Upon retirement, you may lose the group health insurance coverage offered from your employer. In some cases, the insurance can be extended for a short period of time, but in most others it may discontinue altogether or become too expensive to maintain.
The dividing line for most retirees is age 65. If you are younger than age 65 and you cannot continue your group health insurance coverage for any reason, the next best option is to purchase an individual or family plan from a provider such as Aetna, Anthem Blue Cross, or United Healthcare among others.
If you are over age 65 and losing group coverage, then you will need to enroll in Medicare Part B (if you have not already done so) and purchase supplemental coverage. The two options available for retirees over age 65 are traditional Medicare supplements and Medicare Advantage plans.
Retiree Health Insurance Over Age 65
Many retirees are age 65 or older when they lose their group health insurance coverage. In some cases, they can maintain their current group coverage, but in many cases they are involuntarily dropped from the plan.
In fact, many large companies are discontinuing health insurance benefits altogether for retired workers over age 65 whether they recently retired or were offered health benefits in the past.
The good news is that those who are both voluntarily and involuntarily losing group health insurance can almost always purchase a supplemental plan on a guaranteed issue basis. In this case, Medicare will be their primary coverage. Those over age 65 must first be enrolled in both Medicare Part A and Part B and then they can best decide how to supplement the gaps in Medicare.
Medicare Supplement Coverage for Retirees
The first option is to purchase a traditional Medicare supplement. There are ten plans to choose from and each offer a varying degree of coverage.
There are no traditional Medigap or supplemental plans that cover prescription drug coverage, so it is wise to purchase a stand-along Part D drug plan unless credible rx coverage is available elsewhere.
Supplemental plans and Part D coverage can both be compared on price and purchased direct (at no additional cost) from independent agents who represent a wide array of insurance carriers.
Medicare supplements are popular because the potential out-of-pocket expenses associated with these plans is very limited and predictable for the insured. Plan F is often purchased as it covers all of the gaps in Original Medicare Part A and Part B.
Additionally, almost all supplemental plans have no network restrictions to navigate. This means the insured can see any doctor or hospital that accepts Medicare patients. Those who purchase traditional Medigap plans can rest assured that they will not need referrals nor will they be turned away because of any network restrictions.
Medicare Advantage Coverage For Retired Seniors
Advantage plans are not quite as popular as traditional Medicare supplements based on enrollment figures. Typically, this coverage is less expensive on a monthly basis and covers all what Part A and Part B cover and some of what they do not.
Those who purchase an Advantage Plan can have the potential for larger out-of-pocket expenses. It is wise to ask the insurance provider about the yearly maximum for out-of-pocket expenses both in and out of network.
It is also preferable to know about any network limitations that might exist with any Advantage Plan under consideration. In some cases, certain medical facilities and doctors will choose not to accept one or more Medicare Advantage Plan. These limitations can become an issue for the insured if an out-of-network specialist or facility is recommended by their primary care physician.
Many Medicare Advantage Plans will include prescription drug coverage thus eliminating the expense of purchasing a stand-alone Part D plan. When deciding between the two options (Medigap and Advantage) it is wise for seniors to speak with an independent agent about both and consider their options both now and in the future.
Understanding Medicare Open Enrollment (AEP)
Typically, Advantage Plans can be changed each year during open enrollment, but the insured is only allowed a one year free-look period if they wish to return to Original Medicare and purchase a traditional supplement.
That is to say, if the insured was enrolled in an Advantage Plan longer than one year and then desired to purchase a traditional supplement, the Medicare supplement provider can decline their application due to ongoing or past health concerns.
Retired Under Age 65 Health Insurance Plans
If you are under age 65 and losing your group health insurance due to retirement, then you will need to purchase coverage in the individual market. There are several well known and highly rated carriers providing both individual and family health insurance.
Health care reform has changed the landscape somewhat, but many plans are still available. Unfortunately, the cost of these same plans has increased with the implementation of the reform efforts, but no longer can children be turned down for coverage. However, health insurance providers can still charge significantly higher premiums for those under age 26 who have preexisting conditions.
Conversely, retirees under age 65 can still be turned down for coverage and/or issued policies with exclusionary riders. It is wise for retirees to shop around with an independent agent and to disclose their health backgrounds.
An experienced agent can recommend suitable and cost effective options for those under and over age 65. And remember, there is no additional cost whatsoever to use an agent to purchase health insurance coverage.
Should no provider be willing to offer health insurance coverage to the retiree, then the high risk pool in the state where the retiree resides can be investigated. The high risk health insurance pool can be the stopgap coverage that will bridge the time until Medicare eligibility at age 65 or until other reform laws allow for better access to health insurance.
Information And Insurance Quote Request
Hyers and Associates, Inc. is a full service, independent agency offering Medicare supplement and individual and family health insurance policies direct to consumer.
We work with the leading insurance providers in several states in order to offer comprehensive and affordable coverage from several highly rated carriers. Contact us today to discuss your best options.
Category: Medicare Supplements, Retirement Planning
High Deductible Plan F Medicare supplement insurance can be a policy choice. It offers low monthly premiums in exchange for higher out-of-pocket expenses. In fact, HD Plan F offers some of the lowest rates of any supplement on the market.
Traditional Plan F can be a better choice for those who would rather have no deductible. Insurance companies are not required to offer HD Plan F, so consumers won’t have quite as many options to compare.
Our independent insurance agency offers both High Deductible and Traditional Plan F from several highly rated and dependable carriers. (We offer all other plans as well in many states across the country.)
How Does High Deductible Plan F Work?
The plan itself is fairly straightforward and works like all other Medicare supplement insurance coverage. The only difference is there is a one-time deductible that must be met each year before the insurance company will pay benefits. (Medicare will always pay its share first, but your HD Plan F won’t fill in any gaps until the deductible has first been reached.)
In 2024, the amount that must be met for High Deductible Plan F is $2,800. It was $2,700 in 2023, $2,490 in 2022 and $2,370 in 2021. It was $2,340 in in 2020, $2,300 in 2019, $2,240 in 2018, $2,200 in 2017 and $2,180 in both 2016 and 2015.
Typically the increase is about $40 a year, but in the last two years, it’s been higher. The amount is determined by the Centers for Medicare and Medicaid Services and based on inflation measurements. Increases affect all plans – both new and old.
Currently, Supplemental Pans F, and G are the only Medigap plans offered in a high-deductible version. If you were new to Medicare before 2020, you can still enroll in HD Plan F. After 2020, only HD Plan G is available for purchase.
What Are The Disadvantages Of HD Plan F?
One disadvantage would be if the insured decided later on that s/he no longer wanted the policy. Oftentimes when the insured wants to purchase more comprehensive coverage, it’s because they are reaching the deductible on a more regular basis.
Someone who was once in good health, but later finds that the $2,800 deductible must be met each year might want a better policy. It can be difficult to pass medical underwriting and switch plans when in poor health, however. With most providers in most states, the insured cannot purchase new coverage without first passing medical underwriting questions/interviews.
In a nutshell, switching can be difficult in the future. Contrary to popular belief, there is no open enrollment period each year for Medicare supplement insurance. In most cases, underwriting will still be required during the yearly Annual Election Period that occurs in the fall.
Medicare Annual Election Period And Underwriting
The time period from October 15th to December 7th each year (collectively known as the Annual Election Period or AEP) is for changing Part D plans and/or Medicare Advantage coverage, but it does not allow the insured to choose any new supplement without undergoing medical underwriting.
Two states, Missouri and California, do offer an open enrollment (yearly anniversary) window each year when the insured can change plans, but this is only for “like or lesser” supplements. Upgrading coverage may not be possible in using these windows either.
Who Might Purchase HD Plan F Medigap Coverage?
Typically those who purchase High Deductible Plan F fit into a couple of categories. Generally speaking, they are in good health, have enough savings to cover the deductible year over year, and do not like the hassle associated with network-driven policies like Medicare Advantage plans.
The primary advantage of HD Plan F is lower monthly premiums. Many consumers do not worry about potentially paying a $2,800 deductible each year as they are leaving group health insurance plans with similar deductibles.
Additionally, Medicare supplements do not have network restrictions like most other types of health insurance plans. The insured is still free to choose any doctor or hospital accepting Medicare and does not need to worry about referrals.
Seniors who travel often or who have a residence in more than one state will likely choose a traditional Medigap plan like High Deductible F knowing that they can receive routine care both in and out of their primary resident state.
Request Medigap Quotes And Information
Hyers and Associates is full full-service, independent insurance agency offering supplemental insurance policies direct to consumers in several states. We work with the leading providers in order to secure the lowest rates for our clients.
Compare High Deductible Plan F Quotes Here →
Category: Medicare Supplements
Seniors eligible for government Medicare are sometimes in search of combination insurance policies that will cover both the gaps in Medicare and final expenses associated with a funeral. Fortunately, there are a few companies that offer both coverages on one application making it easier to insure both needs.
Insurance providers such as Mutual of Omaha, Forethought Life, Sentinel Life and American Continental (to name a few) all allow applicants to combine Medicare supplement and funeral expense insurance.
Advantages Of Combination Insurance Coverage
Certainly the convenience of knowing that two important needs can be covered in just a few strokes of the pen is a nice feeling. The ability to cover out-of-pocket expenses associated with Original Medicare as well as the expenses needed to pay for a funeral all with one carrier will keep insurance issues simple for those who want peace of mind.
It will also be much easier for the spouse and/or the children of the insured knowing that they will only need to work with one insurance company in order to cover two basic needs. This type of simplicity is what families want most in times of need.
Supplemental Insurance Offers The Same Benefits
A Plan F is a Plan F no matter the carrier from whom it is purchased. The only difference is if the insured chooses to purchase a “select policy” (one that operates on a network) or a high deductible Plan F, but those options are available regardless of the attached life policy. The coverage and benefits would not differ one iota so long as a traditional supplement is chosen.
All Medicare supplement carriers offer several policies for seniors to choose from. That is to say that not all carriers offer all plans, but almost all companies offer the most popular supplemental insurance coverages like Plans C, D, F, G and N. Should the applicant choose to combine the two coverages, s/he can still purchase a plan that is most suitable for his or her needs.
How Does The Funeral Insurance Policy Work?
Most life insurance policies designed to cover funeral expenses operate in the same fashion regardless of whether they are attached to another type of policy. Again, the life policy will not differ because the applicant is combining it with a Medigap plan.
In most cases, a whole life funeral insurance policy will require monthly premium payments until it is considers paid-up. No additional premium payments are needed once a policy is paid-up with a life insurance provider. The policy will build cash value over time that can be loaned against or tapped for unforeseen future expenses if needed.
Many funeral insurance policies offer different versions for the insured to choose from at onset. One such example is referred to as a modified death benefit meaning the policy offers a smaller death benefit initially, but will gradually build up over time.
Policies with a modified death benefit are advantageous for those who wish to save money on their premiums as well as those who are less worried about a smaller death benefit in the first few years of the policy.
Are There Discounts When Combining Insurances?
Not usually. Some insurance companies will offer discounts on Medicare supplement insurance when both spouses are insured, but that is true whether or not a funeral policy is purchased. And generally speaking, the attached life insurance coverage will be similar in price whether or not a Medigap plan is purchased in conjunction with the policy.
There usually will not be any considerable savings associated with the combination purchase, but the simplicity of having both insurances with one company cannot be overlooked.
What If I Cancel One Of The Policies?
That is always an option and with almost all companies who provide dual applications, there will be no issues. If for example, the Medicare supplement policy was cancelled because another carrier was offering a much lower price on the same coverage, then the funeral insurance policy could be kept in force with the original carrier.
The opposite is also true. Should the insured decide to cancel the final expense coverage or transfer it to a paid-up policy, then the Medicare supplement would not be affected. In this way, policyholders are not locked into both coverages for their lifetime.
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In summary, purchasing a funeral expense policy and a Medicare supplement insurance plan from the same carrier can be an efficient way to cover two basic needs at one time. The simplicity is helpful for the insured and his or her heirs.
Hyers and Associates, Inc. is a full service Medigap and life insurance brokerage firm. Contact us today to learn more about your best insurance options.
Category: Life Insurance, Medicare Supplements
As you approach Medicare eligibility, you’ll be faced with the decision of how to best supplement your government provided Part A and Part B Medicare insurance coverage.
You want to know which options and which plan(s) provide the most benefits at the lowest price. There are Medicare supplements and Medicare Advantage plans to choose from, but you can’t have both simultaneously.
There are only three options to consider when it comes to supplementing your Original Medicare:
- Purchase a Medicare Supplement Plan
- Purchase a Medicare Advantage Plan
- Do nothing and purchase no insurance coverage
The Cost of Medicare Supplement Insurance Plans
Supplemental insurance prices will vary from state to state and zip code to zip code. There are several factors that will determine your monthly premiums. Rates are usually only locked in for one year and can increase as you get older.
However, the underlying question some of our clients ask is, “What is the cost if I don’t purchase coverage?” The short answer is we simply don’t know. Consumers who are already in poor health will almost always purchase a Medicare supplement right away. Missing your personal 6 month Open Enrollment window can make it hard, if not impossible, to purchase a Medigap later.
But Medigap plans are like any other insurance. You purchase comprehensive coverage and hope that you don’t need it. Really, the best insurance is the kind you don’t use. You don’t want to use your home, auto, life, or disability plan because that means something has likely gone wrong. However, you do want to know you don’t have open ended costs if a health issue arises.
So to answer the question – yes, Medicare supplement insurance is usually worth the cost. There are several different plans to choose from and each will fill in most or all of the gaps in Medicare. In this way, you can know exactly what your out-of-pocket exposure is each year. And with almost all supplements, you don’t have to worry about referrals or network restrictions. This means that you can use any doctor or hospital that accepts Medicare patients.
Really, you’re purchasing peace of mind. With most Medigap plans, you know you can go where you want when you want without facing significant out-of-pocket expenses. You have paid into Medicare your entire working life, so it makes sense to close or minimize your gaps with a supplement like F, G, N or High Deductible F.
You Can Purchase a Medicare Advantage Plan
Another option to supplement Medicare is to purchase an Advantage plan. You will still pay your Part B premiums, but Advantage plans will insure you for what Medicare A and B covers as well as some of what they do not. Additionally, many plans will include rx coverage as part of the coverage. Part D drug is not included with a supplement and must be purchased separately.
Medicare advantage plans are popular with some of our clients simply based on price. If you live in Florida for example, Medicare supplement plans can be expensive. Advantage plans are usually less expensive for a couple of reasons.
The primary reason is most Advantage plans have more out-of-pocket exposure. It is important to ask about your maximum out-of-pocket each year both in and out of network. And that brings up another point; Advantage plans rely on participating networks of doctors, hospitals, and medical facilities in order to offer lower monthly premiums.
This can be a problem if you need care outside of the network of if you spend a lot of time in multiple states. As an agent, the issue I see most with consumers is the need to visit a certain specialist (or facility) and that provider does not accept their coverage because they’re out of network.
The Centers for Medicare and Medicaid Services allows a one year free trial period for consumers who choose Advantage plans. After one year, medical underwriting will be necessary with most Medigap providers in order to enroll into a traditional Medicare supplement. Consumers can be denied coverage due to poor health if they wait longer than a year.
In a nutshell, Advantage plans are not perfect and traditional supplements are not always the best option either, but going without coverage can be the most ill-advised choice.
What if You Choose Not to Purchase Insurance?
I don’t recommend it. Why? Well, there are may reasons, but most of all because you cannot time your health. You may need coverage before you have a chance to buy it. If we had the elusive crystal ball, we would buy insurance the day before we needed it.
There are some consumers who will roll the dice and not purchase any insurance, but they need to know that it is very difficult to purchase a Medicare Supplement or Advantage plan if you are already in poor health.
That is to say that if you missed your open enrollment window, then you can be denied coverage. There is this misconception that the time period between October 15th and December 7th each year is Medicare open enrollment for supplemental coverage. This is not correct!
This time of year (referred to as the annual election period or AEP) can be used to change Part D drug plans or to disenroll from an Advantage plan, but not to purchase new supplemental coverage on a guaranteed issue basis. This means you must be in reasonably good health to purchase most supplemental plans unless you are using your one year free trial period provided by CMS.
Timing your insurance purchase can be a foolhardy plan. Most people do not try and time any of their other insurances, so your health coverage should be thought of in the same way. You can avoid the insurance company declining the application, monetary penalties, and mandatory delays simply by purchasing coverage when you were supposed to originally.
Call an agent and talk to them. Call us! The Medicare puzzle can be complex at first glance, but we’ll make it simple. It’s a good idea to speak with our experts, learn from other’s mistakes, and avoid future complications when it comes to Medicare.
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Hyers and Associates is a full service insurance agency working in several states across the country. We specialize in Medicare supplements, Medicare Advantage, and Part D prescription drug plans. We offer all plans direct and at no additional cost.
Category: Medicare Advantage, Medicare Supplements
If you will soon be age 65, you’ll want to know how to sign up for Medicare Parts A and B with the federal government. You may have questions about supplemental insurance as well.
Medicare Parts A & B enrollment is done through the Social Security Administration and can be accomplished in three different ways. See more on that below. Supplemental insurance is obtained through brokers like us.
Most consumers enroll at age 65, but those on disability can enroll earlier. And those who have qualifying group coverage at work can defer Part B enrollment until retirement.
Signing Up For Medicare At Age 65
There are three ways to enroll in Medicare:
An easy and quick way to enroll is online. Because of Covid, many Social Security offices are not allowing face-to-face meetings.
However, the government has improved the functionality of their website and you can now enroll online in Part B only. This would apply to those who were already (and automatically) enrolled in Part A at age 65. You’ve always been able to enroll in Parts A & B together, but this new feature is helpful.
You can save the hassle of visiting your local office which may be far away or temporarily closed. If you’re enrolling in Part B only (because you already have Part A), you may need to provide proof of creditable coverage from work.
Calling the toll-free number (1-800-633-4227) is the next best way to start the process. It may take some time to get someone on the phone, but they’ll mail you your needed forms. It’s wise to start early as it can take a month or more to get everything going. In fact, Medicare allows you to start the process 3 months before your 65th birthday. We recommend doing so.
And where and when available, you can make an appointment at your Social Security office. Again, it may take a couple weeks to get an appointment, so start the process early. Meeting with a representative is helpful if you’re unsure about starting your Social Security payments. Medicare is tied to Social Security so oftentimes you’re working on both at the same time.
Watch Our Video Below On How To Enroll In Medicare & Choose Supplemental Coverage
Medicare Late Enrollment Premium Penalties
No matter how you choose to enroll in Medicare, it’s most important to do it at the right time. If you do not enroll in Parts A and B during your designated open enrollment window, you can be accessed higher premiums for life. And your coverage might be delayed as well.
Both Part B and Part D (drug) components of Medicare have late enrollment penalties for those who miss their personal deadlines. For most consumers, their enrollment window is the 3 months before their 65th birthday, month of, and three months after. For others, it’s when they enroll in Part B which can be early due to disability – or later because of employer coverage at work.
If you’re not sure, talk to an expert. Call us or someone like us. Missing your open enrollment window will cause coverage delays, monetary penalties, and unhappiness.
Understanding Medicare Part A
Open enrollment will differ for everyone, but most consumers enroll in Part A at age 65. Medicare Part A is free to U.S. citizens and permanent residents who are eligible for social security benefits, railroad retirement, and/or those who paid (or were a spouse of someone who paid) Medicare taxes.
This is usually a cost-free benefit. SSA advises consumers to enroll at age 65 even if they are not retired and do not plan on taking social security benefits. If you cannot meet the above mentioned criteria, you can still enroll in Part A by paying monthly premiums.
Most consumers get their Medicare card in the mail as they near age 65. Enrollment happens automatically, costs nothing, and is set going forward.
Understanding Medicare Part B
Medicare Part B is available to those age 65 who are also eligible for Part A. It’s also available to those who have been receiving disability benefits for 24 months.
Medicare Part B is NOT free. Premiums can vary based on your income. Those above certain income thresholds pay higher premiums based on a sliding scale. Those below certain levels pay less than the going rate. In general, Part B premiums are approximately $140 a month for most Medicare recipients.
It’s important to enroll in Part B at the right time for you personally. For some, that’s age 65 and for others it’s earlier due to disability. Still others can defer their Part B enrollment until after age 65 if they have qualifying group health insurance at work.
However, some consumers still have to enroll in Part B even if they have insurance at work. The size of your employer group will determine your best course of action.
It is highly recommended to speak with your human resources manager and a SSA representative to best understand how to proceed with Part B enrollment.
Paying Part B Premiums
Almost all Medicare beneficiaries have to pay Part B premiums. Again, it’s not free. If you’ve started Social Security, the premiums will be deducted automatically. There’s nothing you need to do… unless you want to defer Part B enrollment. If that’s the case, you need to tell SSA or Medicare.
If you are deferring Social Security, but still enrolling in Part B, then you can pay your premiums through an electronic funds transfer or bank draft. You can also mail a check quarterly.
Supplementing Your Medicare Coverage
Medicare does not cover everything. The government sponsored program has many gaps. It’s wise to plug them so you don’t face large bills later. There are two paths here:
- Enroll in a (Part C) Medicare Advantage Plan
- Purchase Medicare Supplement Coverage
One is not necessarily better than the other. Working with a broker, you can decide which type of policy best fits your needs and budget. You can’t have both – it’s one or the other.
Path 1) Medicare Advantage Part C Plans
Medicare Part C plans are private insurance plans referred to as Medicare Advantage plans. By rule, these policies must cover all of the benefits provided by Medicare Parts A & B, but privately so. In other words, you are turning your Medicare admin over to a company like Aetna, Humana, Anthem BCBS, United Healthcare or others. You typically need to stay in their network of doctors and hospitals to receive the best cost for healthcare.
Advantage plans offer benefits above and beyond traditional Medicare Parts A & B. Most include Part D drug benefits, dental, vision, hearing, recovery benefits, meals, transportation and more. But more importantly, they shore up the holes in original Medicare so you have known out of pocket costs for the year.
Medicare Advantage plans come in several shapes and sizes with differing benefit structures and maximum out of pocket costs for the year… both in and out of network. We can help you understand what to expect from these types of policies.
Path 2) Medicare Supplement Insurance
With a Medicare Supplement plan, you keep your Original Medicare Part A and B benefits from the government. You’re simply plugging the holes using a secondary payer. Supplements fill in all or most of the gaps. They start paying once Medicare stops.
There are generally no networks to worry about – you can see whoever you want that accepts Medicare. That’s virtually everyone. These policies are typically more expensive than Medicare Advantage plans, but are also more comprehensive as well. You will usually have less out of pocket exposure with a Supplement.
These policies typically don’t include much in the way of ancillary benefits. You will need to purchase dental, vision and Part D Drug coverage separately. They aren’t able to roll everything into one like their counterparts.
Medicare Part D Prescription Drug Coverage
The final piece of the Medicare puzzle is Part D prescription drug coverage. Part D is usually fairly simple and refers to the prescription drug plans that are offered by private insurance companies.
Some are sold on a stand-alone basis while others are packaged together with Medicare Advantage plans. Medicare supplements and Part D Drug coverage are always sold separately, however. Even if they are from the same insurance company, they must be two separate policies by rule.
It is important you enroll when first eligible to avoid late enrollment penalties and/or delays. Most consumers purchase a Part D plan either separately or as a package when eligible.
Open enrollment for Part D plans occur each year from October 15th to December 7th. If you are unhappy with your prescription drug coverage, then you can purchase a new plan (effective January 1st) without medical underwriting or proof of insurability.
Contact Us for More Information
Hyers and Associates is a full service health insurance brokerage offering Medicare guidance and insurance across the country. We can help you sign up and enroll in Medicare. We can also help with your supplemental coverage as well. Contact us today!
Category: Medicare Advantage, Medicare Supplements
You have several choices to consider when shopping for Medicare supplement insurance coverage. Plan C is popular as it covers almost all of the gaps associated with Original Medicare Parts A and B. It can be a good alternative to Plan F if you desire slightly lower premiums and wish to maintain comprehensive overall coverage.
Plan C is just like Plan F in every way except that it does not cover “Part B Excess Charges.” The only two plans that cover Part B Excess Charges are Plans F and G. As these charges are very rare, most consumers are comfortable with Plan C.
Compare Plan C Medicare Supplement Insurance Benefits And Gaps
| Benefits |
A |
B |
C |
D |
F |
G |
K |
L |
M |
N |
| Part A Hospital Coinsurance |
✔ |
✔ |
✔ |
✔ |
✔ |
✔ |
✔ |
✔ |
✔ |
✔ |
| Lifetime Reserve Days |
✔ |
✔ |
✔ |
✔ |
✔ |
✔ |
✔ |
✔ |
✔ |
✔ |
| 365 More Hospital Days |
✔ |
✔ |
✔ |
✔ |
✔ |
✔ |
✔ |
✔ |
✔ |
✔ |
| Parts A and B Blood |
✔ |
✔ |
✔ |
✔ |
✔ |
✔ |
50% |
75% |
✔ |
✔ |
| Part B Coinsurance |
✔ |
✔ |
✔ |
✔ |
✔ |
✔ |
50% |
75% |
✔ |
✔ |
| Part A Hospice Coinsurance |
✔ |
✔ |
✔ |
✔ |
✔ |
✔ |
50% |
75% |
✔ |
✔ |
| Skilled Nursing Coinsurance |
|
|
✔ |
✔ |
✔ |
✔ |
50% |
75% |
✔ |
✔ |
Part A Deductible
$1,288 in 2016 |
|
✔ |
✔ |
✔ |
✔ |
✔ |
50% |
75% |
50% |
✔ |
Part B Deductible
$166 in 2016 |
|
|
✔ |
|
✔ |
|
|
|
|
|
| Part B Excess |
|
|
|
|
✔ |
✔ |
|
|
|
|
| Foreign Travel Emergency |
|
|
✔ |
✔ |
✔ |
✔ |
|
✔ |
✔ |
✔ |
| Preventive Care Coinsurance |
✔ |
✔ |
✔ |
✔ |
✔ |
✔ |
✔ |
✔ |
✔ |
✔ |
| Out of Pocket Limit |
|
|
|
|
|
|
$4,960 |
$2,480 |
|
|
By viewing the outline of coverage above, you can see that Plan F is the most comprehensive coverage available. Plans C and G are the next best options as they both have only one gap. Plan C is usually more expensive than Plan G, but less than Plan F.
What Are Medicare Part B Excess Charges?
These are charges that medical facilities and practitioners charge above and beyond what Medicare part B approves. They are usually a percentage of the total medical bill and can be as high as 15% of the total cost.
An excess charge on a costly Medicare Part B approved expense could be significant if the doctor or hospital does not accept Medicare assignment. Most medical professionals accept Medicare assignment so it is rare for consumers to run into these charges where they are allowed.
Are There Advantages to Medicare Plan C Insurance?
It depends on what state you live in and where you spend the most time. Considering that some states do not allow for Part B Excess (Ohio is a good example) then it can be a moot point. Consumers who spend time in multiple states or travel often might feel better with a supplement that covers this gap.
When comparing monthly rates for Plan C, consumers will find that it is usually only a couple of dollars less per month than Plan F. In other words, it’s not much savings. (Premiums for Plan G can be $15-$20 less per – so it is sometimes a better value overall.)
As mentioned, most doctors and hospitals (and some states) simply do not allow for Part B excess charges. In that way, Plan C and Plan F are nearly identical. However, most consumers feel better knowing these charges will be covered – especially if the cost is only a couple of dollars more per month for Plan F.
Select Plan C Medigap Insurance Network Policies
Medicare supplement Select Plans are those that use a pre-approved network of doctors and hospitals for routine care. They offer lower premiums than traditional coverage as the insurance company has negotiated lower prices within the network.
Like all network driven insurance coverage, the risk to the insured is if they receive non-emergency care outside of the approved network. AARP (through Unitedhealthcare) and Anthem BCBS are two companies offering Select Plan C, but traditional non-network plans are more often purchased by seniors. It’s important to make sure you understand any limitations with a Select supplemental plan before purchase.
What Is The Future Of Medicare Supplement Insurance Coverage?
Health care reform did not eliminate Medicare Advantage plans as some predicted. In fact, these policies are seeing increased enrollment. Some supplemental plans will be phased out in 2020, however. New legislation states that all plans covering the Part B deductible will be eliminated. This includes Plans F and C as well as their Select and High Deductible versions.
This development will increase the demand for Plans G and N in our opinion as the 2020 gets closer. Most consumers do not want to own a plan that no longer accepts new members. When no new members can be accepted, rates will sometimes rise more dramatically.
Summary And Quote Request
In summary, Plan C offers negligible savings over Plan F in most cases. If you are deciding between the two, it might be wise to purchase Plan F and know that Part B excess charges are covered. With these two plans leaving the market, you might also consider Plans G & N.
Hyers and Associates, Inc. is a full service Medicare supplement insurance brokerage. We offer the direct rates from several highly-rated insurance carriers. We also help educate our clients about supplemental policy trends now and in the future.
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Category: Medicare Supplements
There are several factors that will determine the cost of a Medicare supplement policy upon purchase. Each insurance company and each state has its own rules and regulations affecting policy prices.
That is why it’s usually wise to shop around with an independent agency. The prices of Medicare supplement insurance plans are controlled by law, so it will be no more or less expensive to work through an insurance agent.
Common Medicare Supplement Price Factors
There are several factors that will determine the best overall price when purchasing a supplemental policy. There are some providers that will always offer lower prices than others and it’s important to know why.
Listed below are the most common parameters used to determine price:
- Your Age, Gender and Zip Code
- Tobacco Use
- Type of Coverage (Issue or Attained Age; Community Rated)
- Age of Plan Selected
- Premium Payment Method
- Available Discounts
Age and Gender Affects Medicare Rates
All insurance companies will base your premium on your current age. Some use age bands, but most underwrite to your exact age when the application is made. The older you are, the more expensive the supplemental policy.
Gender is a factor in most areas, but not all. Generally, Medicare supplement insurance is less expensive for women assuming all other variables are equal. However, many providers and some individual states underwrite based on unisex tables.
Anthem Blue Cross Blue Shield and AARP United Healthcare have the exact same rates for men and women in most states. California requires unisex rates for all insurance companies and in Texas, Mutual of Omaha uses a unisex table while most others do not.
Thus, if you are a female shopping for coverage, you will likely get your best rates if you choose an insurance company with separate prices based on gender – assuming your home state allows for it.
Resident State and Zip Code Factors
Overall Medigap rates are also affected significantly by where you call home. Some states are more expensive than others based on demographics and the cost of care as determined by actuaries.
Furthermore, many insurance companies, but not all, will determine your rates depending on the zip code in which you reside. In Ohio for example, Medicare insurance rates are higher in the northern part of the state (near Cleveland) than in most other areas.
Florida is another good example. Overall, supplemental rates in FL tend to be higher than in most other states based primarily on demographics and the cost of health care. There are certain areas of Florida that have some of the highest rates in the country.
Supplemental Insurance and Tobacco Use
As with almost all insurance coverage, prices will be higher for those who are regular tobacco users. This is true of life and health insurance, disability, long term care, and Medicare supplements.
It does not matter what form of tobacco that is used, it will still increase your premiums. With most providers, you must be tobacco free for at least one year in order to qualify for a lower rate. One caveat to this rule is that some states do not factor in tobacco use during open enrollment.
Type of Coverage and Age of Insurance Plan
There are three types of coverage to choose from in most states: Issue Age, Attained Age, and Community Rated plans. Generally attained age plans are the least expensive policy type upon enrollment. Some states only allow for one or two types of coverage to be sold however, but the majority of plans offered today are attained age.
Issue age and community rated Medicare supplements do not raise rates based on the insured growing older each year, but they do raise rates based on claims, diminishing discounts and other factors. It is the opinion of this insurance agent that one type of coverage is not significantly better than the other as all three will increase rates each year.
The age of the plan is yet another factor in determining your rates. In general, the older the coverage – the more expensive the plan. If a carrier is new to your area, then almost always they will have lower rates than one that has been offering insurance for several years. Providers with more experience have more claims and will raise their rates each year accordingly.
Premium Payments and Spousal Discounts
You can usually save a small percentage or predetermined dollar amount by paying for your Medicare supplement insurance either monthly through an automated bank draft or yearly by check.
Insurance companies try to avoid administrative expenses by offering incentives for regular monthly or yearly payments. In fact, most providers will only allow for monthly payment via bank draft.
Additionally, several Medigap providers offer discounts in one form or another. The most common is a marital (spouse) discount that will usually decrease the premiums by 5-7% for each insured spouse or domestic partner assuming both are enrolled. Some carriers now offer household discounts as well. By simply having someone else living with you, you can qualify for a 5-7% discount.
It is a good idea to let us know if a spouse will be Medicare eligible in the near future or if you are living with someone else as it may affect our recommendations for your Medicare supplement insurance company.
Other companies provide preferred rates for those in very good health. This is a less common practice and will not affect rates for those in open enrollment. Still others, AARP for instance, offer a discount that erodes each year regardless of any other available premium breaks.
Contact Us to Compare Supplemental Insurance Quotes
As you now know, there are several factors that will help determine your overall Medicare supplement insurance rates. That’s why it is such a good idea to talk with an agent as oppose to trying to shop it around on your own.
Placing your insurance through an agent will not affect your rates one iota, but will give you the best opportunity to find affordable coverage now and in the future.
Hyers and Associates, Inc. is a full service Medicare insurance agency offering supplements from several carriers across the country. Contact us today to research the best Medicare supplement quotes and rates in your area.
Category: Medicare Supplements
If you are currently enrolled or soon to be enrolled in Medicare, you usually have just two insurance choices to close/minimize the gaps in this government insurance program: Medicare Supplements or Medicare Advantage plans.
It’s a good idea to choose one or the other as Original Medicare has several benefit gaps with open ended expenses. Either of these two choices will close these gaps and reduce your out-of-pocket exposure to a known amount.
Comparing Medicare Part C (Advantage) Insurance
Part C is the generic term that includes all privately sold Medicare Advantage plans available for purchase. Your county of residence will determine which Advantage plans are available for enrollment. These are sometimes referred to as MA or MAPD plans for short. (The P D stands for prescription drug.)
Medicare Advantage plans are private insurance programs offered from providers like Aetna, Anthem BCBS, Cigna, Humana, United Healthcare among many others. These same insurance companies will also offer Medicare supplements as well, but you can’t have both. It’s one or the other.
When you compare Medicare supplements to Medicare Advantage (MA) plans, you are simply trying to determine a suitable and affordable way to cover the insurance gaps not covered by Original Medicare Parts A & B. There are pros and cons to both.
Comparing Medicare Supplements to Advantage Plans
| Benefits |
Medicare Supplements |
Medicare Advantage Plans |
| Monthly Premiums |
Usually higher – Especially for plans C, D, F & G |
Usually lower than most Medicare supplements |
| Potential For Out-Of-Pocket Expenses? |
Less. Plans C, D, F, G, N and others offer more comprehensive coverage with less out of pocket exposure |
Greater. Most Advantage plans will have both in and out of network out of pocket maximums. These can be as high at $10,000. |
| Yearly Deductibles? |
Less. Most plans cover the larger Part A deductible. Some don’t cover the Part B deductible which is small, yearly amount. |
Yes. Varies from plan to plan and whether you are in or out of network. Copays and coinsurance are typically much higher with Advantage plans |
| Choice Of Doctors & Hospitals? |
Yes. Insured can use any doctor or hospital with almost all traditional Medicare supplements no matter the insurance company chosen. |
Depends on the plan. PPO’s have larger networks than HMO’s, but you must stay in network with both to reduce your out of pocket exposure. HMO plans offer no coverage out of network. |
| Includes Part D Rx Coverage? |
No. Part D coverage must be purchased separately on a stand-alone basis. |
Yes. Most Advantage plans bundle Part D coverage into one policy. These are called MAPD plans. |
| Overall Flexibility |
Yes. Allows insured to change plans and disenroll throughout the year. No network limitations and plans will travel out of state. Good for those who spend time in multiple states. |
No. Insured must wait until certain times of the year to disenroll. Medical underwriting may be necessary to later purchase a supplement. Usually only covers emergencies out of network. |
| Offers Ancillary Benefits? |
No. Supplements are not allowed to offer ancillary type insurance options at this time. |
Yes. Many Advantage plans include dental, vision, hearing and other perks. |
Medicare Premiums, Out-Of-Pocket & Plan Flexibility
It is difficult to compare monthly insurance premiums versus potential out-of-pocket costs. If you remain in good health, a low cost Advantage plan will be the least expensive choice overall. However, if you have regular health issues or a significant incident, an Advantage plan can have much higher out-of-pocket expenses when compared to a Medicare supplement like Plan F, G or N.
Furthermore, your one year trial period is up, you may be unable to switch back to a traditional supplement if you have certain preexisting conditions. Most Medicare supplement providers require medical underwriting if you have been enrolled in an Advantage plan for over one year. In other words, you can be declined coverage. Additionally, it can be difficult to disenroll from a MA plan outside of the Oct.15th thru December 7th Open Enrollment window each fall.
In fairness, there are states like Florida where Medigap rates can be higher than most other places. And regardless of out-of-pocket expenses, some consumers simply cannot afford both a Medicare supplement and a stand-alone Part D plan. For these folks, an Advantage plan can be the most suitable option as some are offered at $0 per month.
Medicare Advantage Networks – Doctors and Hospitals
One important difference between supplements and MA coverage are the network options. Unlike almost all supplements, MA plans have a network of doctors, hospitals and medical facilities that the insured is mostly required to use for service. All plans will cover emergencies out of network, but your idea and the insurance company’s idea of an emergency may differ.
The problem arises when a specialist is needed for consult or if the insured is admitted to a rehabilitation or other medical facility that is out of the provider network. It’s not that the insured cannot see these professionals or use the facility, but the Advantage plan may provide little in the way of reimbursement – if any at all. This can lead to significant out-of-pocket expenses.
Prescription Drug Part D Rx Coverage
This is an area where MA plans tend to be more beneficial to the insured. Current laws allow insurance companies to package Advantage plans and Part D coverage together in one package. Not all MA plans combine Parts C and D together, but many do as an incentive to the consumer. And many of these combination MAPD plans can be found for under $75 a month. Some are as little as $0 a month.
Conversely, Medicare supplements and prescription Part D coverage must be sold separately by law. There was a time when the two plans could be purchased in tandem, but past regulations separated the two. Many companies offer both supplemental and Part D, however they cannot be purchased together. And it’s wise to shop them independently on one another.
This means that Part D plans will come at an additional cost for those who want a traditional Medicare supplement. Part D premiums will vary, but plans that fit most consumers cost between $15-$30 a month. The plan that’s most suitable will depend on what prescriptions you take. Even if you don’t take any at all, it’s wise to have a plan in order to avoid the lifetime Late Enrollment Penalty.
What Is The Future For Medicare Advantage Plans?
It’s hard to say. Health care reform is an evolving piece of some of the most significant legislation passed in recent decades. Medicare supplements are here to stay, but Advantage plans seem to fall in and out of the political cross-hairs. For now, MA and MAPD plans are alive and well.
It is important to note that if your MA provider leaves your service area or discontinues coverage, you will receive an open enrollment window when you can purchase some supplements (or new MA plan if one exists) without any required medical underwriting.
Contact Us For Quotes And Coverage
In summary, there is not a one-size-fits-all plan for Medicare beneficiaries. While more of our clients tend to purchase Medicare supplements, many also are very content with Advantage plans. We do both and will help you narrow down your choices to the ones that look most suitable for your needs and budget.
Hyers and Associates is an independent insurance agency serving several states nationwide. We work with the leading Medicare insurance providers to help our clients compare their options and enroll in coverage directly – at no additional cost.
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Category: Medicare Advantage, Medicare Supplements
Forethought Life Insurance Company is offering affordable Medicare supplement coverage in several states across the U.S. Forethought is well known for their diverse annuity and life portfolio, but they also offer supplemental Medicare policies through independent agencies like ours.
It is not uncommon to see insurance companies enter the Medicares supplement marketplace after developing a strong track record in other areas first. Forethought Life carries an A- rating by A.M. Best which translates to an “excellent” rating and they have been offering insurance and financial products since 1985.
Medicare Plans Offered by Forethought Life
They offer supplemental insurance plans A, C, F, G, and N in several states and are very well priced in most areas of Ohio as well as other areas of the country. (Plan G may be their most popular supplement.)
There are no network restrictions with their insurance coverage and no referrals are needed to use a certain doctor or hospital. In this way, they work like all other supplemental insurance plans offered by every other Medigap insurance carrier.
Underwriting will only be needed for those who are not in a period of guarantee issue or open enrollment. If underwriting is required, it simply consists of answering a few health related questions on the application and a short phone interview. Consumers need not worry about taking a physical with their primary physician to be accepted for coverage.
Combination Final Expense Life Insurance
One unique attribute with their applications is that final expense life insurance can be added should consumers want or need that financial protection. Forethought’s premiums are very competitive in the final expense marketplace and can help senior consumers with two needed products at one time. Of course, there is no obligation whatsoever for those who do not wish to obtain any life coverage.
Forethought Life Insurance Company is a subsidiary of the larger Forethought Financial Group and has offices in Indiana and Texas. Through their subsidiaries, they engage in banking, trust and insurance services. They are best known in the industry for their funeral trusts and long term care annuities, but they are now becoming very popular for their affordable supplements plans as well.
Request Medigap Quotes and/or Consultation
If you are new to Medicare or simply shopping around for better rates on your existing coverage, then Forethought should be on your list of companies to research.
It is best to speak with an independent agent who represents several companies in order to compare and contrast claims service, rating and renewal history.
We are an independent agency offering coverage from several reputable carriers. Contact us today to learn more about your Medicare insurance options.
Category: Medicare Supplements
When shopping for Medicare supplement insurance to help cover the gaps in your Medicare Part A and Part B coverage, it is important to know what your out of pocket expenses will be each year.
The Part A and B deductible amounts increase each year as determined by the Centers for Medicare and Medicaid Services. All coinsurance amounts are also adjusted each year. Thus, you are purchasing coverage for out-of-pocket expenses now as well as higher amounts in the future.
Medicare Deductible and Coinsurance Percentage Increases from 2010 to 2011
| Medicare Gap |
2010 |
2011 |
% Increase |
| Part A Deductible (Inpatient Hospital) |
$1,100 |
$1,132 |
2.91% |
| Part B Deductible (Physician’s Services & Supplies) |
$155 |
$162 |
4.52% |
| Hospital Coinsurance Days 61-90 |
$275 |
$283 |
2.91% |
| Hospital Coinsurance Days 91-150 (lifetime reserve) |
$550 |
$566 |
2.91% |
| Skilled Nursing Facility Coinsurance |
$137.50 |
$141.50 |
2.91% |
Future Medicare Out-of-Pocket Expenses
The year over year percentage increase from 2010 to 2011 are nominal – none more than 5 percent. However, it is important to keep these figures in mind when comparing supplemental policies to Advantage plans. Medicare Advantage plans can have a great deal in out-of-pocket expenses when compared to comprehensive Medigap policies like Plans C, D, F and G.
Each year, the coinsurance and deductible amounts are slated to increase. When choosing a plan that may not cover some of the above listed features, it is important to know that these amounts can add up over time – especially the hospital and skilled care coinsurance out of pocket expenses.
Medicare Part B Premiums From The Government
Medicare Part B monthly premiums will remain at $96.40 for most beneficiaries in 2011. Those who have their premiums withheld from their Social Security checks will not have a premium increase from year 2010.
Those who have not yet elected to receive Social Security or who do not have their Part B premiums withheld from their monthly checks will pay $115.40 in year 2010.
This is a 4.4% increase year over year for those Medicare beneficiaries. In other words, the federal government is providing an incentive for eligible citizens to take their Social Security payments earlier rather than waiting.
Medicare Income Related Monthly Adjustment
Higher income beneficiaries will pay $115.40 monthly as well as an income-related monthly adjustment depending on overall declared income as reported to the I.R.S. This income adjustment should factor in to your decision to opt into Medicare A and B at age 65 if you are still working while collecting significant income.
In some cases, it may make financial sense to stay on an employer sponsored plan (if available) as oppose to signing up for Part B. However, some companies will encourage senior employees to disenroll from group coverage or not offer continuing coverage at all.
It is also very important to find out if you are required to sign up for Part B through the Social Security Administration at age 65 based on the size of your employer. That is to say some employees over age 65 who continue working may still need to enroll in both Parts A and B regardless of their group coverage status.
Request Information and Quotes
Hyers and Associates is a full service, independent Medicare supplement insurance agency offering quotes from several carriers.
We work in in several states, from California to Florida, and help consumers compare and contract Medigap plans offered by the most affordable providers in their zip code.
Contact us for quotes and information today!
Category: Medicare Supplements
As of October 15th 2010, Anthem Blue Cross Blue Shield of Ohio is offering Medicare supplement coverage on a guaranteed issue basis in certain circumstances – along with their standard underwritten plans.
This is good news for those over age 65 who have had trouble switching from costly Medicare supplements because of poor health or other medical underwriting issues.
Ohio Anthem Blue Cross Qualification Rules
In order to qualify, individuals must switch from an existing supplemental policy to a new Anthem plan with equal or lesser coverage. This means if you currently own Plans F or J, you can switch to a modernized Plan F (Plan J is no longer for sale as of June 2010) with no health questions asked. Likewise, you could switch from Plan G to Plan G or Plan N to Plan N, etc.
There is no waiting period for preexisting conditions that needs to be satisfied when changing. It is important to keep your old policy in force up until the day the new Anthem policy becomes effective.
Current and former Blue Cross Blue Shield members may apply for coverage on a guaranteed basis too – as well as those who were previously turned down. (Editor’s note: This guaranteed changing option without underwriting is no longer offered.)
Medicare Supplement Insurance Plans Offered
Anthem offers five attained age rated Medicare supplements in Ohio labeled A, F, high deductible F, G, and N. However, if you currently own other coverage (Plans C, D, E, H, or I for instance) there will be an equal or lesser plan that matches up to these plans.
Plans F, G and N are most popular with consumers as they provide the most benefits to the insured. Part D prescription rx plans are also offered from Anthem, but can only be changed between Nov. 15th and Dec. 31st each year.
If you have owned a Medigap plan for more than a couple of years and your premiums have risen substantially, you may find switching to like or lesser coverage will reduce your monthly insurance costs significantly.
Monthly Premiums for Anthem Supplemental
Anthem Blue Cross Blue Shield offers consumers a few other ways to reduce their monthly costs. If premiums are paid electronically through a monthly bank draft (EFT), then rates will be decreased by $2 per month. Should the premium be made annually, then the one-time payment would be reduced by $48.
A household discount of 5% is also available to both enrollees when more than one member of a household enrolls in a supplemental insurance plan. This discount will become effective once both household members have been approved either at onset or in the future.
The guaranteed issue Medicare supplement offer is only good until December 1, 2011. Medical underwriting will be required for all applicants once again after December of next year.
It is rare for a Medicare supplement provider to offer a guaranteed issue plan in this way, thus it might be wise to take advantage of this offer as very few (if any) will match it.
Request Medigap Quotes Today
Hyers and Associates is a full service, independent insurance agency offering supplemental insurance plans direct to consumer. There is no mark-up or additional cost to use our services.
We provide insurance in several states across the U.S. and are offering Anthem supplemental plans in Ohio, Indiana, and Missouri.
Contact us for quotes and assistace.
Category: Medicare Supplements
There are several insurance companies offering Medicare supplement insurance plans across the U.S. – some are more well known than others.
For every Anthem Blue Cross/Blue Shield and United Healthcare there are a dozen other companies offering the same benefits and coverage. How are you to know which insurance company is best for you?
Understanding Medicare Supplement Networks
The first thing to know is that if your doctor or hospital accepts Medicare patients (and therefore Medicare assignment) then they will accept any traditional supplemental insurance policy that you purchase.
That is to say that the vast majority of Medigap plans sold do not have any network restrictions. In this way, there are no network differences between Aetna and the other dozen companies you may not yet heard of.
Too often, consumers buy name brand thinking that they are purchasing better insurance with a larger network. And that is understandable considering that many times, these same consumers are leaving a group or individual health insurance plan with one of the major carriers like Anthem, Aetna, Humana or United Healthcare.
The fact is networks are the same with almost all Medicare supplement insurance providers. Thus, you can usually save on your monthly premiums by purchasing a Medigap insurance plan from a niche carrier. You will be afforded the same access to health care professionals and facilities with either plan. And the niche supplemental carriers are usually less expensive on a monthly basis.
Medicare Supplement Insurance Select Plans
Medicare Select plans are the exception to the rule. These types of plans do operate on a network and you will be charged more if you see a health care professional out of network. Select insurance coverage is not the norm in the industry. Only a few carriers (Mutual of Omaha for example) offer this as an option, but it is rarely purchased by consumers.
In fact, those who wish to operate in a network are more likely to purchase a Medicare Advantage plan. The drawback to both Select and Advantage coverage is larger out of pocket expenses when you need to see a specialist or use a facility out of network. For this reason, most consumers will purchase a traditional supplement from a low cost carrier.
Medicare Claims Filing, Payment and Billing Issues
Another primary concern for those who purchase Medigap insurance is the company’s claims handling ability. It goes without saying that you would not want to purchase a plan with a company that has a bad reputations in this area.
Fortunately, Medicare is a highly regulated social program. There is very little gray area when it comes to claims and billing. It has been our experience that very few, if any, companies can or will cause claims difficulty for the insured. We work with over a dozen Medicare supplement insurance providers and there are very few complaints with billing and claims payments.
Any company earning a bad claims payment reputation would certainly fall out of favor with insurance agents and their clients. With so many low cost providers available, agents would not risk losing clients knowing that the chosen carrier would cause future problems. And, of course, the government run CMS would likely act if a carrier was a frequent rules and regulations violator.
Rate Increases on Existing Supplemental Coverage
This is an area where some companies separate themselves from others. However, all supplemental insurance providers will raise your rates every year. It does not matter if you purchase an attained age, issue age, or community age rated policy. All plans experience rate increases each year.
Even the companies with more favorable rate increases will be undercut when new carriers enter their market. While it is important to choose a company with a reliable rate history, it’s hard to predict future premium increases. It is important to work with an independent agent who can guide you toward more affordable Medicare supplement insurance when it becomes available in your state of residence.
Summary and Quote Request
When you purchase Medigap insurance, you are very rarely choosing one network over another. If your doctor accepts Medicare, they will accept any traditional supplemental coverage in which you have enrolled. The only exception to this rule is a Select Plan although very few consumers choose this type of coverage.
You can save on your monthly premiums by choosing a niche provider over some of the more well known carriers. Typically, the national insurance companies do not price their plans as competitively as others. And when you work with an independent agent, you can usually change to a lower cost plan in the future should you remain in moderately good health.
At Hyers and Associates, we provide Medicare supplement insurance quotes, coverage and enrollment assistance in several states. Contact us today to view the most affordable Medicare supplement plans in your area.
Category: Medicare Supplements
Medicare supplement Plan G was updated way back in 2010 and should now be considered by most beneficiaries as a smart purchase when supplementing original Medicare Parts A and B.
After Plan F, Plan G is one of the most comprehensive plans available. It is an affordable choice if you are willing to cover the small, one-time Part B deductible in exchange for lower monthly premiums.
Medicare Supplement Plan G Benefits & Coverage
Plan G covers all of the gaps in Original Medicare except for the Part B deductible. The Medicare Part B deductible amount for 2018 is $183 – the same as 2018. This amount can increase slightly, stay the same, or actually decrease each year. It never increases by significant amount, however.
Prior to June 1, 2010, Plan G only covered 80% of Part B Excess charges, but plans purchased after June 1 cover this benefit at a 100% level. If you live in or often travel to a state that allows doctors and/or hospitals to charge Part B excess, then it’s wise to consider a supplement that covers Part B Excess charges.
Plan F and Plan G are the only two policies that coverage Part B Excess Charges in their entirety. It is important to note that some states do not allow for Part B Excess Charges. Ohio is one such state. In this case, Plan N can be a good choice as well.
Plan G Monthly Premiums & Out of Pocket Costs
Plan G is usually quite affordable and typically costs around $20-$25 less than Plan F on a monthly basis. If you wish to keep your Medigap insurance premiums affordable, but also want to purchase comprehensive coverage, then Plan G can be a very good choice.
Almost all supplemental insurance plans will experience rate increases year over year and Medicare Supplement Plan G is no exception. Predicting future rate increases is difficult, but as long as you stay in reasonably good health, you should be able to purchase a less expensive policy in the future.
Lower Premium Increases With Plan G Insurance
With some carriers, their Plan G rate increases have been smaller when compared to their other supplemental offerings. The reason is Plan G is not a guaranteed issue plan outside of open enrollment at age 65. Less availability and tighter underwriting standards can sometimes translate to lower costs and smaller premium increases.
In most states there in not a yearly open enrollment period which means you may need to undergo medical underwriting in order to qualify for new coverage. Underwriting is required to prove that you are in moderate to good health. Assuming you qualify medically, you can change to a new Plan G or any other Medicare supplement in order to keep your monthly premiums down.
Shopping Online For Less Expensive Medicare Plans
There are several insurance companies offering Medicare supplement Plan G and new companies are entering the marketplace quite often. It is important to work with an agency that is keeping up with these changes. As more affordable plans become available from other carriers, it is wise to reach out to an agency like ours to compare your rates.
Whether you purchase Plan G, Plan F or any other Medicare supplement insurance policy, it is important to keep in contact with an agency like ours as rates increase and new carriers offer coverage in your area.
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At Hyers and Associates, Inc. we are an independent agency specializing in Medicare supplemental insurance policies. We represent several providers and are always looking for new, low cost carriers for our current and prospective clients.
Request Plan G Supplement Quotes Here →
Category: Medicare Supplements
Plan F Medicare supplement insurance policies are the most comprehensive supplemental plans available for purchase today. They cover all gaps in Medicare and have no out-of-pocket costs to the insured for Medicare approved expenses.
With Plan F, there are no deductibles, coinsurance or copays to meet. So long as your expenses are Medicare approved, Plan F will cover the remainder. There are no lifetime limits or maximums – and coverage cannot be cancelled so long as you pay your premiums.
(It’s important to note that no Medicare supplements sold today cover prescription drug costs. In order to cover these expenses, a private Part D prescription drug plan must be purchased.)
Plan F Medicare Supplement Insurance Benefits
When viewing a Medicare supplement benefit chart, you will see that Plan F covers all of the gaps in Medicare Parts A & B. This is why agents sometimes refer to Plan F as the “Cadillac Plan.” It’s the most comprehensive available, but it will no longer be offered to those who are new to Medicare beginning in 2020. More on that later.
When comparing Plan F Medicare supplement insurance quotes, you are shopping on price, rate increase history and the reputation of the insurance carrier. It can be good idea to shop with an independent agency (like ours, of course) so you can learn more about yearly premium increases from the various companies.
Understanding Medicare Part A & Part B Deductibles
Plan F fully covers both Part A and B deductible amounts as well as Part B coinsurance at a 100% level. Most Medicare supplements cover the Part A deductible, but only two (Plan C & F) cover the smaller Part B deductible.
While the Part B deductible might be of little concern to some, some consumers simply want a hassle-free plan with no out-of-pocket exposure to worry about – and that policy is Plan F. If you are not worried about the small Part B deductible, then Plan G can be a good choice. The lower premiums with Plan G usually make up for the deductible and Plan G premiums tend to increase more slowly.
Plan F No Longer Available For Sale In 2020
As mandated by CMS (Center for Medicare and Medicaid Services), Plan F will no longer be offered as of January 1, 2020. Those who were eligible for Medicare before 2020 will be able to keep their F plans and even shop for new ones, but those who are eligible after 2020 will not be able to purchase a Plan F.
The Medicare Access and CHIP Reauthorization Act of 2016 was passed to reduce Medicare costs and increase cost sharing. The law states that beginning in 2020 no plans sold to new members can cover the Part B deductible. That eliminates Plan F and Plan C as well as High Deductible Plan F.
This is not the first time Medicare has withdrawn a supplement from the market. Plan J (the most comprehensive at the time) and a handful of others were decommissioned in 2010. With no new enrollments allowed, some carriers did experience above average rate increases on their existing pool of policyholders. As we get closer to 2020, this change is something to be aware of and it might cause rates to increase more quickly with some F supplement plans.
Coverage For Medicare Part B Excess Charges
Not all states allow doctors to charge Part B excess fees. If your home state – or one that you visit often does – then it can be wise to purchase a plan that covers this benefit. Plans F and G are the only two Medicare supplements sold today covering Part B Excess charges.
If you did face a Part B excess charge (up to 15%) on a significant medical claim and you did not have Plans F or G, you could encounter a large medical bill. While these charges are very rare, it is something to be mindful of in the long run. If your resident state does not allow for Part B Excess Charges (like Ohio for instance) you might consider other plans like C, D and N.
High Deductible Plan F Medicare Supplement Insurance
Plan F is unique in that it is the only Medicare supplement sold today that offers a variation with a deductible. High Deductible Plan F is popular as the premiums are usually very low when compared to most other supplements sold today.
With HD Plan F, your benefits will not begin until a predetermined deductible has been reached. Currently, the deductible for HD Plan F is 2,180. This does not mean that Medicare does not still pay its part first – it does. It simply means that your supplemental benefits don’t begin until you have first met the deductible.
This is a yearly deductible and Medicare officials usually increase this amount each year based on inflation. Any mandated increases will affect all High Deductible Plan F policies – both old and new.
Medicare Select Supplemental Insurance Plans
No matter the chosen insurance carrier, almost all supplemental insurance plans have no network restrictions. As long as your doctors and/or hospitals accept Medicare patients, then they will also accept any supplement you purchase from any company. There are a couple of exceptions, however.
There are two supplemental insurance policies (Plan C & F) sold today that offer “Select Plans” in some areas of the country. Select Plans will only cover non-emergency benefits if you stay in their designated network. The network may not include all of the doctors and hospitals you might want to use. Thus, it’s important to understand any limitations of a network-driven Select Plan before purchase.
Most Select Plans will pay for emergency care outside of the network with no restrictions, however. In our experience, Select Plans C & F are rarely purchased, but they can be beneficial for those in need of lower premiums.
Request Quotes & Information
There are several competing insurance companies offering Medicare supplement insurance in every state. This is a well-regulated insurance product and almost all companies pay claims in an orderly and efficient manner.
Our independent agency can help take the guesswork out of shopping for Plan F and any other supplement plan. We will show you the direct rates with dozens of carriers side by side and walk you through the value each has to offer.
Compare Medicare Supplement Rates →
Category: Medicare Supplements
Medicare supplement premiums are usually locked-in during the first year of the policy. After 12 months and on your policy anniversary, you’ll usually find the insurance company increases your monthly rates by 5-10%.
Many carriers are enacting price increases of ten percent or more year over year. Some are raising prices more than once in the same year. Rest assured however, there are several ways to reduce your monthly premiums.
When Can I Change My Medicare Supplement Insurance Plan?
The short answer is: you can switch Medicare supplement plans year round. In most states, there is no open enrollment period once you are already a Medicare beneficiary. When your premiums increase, you can contact an independent agency (like ours) and we will help you find new companies offering the same coverage at a lower rate.
There is one caveat, however. You must be in reasonably good health to medically qualify for a new supplemental insurance plan. Most companies have several questions on their application and if any are answered yes, you will be ineligible for new coverage. A phone interview might be required as well, but you do not need to get a physical.
In some cases, a certain amount of time must have elapsed since a particular health event. You might need to be 3-5 years removed from a heart incident, for example.
In our experience, many consumers can be medically underwritten for a new plan. While underwriting questions and time limits apply to some, they are not consistent across the board. Some insurance companies underwriting standards are more lenient than others.
Guaranteed Issue Medicare Supplement Insurance Plans
Several insurance companies have increased premiums more substantially over the last few years in several areas of the country. As long as you are in decent health, you will be able to purchase the same coverage (Plan F for instance) with another company for less.
However, for those who cannot medically qualify for new coverage, there might be other options in certain states. Every now and again, an insurance company will offer their Medicare Supplements with little to no medical underwriting.
They might be trying to drum up business or increase their insured population. Policies might be offered on a Guaranteed Issue basis or with small strings attached. For instance, it might be required that you have an existing plan with a competitor to switch to a new lower cost plan. Others will accept all comers with few health questions asked on certain plans.
Pro tip: It’s wise to have a relationship with an independent broker who is familiar with any Medicare Supplement specials offered in your State.
Yearly Anniversary And Open Enrollment States
Two states offering a yearly open enrollment that we serve are Missouri and California. They both have an annual open enrollment period when you can switch to like, or lesser, coverage (Plan F to Plan F or Plan F to Plan G for instance) without medical underwriting. The open enrollment window is unique to the individual and occurs on either the anniversary date when the coverage was purchased or the insured’s birthday.
If you live in either of these states and are unsure of your options, then contact our agency. We can discuss the optimal way to purchase a new Medicare supplement without any medical underwriting needed.
Request More Medigap Information
We are an independent agency licensed with all of the major carriers. We work in several states and offer several competitively priced Medicare supplement insurance plans. There is no additional cost to use our services as Medigap prices are controlled by law. You are always buying direct when using us.
We will provide you with current quotes on the plan(s) of your choice. We’ll advise you on your best options when your monthly premiums have increased or when you are in your open enrollment window.
Contact us to learn more about lowering your Medicare supplement rates today.
Category: Medicare Supplements
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