medigap comparison Archives

2018 Medigap Comparison

March 27, 2018 By Garrett Ball Leave a Comment

NOTE: This article contains outdated figures, as some of the Medicare premiums and benefits change each year. For updated information, please refer to other pages on our site like this: Medicare Part B – The Bottom Line | 65Medicare.org and our Medicare Blog.

Several factors should be considered when doing a Medigap comparison. One factor is whether you are in relatively good health or not. Do you have an extensive list of medications you are presently taking? How many times per year do you anticipate seeing a health care provider? Are your finances limited, or do you not have any restrictions on how much you pay for your monthly premium? Do you lead a healthy lifestyle, i.e. exercising and eating healthy? Or do you lead a sedentary life and/or are a smoker? These are some of the important questions that you should ask yourself, before making your final decision.

All Medigap plans are standardized. In other words, they must abide by federal and state rules and regulations governing those plans. This means that “like” plans provide the same coverage (one Plan G from Company X is the same as another Plan G from Company Y). That said, Massachusetts, Minnesota and Wisconsin have their own standardized plans. If you’re doing a Medigap comparison, an overview of the ten nationally-standardized Medigap plans is outlined below:

Plan F, Plan G and Plan N – A Medigap Comparison

Plan F:

Covers the Medicare Part A hospitalization deductible of $1,340 for each benefit period
Has a $0 copay/$0 deductible Medicare Part B
If you are in a “guaranteed issue” period (When is a Medigap Guaranteed Issue?), this plan is available without underwriting (i.e. no health questions required)

**This plan will be closed as of 2020 to new Medicare beneficiaries. As a result, it is probable that the rates of existing policyholders will be increased at a higher percentage than normal since the pool of subscribers will be smaller and older.

Plan G:

Covers the Medicare Part A hospitalization deductible of $1,340 for each benefit period
Covers skilled nursing facility care, blood, hospice care, and foreign travel
Has a $0 copay and a $183 Medicare Part B deductible
Application must go through medical underwriting unless you are enrolling during Medigap open enrollment (when you are first eligible for Medicare).

Plan N:

Covers the Medicare Part A hospitalization deductible of $1,340 for each benefit period (Find out about Part A coverage)
Covers skilled nursing facility care, blood, hospice care, and foreign travel
Does not cover the $183 Medicare Part B deductible
Does not cover the full Part B coinsurance – you are responsible for $20 doctor’s office co-pay
Emergency room copay of up to $50, if not admitted to the hospital (otherwise it is waived)
You may have to pay Part B excess charges of 15% (the difference in cost between the Medicare-approved payment amount for services and the amount your health care provider charges). Many providers accept the payment schedule, but if they do not, they may charge these Part B Excess charges.
Application must go through medical underwriting unless you are enrolling during open enrollment (when you are first eligible for Medicare).

Plan F, Plan G and Plan N List, by email, for your zip code

Plan F, G and N Rates for your Zip Code

We will send, via email, the list of the rates and company ratings for Plan F, G and N for your zip code.

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Other Plans to Consider for a Medigap Comparison

Although Plans F, G and N make up about 75% of the market share of Medigap plans, there are some other options that you can consider if you are doing a Medigap comparison.

Plan A:

Covers 100% of:

Medicare Part A coinsurance and hospital costs (up to an additional 365 days after Medicare Benefits are used up.
Medicare Part A hospice care
Medicare Part B coinsurance or copayment
First 3 pints of blood

Plan B:

Covers 100% of:

Medicare Part A coinsurance and hospital costs (up to an additional 365 days after Medicare Benefits are used up.
Medicare Part A hospice care
Medicare Part B coinsurance or copayment
First 3 pints of blood
Medicare Part A deductible ($1,340 for each benefit period)

Plan C:

Covers 100% of:

Medicare Part A coinsurance and hospital costs (up to an additional 365 days after Medicare Benefits are used up.
Medicare Part A hospice care
Medicare Part B coinsurance or copayment
First 3 pints of blood
Skilled nursing facility care coinsurance
Medicare Part A deductible ($1,340 for each benefit period)
Medicare Part B deductible ($183 per year)
Covers 80% of foreign travel emergency (up to plan limits)

**This plan will be closed to new subscribers as of 2020.

Plan D:

Covers 100% of

Medicare Part A coinsurance and hospital costs (up to an additional 365 days after Medicare Benefits are used up.
Medicare Part A hospice care
Medicare Part B coinsurance or copayment
First 3 pints of blood
Skilled nursing facility care coinsurance
Medicare Part A deductible ($1,340 for each benefit period)
Covers 80% of foreign travel emergency (up to plan limits)

Plan F – High Deductible:

There is a $2,240 deductible per year. Once this deductible is met, plan pays the same as Plan F.

Plan K:

Covers 100% of Medicare Part A coinsurance and hospital costs (up to an additional 365 days after Medicare Benefits are used up.

Covers 50% of:

Medicare Part A hospice care
Medicare Part B coinsurance or copayment
First 3 pints of blood
Skilled nursing facility care coinsurance
Medicare Part A deductible ($1,340 for each benefit period)

Plan L:

Covers 100% of Medicare Part A coinsurance and hospital costs (up to an additional 365 days after Medicare Benefits are used up.

Covers 75% of:

Medicare Part A hospice care
Medicare Part B coinsurance or copayment
First 3 pints of blood
Skilled nursing facility care coinsurance
Medicare Part A deductible ($1,340 for each benefit period)

Plan M:

Covers 100% of: medigap comparison

Medicare Part A coinsurance and hospital costs (up to an additional 365 days after Medicare Benefits are used up.
Medicare Part A hospice care
Medicare Part B coinsurance or copayment
First 3 pints of blood
Skilled nursing facility care coinsurance
Covers 50% of Medicare Part A deductible ($1,340 for each benefit period)
Covers 80% of foreign travel emergency (up to plan limits)

Plan F, Plan G and Plan N List, by email, for your zip code

Plan F, G and N Rates for your Zip Code

We will send, via email, the list of the rates and company ratings for Plan F, G and N for your zip code.

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No, thanks

Under certain circumstances, if you have a guaranteed issue right, you may be able to buy a policy for Plans A, B, C, F, K and L, without having to answer any medical questions (medical underwriting is avoided). Examples of guaranteed issue rights include: losing group coverage, moving out of your plan’s service area, or wanting to disenroll from an Advantage plan after being in the plan less than a year after turning 65. In those cases, a Medigap comparison can help you determine which plans works best for you.

All plans are available without underwriting/health questions if you are turning 65 and in open enrollment. If you have additional questions about what the plans cover, which plan is right for you, or want the rates for certain plans, you can contact us online or call us at 877.506.3378.

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Comparison of Medicare Supplement Plans

April 20, 2017 By Garrett Ball Leave a Comment

Doing a comparison of Medicare Supplement plans is crucial to making a financially prudent choice when you are turning 65 or simply comparing Medicare Supplement plans.

Sure, you can simply pick the first company you receive a solicitation from or the company that your friend/family member says to pick. But that’s not usually the best strategy, as everyone has different needs and the rates vary considerably by age and zip code.

There are three primary categories to look at when you are comparing these plans – coverage, premiums, and customer service – so we are going to look at each of them separately.

Coverage Differences: A Comparison of Medicare Supplement Plans

The paramount thing to understand when you comparing Medicare Supplement plans is the standardization of plans. The Federal government has mandated that each company that offers Medicare Supplements do so in accordance with the standardized Medigap coverage chart. In other words, you can compare a Plan F, for example, with one company to a Plan F with a different company with the assurance that the benefits will be identical. This obviously greatly simplifies the comparison process.

However, there are 10 different plans, so comparing those different coverage levels is something that is important to do. The aforementioned Plan F is the most common and comprehensive plan – it fills in all the “gaps” in Medicare and pays whatever Medicare itself does not cover. Although it’s the most common plan, it is not always the best “deal”.

Plan G is the next step down from Plan F. Plan G is also a very comprehensive plan – it fill in all the “gaps” in Medicare with the exception of the Medicare Part B deductible. Currently, that deductible is $183/year. So under a Plan G, that would be your only out-of-pocket cost. Typically, the premium for Plan G (in most locations) is $20+/month lower than the Plan F premium – so obviously, in that case, Plan G makes the most sense mathematically.

Another commonly offered plan is Plan N. Plan N is a lower-coverage, lower-premium alternative. It does have some cost-sharing in the form of the same Part B deductible and co-pays for doctor visits and emergency room visits. Additionally, Plan N does not cover the Part B Excess charges (What are Part B Excess charges?).

Obviously, that is only three of the 10 plans, but those three are the ones that are most commonly offered by insurance companies in most locations and the represent a top, middle and lower coverage option. You can read more about the other 7 Medigap plans here.

Premium Differences: A Comparison of Medicare Supplement Plans

So, once you understand the plan standardization and what each plan covers, you can look more specifically at the actual premiums charged by the insurance companies in your area.

It’s easy to think that, because the coverage is standardized, the premiums will be very close or identical as well. However, in reality, that is not the case. On the contrary, a premium comparison of Medicare Supplement plans reveals that there is a wide disparity in what companies charge for the exact same set of benefits.

While everyone is seeking the “best Medigap rate”, the answer to that is not found with one specific company or plan. In fact, it is very dependent on where you live, your age, what plan you want, etc. Many insurance companies no longer publish their rates online, so the easiest way to compare the plans is by getting a list of Medigap plans from an independent broker.

From that information, you can narrow down your choices to which plan you want and which companies offer competitive rates for that specific plan.

Customer Service Differences: A Comparison of Medicare Supplement Plans

This is one of the common questions regarding Medicare Supplement plans – “since coverage is the same but rates are different, it must be because some companies are better at customer service?”. Actually, that’s not the case.

Customer service on Medicare Supplement plans is virtually negligible as well. Medicare Supplement claims are all processed through the Medicare “crossover” system, meaning that they are paid on the same time schedule and in the same amount, regardless of which Medigap provider you have. Recent studies have shown that over 94% of people rate their Medicare Supplement provider very favorably.

Some companies may offer some value-added incentives, such as an easy-to-use policyholder website to track claims payments, but overall, the actual processing and payment of claims is identical from company to company. That said, it is prudent to be with a company that is well-regarded and highly-rated if everything else is equal.

If you have other questions about how to do a comparison of Medicare Supplement plans, contact us here. Or, if you want to get a list of plans in your area by email, you can contact us here.

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65Medicare.org is a leading, independent Medicare insurance agency for people turning 65 and going on Medicare. If you have any questions about this information, you can contact us online or call us at 877.506.3378.

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Compare Medigap Plans – When, Why, and How To Do It

April 5, 2017 By Garrett Ball Leave a Comment

It is financially wise to compare Medigap plans. Whether you are just turning 65 or are already on Medicare, comparing Medigap plans can potentially save you hundreds of dollars a year and thousands of dollars over your lifetime.

First and foremost, it’s important to understand that Medigap plans are Federally-standardized. All plans must go by Medicare’s Medigap coverage chart (see chart here). According to Medicare itself, “the cost of Medigap policies can vary widely. There can be big differences in the premiums that different insurance companies charge for exactly the same coverage” (taken from Medicare’s “Choosing a Medigap Policy” booklet).

So, understanding that crucial fact, let’s look at when you should compare Medigap plans, why you should and how exactly to go about doing it.

When Should You Compare Medigap Plans?

If you are turning 65 or going on Medicare for the first time, you get a 6-month open enrollment period during which you can choose any Medigap plan from any company that offers them in your state without any restriction or pre-existing conditions limitations/exclusions. It is vital to compare Medigap plans during this time period because, after this initial 6-month window, you typically will have to “qualify medically” to obtain a plan or switch plans (Medigap plans are not subject to the ACA pre-existing conditions limitations).

Another situation in which it is prudent to compare Medigap plans would be if/when your rate goes up on your current Medigap plan. Just like any other type of insurance, Medigap rates go up over time. If you are already on a Medigap policy and the rate does go up, it is wise to “shop” to see if another company offers the exact same benefits for a lower premium. In most cases, you will find that, if you’ve had your plan for several years, there are other options that are lower-priced/equal coverage.

A last situation that would/should prompt a comparison of Medigap plans would be if you are losing some other type of coverage (i.e. group/employer coverage, Medicare Advantage coverage). In these situations, even if you are already have Medicare Parts A & B, you are “guaranteed issue” into certain Medigap plans. This just means that you cannot be turned down based on your health or any pre-existing conditions that you have.

Why Should You Compare Medigap Plans?

Comparing Medigap plans is a crucial part of a sound financial plan for retirement. The number show that average healthcare expenditures in retirement, which have been increasing each year, are now at approximately $260,000 for a couple (from Fidelity study, 2016). This does not even take into account long-term care insurance or long-term care costs.

Because of the rapidly increasing costs of health care in retirement, having a Medigap plan and managing the cost of that plan is vital to financial well-being.

Comparing the costs of the Medigap plans is important because of the plan standardization referenced earlier. You are going to get the same coverage regardless of which company you choose – also, claims are all paid through the Medicare “crossover” system so there is no customer service/claims payments variation from company to company. However, rates can vary widely, with differences of as much as $100+/month in premium costs between companies for the exact same coverage. Choosing a plan without “shopping”, because the company has a “big name” or because your friend or family member says it is “best” is not always a wise idea.

The bottom line is that it is a good idea to keep more of your money and give less to insurance companies when that is an option. To do that, you must compare Medigap plans. So, how do you do it?

How Do You Compare Medigap Plans?

Comparing Medigap plans is much easier than most people realize. Whereas individual under-65 health insurance varies greatly in premiums, deductibles, networks, copay amounts, etc., Medigap plans only have one differentiating variable – price. Comparing them is easy to do and there are two options for doing so.

Option 1 is to obtain a list of the companies that offer Medigap in your state from your state’s department of insurance (the list on Medicare.gov has not proven to be accurate or updated regularly). Once you have that list, you can contact each company to obtain their premium information and any other information you wish to obtain to assist in your decision-making. Most states have 25-50 companies that offer Medigap, so this is certainly doable but is a daunting and time-consuming task.

The other option, option 2, is to use a trustworthy independent broker to compare Medigap plans. An independent broker works with all the insurance companies that do business in your state so that you can compare plans/rates in a centralized place. He or she is paid directly by the insurance companies, so it does not cost you anything. In reality, their commissions are built into the premiums you pay regardless of how you sign up for a plan, so you are paying for them whether you use them or not. The advantage to you is that you can compare rates, as well as get their expertise on experiences of other consumers and rate increase history/stability.

Overall, once you understand plan standardization and the reasons behind comparing plans, the process of comparing Medigap plans is quite simple and straight-forward.

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