The first step after reading my collection of Medicare Advantage, prescription drug, and Medigap sales brochures was to find a way to fill in core Medicare coverage gaps’the deductibles for hospital stays and doctor care and the coinsurance for physician visits, lab tests, and hospital outpatient treatment that could really leave me with an unwelcome bill.’ I would have to pay 20 percent of those bills if I didn’t have supplemental coverage. The option I considered first was traditional Medicare supplement insurance, commonly known as Medigap policies, products I knew a lot about having reported on them for years at Consumer Reports. These policies have been around since the beginning of Medicare, but they have a blemished history because insurers used misleading and deceptive tactics to sell them. Congress ended those practices 20 years ago when it standardized the benefits for 10 different kinds of Medigap plans and designated them by using letters of the alphabet. That meant that all consumers had to compare were the premiums and how they were calculated. The idea then was to simplify shopping and end deceptive selling practices. Today shopping for a Medigap plan is anything but simple. Congress has taken away some of the standardized plans and added new ones with very skimpy coverage’a potential landmine for consumers on fixed incomes who choose them. The push to give consumers more information has actually made the job of picking a Medigap plan so much harder. The government’s website tells me that I can choose from among 96 Medigap different policies offered by sellers in New York City. Do I really need that many on top of some 43 choices for Medicare Advantage plans and 30 for prescription drug plans? Alphabet Soup Like any reasonable shopper, I checked out what the government’s handbook Medicare & You had to say about Medigap plans. Not much, it turned out. It said there were two new plans, M and N, and that plans E, H, I, and J are no longer available. It didn’t say what those plans covered. For an explanation of the coverage provided by any of the standardized plans’either old or new’I had to visit www. Medicare.gov or phone 1-800-Medicare, the New York insurance department, or contact the state health insurance counseling and assistance program. It almost seemed like the government does not want seniors to choose Medigap policies but rather steers them toward Medicare Advantage plans, for which there was far more information in the handbook. (I will discuss those in a later post.) I tackled the government website, which was confusing from the get-go. The first page of all the Medigap policies available in New York had columns listing the benefits with green checks and red x’s showing what was and was not covered.’ Okay, I got that, but what were the question marks that appeared next to the benefits?’ Take Policy A, for example, the page showed there was no coverage for the Part A hospital deductible’this year $1,132.’ But a blue question mark raised the question: was it covered or not? ‘ From that page, I was supposed to choose which combination of benefits and coverage I wanted and find out what policies were sold in my Zip code. Plan F was my choice, and the website advised that there were 14 policies for sale in my Zip code.’ Plan F is the most comprehensive and would cover me in case doctors don’t take Medicare’s payment as payment in full, sticking me with what’s called an ‘excess charge.” In the past, most docs have accepted Medicare’s ‘ payment levels, but that may be less likely in the future as doctors get more persnickety about not taking Medicare patients.’ I wouldn’t take that risk.’ Others might, since Plan F is the most expensive.’ It’s a risk benefit calculation’higher monthly premiums versus the possibility of a large bill down the road uncovered by insurance. Since all insurers selling Plan F must offer the same benefits, I needed to know only two things’the monthly premium and how companies figure premium increases each year.’ Medicare’s website was not very helpful. ‘ It gave only a price range for Plan F policies’$197 to $422 and contact information for the 14 companies. I guess I was supposed to call them.’ When it came to how premiums would be calculated, I would give the website a grade of C.’ ‘ A section called ‘Additional Tools & Information,’ gave a clear explanation of the three ways to determine premium increases, but crucial information was missing. Pricing by Age? In general, community-rated policies are best because premiums don’t change just because you get older.’ Issue-age policies are cheaper for younger buyers, and their premiums don’t increase with age.’ However, they are not common.’ Attained age-rated policies become the most expensive in the long run because premiums do rise as you get older.’ ‘ In all cases, premiums will go up each year because health care will only get more expensive.’ ‘ That’s a good reason to avoid policies that might pile on extra costs just because your biological clock is ticking.’ ‘ Since income often shrinks in the later retirement years, this is ‘need-to-know’ stuff, but the government apparently believes that insurers don’t have to tell you.’ ‘ Only five Plan F sellers disclosed their pricing methods: they all used community rating.’ Were the others mum because their methods are unfavorable to consumers?’ I would not buy a policy from a company that failed to reveal its pricing method. Still, I needed actual premiums so I called the Health Insurance Information Counseling and Assistance Program.’ ‘ HIICAPs, as they are called, can be found all over the country.’ The one for New York City was lodged at the city’s Department for the Aging.’ I wanted to know more about how premiums would be calculated in the future, but the counselor I talked to didn’t know much.’ When I asked what community rating was, she replied, ‘Every state has a different rating depending on where you live.” ‘ As for attained-age rating, ‘I don’t know what that is,’ she admitted.’ The department offered a booklet that listed prices for only eleven companies selling Plan F.’ ‘ There was no plan with a premium of $197 as the website suggested.’ ‘ ‘ I did learn that all Medigap plans sold in New York were community rated, a protection unavailable in most other states. As the booklet directed, I visited the website of the New York State Department of Insurance for more current information.’ Eleven sellers offered premiums ranging from $251 to $409.’ State Farm, one of the sellers that sent a marketing brochure, had the highest premium; United Healthcare, the other marketer contacting me, had the lowest.’ I ruled out State Farm; it was too expensive.’ The UnitedHealthcare/AARP policy seemed ideal.’ I still had questions so I called the company’s toll-free number seeking answers. Can I always buy a Medigap policy even if my health changes?’ ‘A qualified yes,’ said a customer service rep.’ If I am outside of my open enrollment period’the six months that begins in the month I turn 65 and enroll in Part B’ and outside the 63-day period for previous coverage, then there is a pre-existing condition waiting period, he explained.’ Does an insurer have the right to refuse me coverage if I get sick in the future?’ If I stay on my previous employer’s retiree plan and the employer drops the coverage as many have been doing, then I might need a Medigap plan someday.’ Yes they can refuse, he said, but not in New York.’ If I moved to another state, I could be out of luck. Having picked a Medigap policy, it was time to choose a prescription drug plan to go with it.’ Congress won’t let insurers sell drug coverage as a benefit included in a Medigap plan.’ Picking the right prescription plan adds a whole new layer of difficulty to an already-complicated task. I’ll tackle that challenge in next week’s post.
Video: Affordable Medigap Insurance– Finding the best Medigap plan to fit your budget
Insurance Commissioners Reject Calls To Limit Seniors’ Medigap Policies
Medigap policies are popular with seniors because Medicare does not cap out-of-pocket expenses. The policies are not cheap — the average premium nationwide was $178 a month in 2010 — but they protect subscribers from unexpected high medical bills, which is important to people on fixed incomes. The C and F Medigap plans cover nearly all of the out-of-pocket costs that beneficiaries would usually pay. Two thirds of people who buy Medigap plans have incomes below $40,000 a year — about the same income levels for all Medicare beneficiaries.
Medigap Plan F Discontinuance for 2014? « Insurance News from Crowe & Associates
Utilization for people with plan F has trended much higher than that of other supplements. If someone is paying for a plan that will cover all of their Medical expenses, they are probably going to be more inclined to go to the doctor or get a test than someone who has a cost share. Given that Medicare is primary when using a supplement, people with a plan F supplement are utilizing more than someone without a plan F supplement.
Medicare open enrollment: What’s the best Medigap policy?
The difficulty for consumers is that the nature of Medigap makes it a lot harder to shop for than Medicare Advantage. Here’s why. Medicare Advantage plans are regulated and overseen on a national level. Medicare routinely collects all kinds of information on them about customer satisfaction and quality of care. In addition, the premium of a specific Medicare Advantage plan is the same for each customer. As a result, it’s possible (as I explained yesterday) to go to Medicare.gov and compare Medicare Advantage plans in detail, including quality ratings and price. It’s also why we can publish rankings of Medicare Advantage HMOs and PPOs through our partnership with the National Committee on Quality Assurance.
Printable Grocery Coupons: A Brief Overview About Medigap Plans F Helping Cover Charges That Are Deductible For Every Person
To begin with allow us 1st see what does medigap means? Medigap ideas really are a sort of the reward insurance or in much better phrases an further insurance coverage which you generally obtain from a private organization that will be getting care of your health treatment fees that are seriously not coated by the original medicare. These usually do not care for the long term treatment options but only consists of a general types like an eye or eyesight check-up, nursing,dental care and few significantly more.The medigap plans are also referred to as the medicare health supplement plans.The medicare supplement plan B supplies the fundamental rewards which involves the hospitalization and also the healthcare expenses.So,the Medicare Supplement Plan F F essentially delivers comprehensive protection which include the excess healthcare costs.Acquiring into facts of what medicare supplement plan F covers let us commence with medicare advantages which once again includes hospitalisation,medical bills and blood. Then comes the 2nd part which it addresses and that is certainly specialised nursing,deduction with the expenses in hospitalisation,then comes the deduction of outpatient expenditures for hospitalisation and healthcare expenditures and also the most effective aspect concerning this plan is the fact that it addresses the abroad journey medical costs too. Isn’t that outstanding? From all of the medigap ideas the medicare supplement plan F will be the optimum as it has an alternative for high deduction.These higher deductible procedures have lower rates as compared but in situation an individual turns into ill or unwell you might end up spending higher out of your pockets.This strategy could wind up costing especially high annually. To avail any medigap plans positive aspects an individual will need to initial be enrolled in strategy A along with the strategy B.To know additional about these insurance coverage medical plans you can easily often consult a medicare insurance coverage supplier.You can readily discuss your requirements with them who are able to recommend you which strategy can get coupled with your every day delightful plus a wholesome life. Medigap plans or the plan deal with 18% medical beneficiaries.The medicare supplement plan F can be availed according to the place you stay.So its time for you personally all to obtain to perform.Discover out the personal agencies which offer the medigap plans and procedures . Talk to your medical insurance coverage supplier and avail one of the best program you could for your self and your members of the family.
1. There Are 10 Standard Medigap Policies
You only need one policy. Each policy builds on the previous one. Plan D includes all the coverage options offered by A, B, and C, plus additional options under Plan D. Plan E, provides everything Plan D does, plus additional coverage, and so on. It is illegal for an insurance company to sell you more than one plan.
Consumer reps: Medigap is not the bad guy
In the current draft of the NAIC cover letter, drafters state that, “We strongly disagree with the assertion that Medigap is the driver of unnecessary medical care by Medicare beneficiaries. Medigap insurance pays benefits only after Medicare has determined that the services are medically necessary and has paid benefits. Medigap cannot alter Medicare’s determination and the assertion that first-dollar coverage causes overuse of Medicare services fails to recognize that Medigap coverage is secondary and that only Medicare determines the necessity and appropriateness of medical care utilization and services.”
Attained Age vs. Issue Age vs. Community Rated Medigap Plans
2. Issue-Age: Medigap premiums are based on the age that you purchase the policy. For example, Mr. Jones buys a medigap plan F at age 65 for $148/month. At age 67 his monthly premium is still shceduled to be $148 as will it be for age 70 and so on. If Mr. Jones buys a medigap plan F at age 70 his price may be $160/month but not sheduled to change in price.
An Overview to Medigap Plans
People who are eligible for these Medigap programs ought to have been enrolled first in a Medicare program prior to their decision to go on with the supplementary packages. Generally, these must be citizens who are over the age of 65 or they have certain serious illnesses or permanent kidney failure, where age plays no actual role. The only requirement other than that is for people to have been living in the United States of America for at least some years before qualifying for such health insurance plans.