the Plan F High Deductible For 2013?
The new deductible for HD Plan F is $2,110 which is a $40 increase from 2012. For comparison sake, the amount was an even $2,000 in year 2010. This is a modest increase by most measures, so High Deductible Plan F will continue to be a popular option for many seniors.
The HD version of Plan F is a good choice for those who want to keep their monthly premiums low while eliminating the worry of a network driven plan. The trade-off is the potential for higher out of pocket expenses however. Those who are in good health and are comfortable with a $2,000+ deductible oftentimes purchase HD Plan F. Premiums in many parts of the country can be near $30 a month for those in their mid to late 60’s.
Out Of Pocket Cost Increases For Plans K and L
By many estimates, supplemental Plans K and L were designed to mimic Medicare Advantage coverage. These two coverage options have more out of pocket and cost sharing amounts than most other Medigap plans. In return, the monthly premiums are lower and can be well under $100 for seniors in their 60’s and 70’s.
The 2013 out-of-pocket maximum for Plans K and L are $4,800 and $2,400 respectively. This is a $140 increase for Plan K and a $70 increase for Plan L. Again, these appear to be reasonable numbers when compared year over year and compare favorably with most Medicare Advantage plans.
Summary
For those who are new to Medicare or who have been enrolled for several years, it is important to note that there are no dramatic changes to the 2013 cost sharing amounts. Medigap Plan, F, G, N, K, L and High Deductible F are and will remain good choices for coverage.
First year premiums and renewal rates will vary depending on several factors. It is always a good idea to speak with an independent agent before purchasing; or while shopping around for new supplemental coverage. This way, you can learn more about the nuances and history of competing insurance carriers that you might be considering.
Contact Our Independent Medicare Supplement Agency
Hyers and Associates, Inc. is an independent insurance brokerage specializing in the senior market. Contact us today to discuss Medicare supplements, Advantage plans, and Part D prescription policies.
Category: Medicare Advantage, Medicare Supplements
Editors Note: AFLAC Medicare supplements have been taken off the market and are no longer for sale until further notice. Our independent insurance agency is now offering Medicare supplement insurance from AFLAC direct to seniors. We provide enrollment for those who are new to Medicare as well as those who would like to lower rates on their existing coverage.
AFLAC is best known for disability and voluntary insurance coverage, but they are now offering very competitive supplemental insurance prices in several states. There are several reasons that they may be a good choice for your Medicare insurance needs.
More About The AFLAC Insurance Company
American Family Life Assurance Company of Columbus was founded in 1955 and is most associated with their ubiquitous duck commercials and advertisements. AFLAC is a Fortune 500 company with over $117 billion dollars under management. They have an A+ rating from A.M. Best which translates to “excellent.”
For many years, their business operations focused on ancillary benefits in the group and individual marketplace. Their primary focus was on disability income replacement, life insurance, and specialty reimbursement policies. A logical next step was to offer ancillary coverage in the senior markets.
AFLAC Medicare Insurance Quotes And Rates
Medicare supplement policies are straight-forward in what must be covered. A Plan F is a Plan F. No company can offer more or less coverage than what is mandated by the Centers for Medicare and Medicaid Services – CMS for short. When CMS updates the coverage requirements, all companies and plans most change accordingly.
AFLAC offers the most commonly purchased supplemental plans purchased by most seniors. Medigap Plans A, C, D, F, G, and N are all available. At this time, they are not offering Medicare Select (network driven) coverage or High Deductible Plan F.
Traditional policies from AFLAC will be accepted by any doctor or hospital that accepts Medicare assignment. In other words, it does not matter who you purchase your Medicare supplement insurance from – you will be covered by any medical professional that accepts Medicare. This is true whether your carrier is United Healthcare, Anthem or any other smaller Medigap insurance provider.
All companies use different actuarial methods to calculate your rates. Most companies (AFLAC included) will determine your rates based on your current age, state and zip code of residence, marital status, and payment method.
Spousal Discounts For Married Applicants
AFLAC is somewhat unique in that they offer a 7% discount when both spouses purchase Medicare supplement insurance and are accepted. In many areas of the country, this marital discount will help to offer much lower rates than their competition.
You and your spouse do not need to purchase the same plan to enjoy this savings. One spouse can enroll in Plan F and the other in Plan G. So long as both are accepted, then each spouse will receive 7% off of their premiums. You can also reduce your rates by $2 a month if you choose to pay using a monthly bank draft.
Request Medicare Supplement Prices & Information
Our independent agency offers the direct rates from all carriers we partner with. You will not find better rates anywhere else online or in person. We are proud to be a one stop shop for all types of senior specific policies.
We represent several companies in several states to help our clients find the Medigap insurance that best suits their needs and budget. Contact us today to find out more about AFLAC Medicare supplement insurance in your area.
Category: Medicare Supplements
If you are in the workforce beyond age 65 and covered by your employer’s group health insurance coverage, it is important to be aware of your Medicare insurance options. There are a few common penalties (both monetary and temporal) that you might face should you miss your enrollment deadlines.
Penalties and Medicare enrollment delays can easily be avoided so long as you are proactive. It is wise to talk with your human resources manager when you turn 65. You will want to ask specifically about your group health insurance eligibility. You can also talk with an insurance agent who is knowledgeable about group plans and Medicare eligibility.
If you are still not satisfied, then you might also reach out to your local social security office. Oftentimes the representative there can provide valuable advice. Additionally, it is a good idea to read about your options online and at Medicare.gov.
Employer Group Size – Twenty Is The Magic Number
As it relates to Medicare decisions, the most important factor is the size of your company in terms of employees when you turn 65. If your group is under twenty employees, then you will need to enroll in Medicare Parts A and B.
You can no longer stay on your group health insurance even if it goes undetected. Once your group insurance carrier figures out that you are Medicare eligible and that your group does not meet the 20 employee requirement, then the insurance company will no longer pay benefits and can recoup costs for benefits already provided.
In a nutshell, if you are within 3 months of your 65th birthday and still plan on working at a company with fewer than 20 employees, then you should enroll in Medicare Parts A and B and you should also consider Medicare supplemental coverages.
Employer Groups With More Than Twenty Employees
If you are soon to be 65 and working for a group with more than 20 employees that provides group health insurance, then you can safely maintain this coverage if you wish.
Some will choose this option in order to avoid paying Medicare Part B premiums. Medicare Part B premiums are means tested, so those in higher income brackets will pay more for this coverage as well as Part D prescription drug plans.
If you are happy with your group health plan, then you can delay enrollment into Medicare Part B and stay on your group health plan while also avoiding the cost of Medicare Part B, supplemental, and Part D premiums.
You may choose to enroll in Medicare Part B at age 65 even if you are still under your large group health plan, but it is important to know that you are not forced into Medicare when you continue working for a large employer group that offers group health insurance.
The COBRA Health Insurance Conundrum
One simple piece of advice is this: Don’t take COBRA health benefits when you retire and are over age 65. COBRA usually lasts 18 months, but by the time these benefits expire, then you will have missed your individual deadline to enroll in Medicare Part B.
If you are over 65, then there are very few reasons, if any, to stay on COBRA for an extended period of time. Your Medicare Part B enrollment window begins when you leave your job, not when your COBRA benefits end.
If you have waited beyond your 6 month Medicare open enrollment window (after separating from employment) to enroll in Part B, then you will be subjected to a 10% Part B late enrollment penalty when you do try to enroll with the government. The 10% penalty will be for your lifetime. And you will have a new waiting period before you can enroll in Part B. It’s a double whammy and it’s not good.
By avoiding COBRA and talking with your local social security office upon separation from employment or turning age 65, you can be sure that you are enrolling in Medicare at the appropriate time. You will also want to use this guaranteed issue period to find the supplemental coverage that you feel best fits your Medicare needs.
What About Medicare Supplemental Coverage?
Medicare covers roughly 80% of most health bills. This is why most seniors purchase a Medicare supplement, Medicare Advantage, and/or Part D plan. These coverages can help pick up some or all of what is not covered by Medicare.
Supplemental plans are sold by insurance agents (like us) and are private policies whereas Medicare Parts A and B are federally sponsored public plans. Supplemental plans can also have late enrollment penalties and delays. And in some cases, you may not be able to purchase any supplement if you have waited beyond your open enrollment or guaranteed issue period of time.
Medicare Parts A and B are only the first half of the Medicare puzzle. Once you have enrolled in Original Medicare with the government, you will want to use your open enrollment window to explore your supplemental plan options. It is wise to speak with an independent agency (like us) to decide which plan(s) best fit your needs and budget.
Medicare Is A Little Complicated
There is no doubt that if you are new to Medicare, the enrollment process can be somewhat intimidating. Above all else, it is most important to enroll at the appropriate time. Missing your open enrollment window will add a premium penalty and delay your eligibility.
If you are unsure, it is wise to lean on the experts who work with senior insurance programs everyday. Talk to a chosen insurance agent, human resources manager and/or a Medicare representative over the phone or in person.
Contact Us
Hyers and Associates, Inc. is a full service independent insurance agency specializing in health coverage for seniors. Contact us today to learn more about your options.
Category: Medicare Advantage, Medicare Supplements, Retirement Planning
Our independent agency now offers United American Medicare supplement insurance direct to consumer in several states. There are no markups or additional costs to request quotes and/or purchase Medigap policies while using our services.
That is one of the primary advantages of working with an insurance agency like ours; you can view the direct rates from several different carriers side by side without having to contact each company directly. And several companies (like UA) only offer policies through their agents.
About The Company And Its Products
United American was founded in 1947 and has an A+ rating with A.M. Best. They have kept this rating for 35 + years which is a testament to their financial strength, size and stability. Very few insurance companies can boast of such a high rating for such a long period of time.
UA offers a wide variety of insurance products in the life and health markets. Policy offerings include life, health, critical illness, cancer, Part D, group retiree and Medigap coverage. They may be best known as a Medicare supplement provider however.
Like many insurance providers, UA offers a few niche products in certain states that are very competitively priced. One such product is High Deductible Plan F and one such area is the state of Florida.
United American Medicare Supplements In Florida
The demographics and cost of health care in Florida usually make for expensive insurance products for seniors. There are only a handful of Medicare supplement insurance providers in Florida that offer competitively priced policies.
Fortunately, United American is one of those companies. At present, they offer some of the lowest priced High Deductible F Plans across the state. That is great for seniors who want a low priced Medicare insurance plan with a reasonable deductible. (As of 2012, the HD Plan F deductible is $2,070 yearly.)
In fact, High Deductible Plan F will usually be nearly $100 less per month than a traditional Plan F. For those who are looking for lower monthly premiums, but are leery of Medicare Advantage coverage, then HD Plan F with United American can be a very good choice.
High Deductible Plan F Medigap Expenses
With HD Plan F, seniors know exactly what their out-of-pocket exposure will be on a yearly basis. There is the added benefit of not having to worry about network or restrictions for care out of state.
Like all traditional Medicare supplements, HD Plan F has no network restrictions. Policy holders can receive care from any doctor or hospital that accepts Medicare assignment – both in state and out of state.
Like all Medigap plans, High Deductible Plan F premiums are likely to increase year over year, but it helps when the percentage increase affects a much smaller starting number.
And The Centers for Medicare and Medicaid services can increase the HD F deductible, but any changes will affect all plans – both new and existing. For instance, the HD F deductible was $2000 in 2011.
Contact Us For Quotes And Coverage
Hyers and Associates is a full service Medicare supplement insurance brokerage offering policies direct to consumer across the United States.
We license with dependable and reputable providers so that our clients can purchase the Medigap coverage that best suits their needs. We can also help with prescription Part D coverage.
Contact us for quotes and information today!
Category: Medicare Supplements
We offer Central States Indemnity Medicare supplement insurance direct to consumer. As an independent insurance agency offering Medigap plans, we are always looking for new companies with the lowest rates for our clients.
We like Central States Indemnity as they are a highly rated carrier with strong financial backing. As a consumer, it can be difficult to compare rates with several carriers on your own. We have created a one-stop shop to help you find the plan(s) that best suit your needs.
Central States Indemnity Company Of Omaha
CSI was founded over 35 years ago and has an A+ rating with AM Best. Their high rating can be explained by the fact that CSI is a Berkshire Hathaway company and therefore have significant financial strength behind them.
Berkshire Hathaway is of course the large investment conglomerate run by Warren Buffett. In 1992, Berkshire acquired Central States to gain a foothold into the large and growing senior markets. CSI benefits from their size and scope and has grown into one of the most stable Medicare supplement providers.
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Understanding Medicare Supplement Insurance Trends
Warren Buffett is known for his investment savvy. With so many baby boomers aging into Medicare, it makes senses that Berkshire Hathaway would enter this growing market. There will always be a need for affordable and stable Medigap carriers.
After all, it does not matter where you purchase your supplemental insurance – a Plan F is a Plan F. Insurance companies cannot adjust plan designs nor offer differing networks. Medigap benefits are controlled by law and traditional supplemental insurance plans have no network restrictions.
Thus, you are simply shopping for a reliable, well-rated carrier offering affordable rates and reasonable premium increases. CSI has a good reputation when considering those factors which helps to explain their popularity with consumers and agents alike.
Now Offering Popular Plan G In Many States
CSI offers Plan G across the U.S. as consumers become more aware of the savings and stability it provides. Plan G is a very good choice for those who would rather exchange lower premiums for slightly more exposure to out of pocket expenses.
Plan G covers everything Plan F does except for the Medicare Part B deductible – which is only $166 for 2016. In many cases Plan G’s premium savings can more than make up the difference, however.
Notably, Plan G is not a guaranteed issue plan. Unless the applicant is in their open enrollment window and new to Medicare Part B, then s/he will need to undergo medical underwriting to enroll in G. This results in members with fewer claims which keeps rates low for everyone.
Their Sister Company: Central States Indemnity Life
Some insurance carriers tend to carve out certain niches for themselves. That is to say not all carriers offer the lowest prices in every state, but some are known for keeping rates stable for their members.
It’s not uncommon for insurance companies to offer plans from one or more subsidiaries. CSI Life Insurance Company was introduced in 2015 to offer yet another competitive choice in many states. It’s not uncommon to see both companies in the top 5 for rates in many areas of the country.
We encourage our clients to shop on more than just price at purchase. Choosing a supplement can be a decision for the long haul. Sometimes it’s better to pay a little more upfront in order to have more stability in the future. Both CSI companies are good examples of this idea in practice as their G and N rates have held steady.
It should be noted that the CSI family of companies is very competitively priced in Arizona, Illinois, Indiana, Ohio, Tennessee, Texas, the Carolinas and several other states in the Southeast as well.
Request Quotes, Information, And Enrollment Materials
Hyers and Associates, Inc. is an independent insurance agency offering Medicare insurance coverage across the United States. We license direct with all carriers in order to offer the lowest rates to our clients.
We can help you compare Medigap plans from several carriers while also discussing the nuances of purchasing insurance and keeping your premiums low now and in the future. Contact us today for more information.
Compare Medicare Supplement Quotes Today →
Category: Medicare Supplements
What are Medicare Select insurance policies? They are traditional Medicare supplement policies (like Plans F, C and N for instance) that require the use of a preferred network of doctors and hospitals for routine care.
Medicare Select Plans are sometimes popular as they are less expensive than traditional non-network driven supplemental plans. They are appropriate for those who are comfortable using a preferred network of doctors and hospitals for regular care.
Understanding Medicare Supplement Insurance Select Networks
Supplemental select policies work much in the same way as Health Maintenance Organizations (HMOs). The insurance company negotiates service contracts with a network of doctors and hospitals in the area where the supplement is offered – usually larger cities. These negotiations result in lower medical costs.
The cost reductions are then passed on to the consumer in the way of lower monthly premiums on their Medigap select policies. There is no additional cost sharing however. A Plan F is still a Plan F – the insured simply needs to stay in-network for his or her medical services.
How Are Emergency Costs Covered Under Medigap Select Plans?
It is important for the consumer to use the approved network for all routine services. If not, then the select plan may not pay its share of the bill. In some cases, referrals from a primary physician may be needed to see certain practitioners. If you travel extensively or winter in a different location, a Select Plan may not be appropriate.
Emergency services are covered out of network so long as the insurance company agrees that the situations was an emergency. Routine care will not be covered out of the approved network. Regardless of how or where medical care is needed, Medicare Parts A and B will always cover its share of approved expenses first.
Advantages & Disadvantages Of Medicare Select Plans
The primary advantage is simply cost. By agreeing to use the approved network, consumers can save money on their Medicare supplement insurance. In some cases however, traditional supplemental plans may be less expensive than even some select plans. It is wise to shop around.
Much like Medicare Advantage plans, the primary disadvantage is simply the constraints of the network. It is important to be certain of any network limitations by first checking with the insurance company and/or the agent before purchasing a policy. And consumers must be aware that certain doctor groups and facilities may be in the approved network one year and out the next.
Consumers who move out of the approved service area will be afforded a 63 day window to purchase a new supplemental plan without the need for medical underwriting. Not all plan designations will be available during a “guaranteed issue” period such as this one, but the consumer will have certain rights to purchase new coverage.
Comparing Supplemental Select Plan Networks And Quotes
Not all carriers offer select plans as they simply do not have the size or scope to build network driven plans. It is usually the larger companies with existing health insurance and Medicare Advantage networks who offer these types of plans, but they are somewhat rare.
A few companies worth considering if you are in the market for a Select plan will be Anthem Blue Cross and Blue Shield, AARP United Healthcare, Assured Life, Gerber Life, Mutual of Omaha and a handful of others.
By working with an independent Medicare brokerage like ours, you can compare both select and traditional Medicare supplements online. We can help you compare the direct rates for both types with several carriers.
Compare Medicare Supplement Quotes Now →
Category: Medicare Advantage, Medicare Supplements
It’s almost a new year which means changes to the Medicare Part A and B deductible amounts for 2012 are here. The Part A deductible is increasing by a nominal amount, but the Part B deductible is decreasing.
You read that correctly, the Part B deductible is going down which means that some Medicare supplement insurance plans will become more attractive based based on their monthly premiums. We’ll address that benefit later in this post.
Medicare Part A and Part B Deductible And Coinsurance Increases and Decreases For 2012:
| Medicare Feature |
2011 Amount |
2012 Amount |
Percent Change |
| Part A Deductible (Inpatient Hospital) |
$1,132 |
$1,156 |
2.12% |
| Part B Deductible (Physician’s Services & Supplies) |
$162 |
$140 |
(15.71%) |
| Hospital Coinsurance Days 61-90 |
$283 |
$289 |
2.21% |
| Hospital Coinsurance Days 91-150 (lifetime reserve) |
$566 |
$578 |
2.21% |
| Skilled Nursing Facility Coinsurance |
$141.50 |
$144.50 |
2.21% |
Part B Deductible Decrease for 2012 and Plan G Supplement Premiums
The most significant change to the Medicare deductibles for 2012 is the somewhat dramatic decrease for the Part B deductible out-of-pocket. This lower amount makes plans that do not already cover the Part B deductible more attractive. Typically the difference in premiums and coverage will dictate your purchase.
One such Medigap option available for purchase is Plan G. Plan G covers everything that Plan F does except for the Part B deductible. If Plan G happened to be $300 less (as can be the case) per year than Plan F and Plan F only covers $140 more in costs, then Plan G is a wise choice. Plan N might also fall into this category if you live in a state (Ohio for instance) that does not allow for Part B Excess charges.
High Deductible Plan F Changes
The Medicare supplement Plan F high deductible amount is also increasing in 2012. The deductible was $2,000 in 2011 and will be $2,070 for 2012. This is not too significant of a change if you already own this plan or if you are considering purchasing it.
The premiums associated with High Deductible Plan F are usually very inexpensive and can be a good choice if you are comfortable with a little more out-of-pocket exposure. It is important to remember if you wish later to enroll in a more comprehensive Medigap plan, some medical underwriting may be required with almost all insurance companies.
If you own High Deductible Plan J (no longer sold from any company by law) then your deductible will also be increasing to $2,070 f0r 2012.
Medicare Part B Premiums From The Government
Medicare Part B monthly premiums will be $99.90 for most beneficiaries in 2011. This is slightly more for those who have been paying $96.40, but slightly less than was originally projected by the Centers of Medicare and Medicaid services earlier in the year.
Medicare Part B premiums are means adjusted however and will be higher if you reach certain income levels. For individuals the percentage increases start with an adjusted gross income of $85,000 and for those who file jointly the increase begins at $170,000 of AGI.
Prescription Part D premiums will also be higher if you are earning the above listed amounts or higher. If you are turning age 65 and still employed with access to employer group coverage, it is wise to weigh all of your options before automatically signing up for Medicare Part B. Depending on the size of your group, it may be necessary to enroll in Part B however.
Request Medicare Insurance Information and Quotes
Hyers and Associates is a full service, independent agency specializing in Medicare supplement insurance.
We work in in several states and help consumers enroll in the Medigap and Part D plan of their choice direct – at no additional cost.
Category: Medicare Supplements, Retirement Planning
The 2011 Medicare open enrollment window is almost upon us. Otherwise known as the Annual Election Period or AEP for short, this period of time can be used by Medicare beneficiaries to switch insurance plans.
The dates are a little different this year as the window starts and ends early. AEP will run from October 15, 2011 to December 7, 2011. It is important however to remember what changes can and can’t be made during this window of time.
Disenrolling From Medicare Advantage Insurance
AEP is most commonly used to disenroll from a Medicare Advantage (MA) plan. Unless there are other extenuating circumstances, Advantage plans can only be cancelled during the yearly Annual Election Period. Most MA carriers will require a letter of disenrollment in writing from the insured; a phone call is not always accepted.
Upon disenrollment, a Medicare eligible person can enroll in a new Advantage plan that better suits their needs or return to Original Medicare. If the latter, then a Medicare supplement and/or prescription Part D drug plan might be purchased in order to fill the gaps in Original Medicare Parts A and B.
It is very important to note, that if someone has been in an Advantage plan for longer than one year, they may need to be medically underwritten in order to enroll in a traditional Medicare supplement insurance plan. This means that the applicant could be turned down if they are in poor health.
It is usually a good idea to get an application for traditional supplemental coverage in early to make sure that certain health qualifications can be met. Underwriting requirements will differ between various providers, so working with an independent Medicare supplement agency (like us) can be a wise choice to ensure coverage is obtained. This way Medicare eligible consumers can ensure a seamless transition to new coverage that will become effective January 1, 2012.
Switching Prescription Part D Insurance Plans
The Annual Election Period (open enrollment) also allows consumers to purchase a new Part D drug plan and drop their old coverage. This time period can also be used by consumers who did not purchase Part D coverage during their initial open enrollment window to find a plan.
For those who did not enroll when they were supposed to, there can be late enrollment penalties however. These penalties amount to a 1% per month addition for each month that coverage was not elected. For example, if someone (without credible coverage) waited 16 months to purchase a Part D plan, then their monthly premiums will be 16% higher than someone who enrolled on time.
Open enrollment allows those who have stand alone Part D drug plans to purchase more suitable (or less expensive) coverage if their current plan is no longer meeting their needs. If Medicare Advantage coverage that is coupled with a Part D plan (MAPD) is dropped, then a new Part D plan will likely need to be purchased as well.
Enrolling In Medicare Supplement Coverage
For those who qualify either medically or through their open enrollment window, AEP can be used to purchase Medicare supplement coverage as well. If someone is dropping an Advantage plan, then most supplemental insurance providers will require a letter of disenrollment signed by the applicant. This same letter can then be sent off to the MA provider for processing.
One common misconception about AEP is that this period of time can be used to switch Medicare supplement providers without any medical underwriting. This is not the case. Consumers can switch supplemental insurance coverage any time of the year, but most companies will require some amount of underwriting. If a change is desired, there is no reason to wait until the end of the year to do so.
The only exception to this rule is for those who are dropping a Medicare Advantage plan after one year and re-enrolling back into Original Medicare. The Centers for Medicare and Medicaid Services allow for a one year Medicare Advantage trial period. If after one year the consumer is not satisfied, s/he can purchase most Medicare supplement insurance plans without the need for medical underwriting.
It is important to note that there are a couple of states that offer a yearly open enrollment window for changing Medicare supplement coverage without underwriting (Missouri and California for example), but these states have specific individual anniversary windows that will not necessarily coincide with the yearly Annual Election Period.
Request Quotes And Information
Hyers and Associates, Inc. is a full service, independent insurance agency offering Medicare insurance and Part D prescription drug policies direct to consumer in many states across the country.
Contact us today if you have questions or assistance with your Medicare coverage.
Category: Medicare Advantage, Medicare Supplements
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