Medicare: Plan N now suggested ipo popular Plans F and G

[omni550]

The annual Medicare Supplemental Plan renewal period is coming up.

Chris Westfall of www.SeniorSavingsNetwork.org now suggests consideration of Plan N for Supplemental coverage due to predicted lower premiums (up to 30% less) going forward than the currently-popular Plans F and G.

As of Jan. 1, 2020 a new law (MACRA) will be going into effect which will make Plan G guaranteed issue and thus drive up annual Plan G premiums much like Plan F has had (which has been guaranteed coverage for a while).

Details explained in his video: https://plannmedicare.org/

omni

 

[REWahoo]

Boomer Benefits made us aware of this potential issue when we were looking at our Medicare supplement plans last year.
This was one of the reasons DW and I decided to switch from Plan F-HD to Plan N at that time.

 

[omni550]

Boomer Benefits made us aware of this potential issue when we were looking at our Medicare supplement plans last year.
This was one of the reasons DW and I decided to switch from Plan F-HD to Plan N at that time.

Good to know. Did your premiums for N come in at significantly less than F-HD?

omni

 

[REWahoo]

Good to know. Did your premiums for N come in at significantly less than F-HD?

omni

No, they are more.

That's because F-HD is a high deductible plan requiring you pay the first $2,240 (2018 amt, increases each year) before it starts paying. That compares to the Plan N requirement to pay the (2018) Part B deductible of $183.

Switching to N increased each of our annual premiums by $220 compared to what we paid for F-HD. We felt that was a bargain since our deductible is now $2,000 less. Our use of medical services is steadily increasing as we age, so the benefit of low premiums and high deductible no longer makes financial sense.

 

[anethum]

I am very dubious about this guy in the video ranting about "guarantee issue" and its possible effects on future rates for Plan G. I think he's mainly trying to scare people into change plans. Guarantee issue comes into play when someone is losing their insurance (e.g. retiree insurance going away; insurer leaving market). I would think that's a small number of folks compared to the number turning 65 each year. Furthermore, why are these folks who are losing their insurance necessarily more expensive to insure?

Plan N typically results in a co-pay for each doctor's visit, usually $20. "Excess charges" are not covered (i.e. additional charges from doctors who don't accept Medicare Assignment) by Plan N, but are covered by Plans F & G. I handle my mom's bills, and 2 years ago she had an expensive "excess charge" bill from an orthopedic surgeon. She didn't owe a penny thanks to her insurance.

In my case, Plan N is $26/month cheaper than my Plan G. I'm happy to stick with my Plan G.

 

[REWahoo]

Good point that Plan N doesn't cover excess charges (not an issue in the 7 states who prohibit it).

Prior to moving to Plan N I did some research on the risk I would be taking on by not having excess charge coverage. Here is what I learned and why I don't consider that lack of coverage to be worth the added premium cost of G or F.

1. 96% of doctors accept medicare assignment.

2. The 4% who don't accept assignment are limited by law to charging no more than what works out mathematically to be an additional 9.5% of the Medicare allowable amount.

3. Most who don't accept assignment will agree to take the Medicare amount once they learn your insurance will not pay the additional charge.

That said, I can understand why some folks want the security of F or G.

 

[MBSC]

The annual Medicare Supplemental Plan renewal period is coming up.

There is no annual renewal period for supplements at the federal level. The federally mandated annual enrollment periods apply to Parts C (Medicare Advantage) and D (drug plans).

 

[ncbill]

I'd pick Plan N only for those states that prohibit excess charges.

Here I'd pick Plan G, because the premium savings from picking Plan N aren't enough to risk the excess charges.

 

[REWahoo]

I am very dubious about this guy in the video ranting about "guarantee issue" and its possible effects on future rates for Plan G. I think he's mainly trying to scare people into change plans.

Could be, but I think if that was the case he would have a much better argument regarding potential higher future rate increases for those currently with Plan F. Since Plan F will get no new (younger, healthier) plan members starting next year, the existing pool is sure to be more costly to insure as the members age, likely resulting in larger rate increases over time.

If I currently had Plan F I would be checking to see if I could pass underwriting to change to a Plan G (or N ) while I was still healthy enough to do so.

 

[steelyman]

I continue to be confused by the terms used these summaries, in particular “Part C” and “Plan C”.

My understanding (I’m no expert so take this with a grain of salt) is that “Part C” is Medicare Advantage while “Plan C” is a supplement (Medigap). The video references “Plan C” at about 7:13.

It’s relevant to me because, although I’m not yet Medicare-eligible, the retiree benefit from my former employer is an Advantage plan so I’m very interested in following changes that may affect coverage.

 

[Another Reader]

I went to a Via Benefits seminar before I signed up for the supplement just to see what they were pushing. The speaker seemed to understand Medicare well, so I asked him about the potential increase in premiums for Plan F once it was closed to new enrollment. His response was that other Medicare plans had closed to new enrollment in the past and did not experience large increases in premiums.

I don't recall the letter names of the closed plans, but would like to know what happened with these plans and if their premium increases are indicative of what will happen with Plan F. Maybe MBSC can weigh in here...

 

[anethum]

Could be, but I think if that was the case he would have a much better argument regarding potential higher future rate increases for those currently with Plan F. Since Plan F will get no new (younger, healthier) plan members starting next year, the existing pool is sure to be more costly to insure as the members age, likely resulting in larger rate increases over time.

That issue with Plan F has been known for a while. It's part of the reason why I decided to select Plan G when I became Medicare eligible this year. It has been discussed at length on this forum. The fact that the Plan F annual premium difference vs. Plan G in my area was well above the small annual deductible not covered by Plan G made it a no-brainer for me. Strangely, the video guy doesn't really talk about it specifically. Rather, he obsesses about "guarantee issue" without making a very good case that it should have a major effect on future rates. He seems intent on trying to get people to move to Plan N (and preferably by contacting his firm).

Most who don't accept assignment will agree to take the Medicare amount once they learn your insurance will not pay the additional charge.

I'm curious if you have any evidence to back that statement up? Relying on the kindness of strangers doesn't give me a warm & fuzzy feeling when it comes to medical bills.

I agree with ncbill. For a modestly higher premium in Plan G, I like the secure knowledge that I'm covered for excess charges. The co-pay avoidance is also nice to have.

Last year, my Bronze ACA plan had a $6,550 annual deductible with a monthly premium for a 64 year old nearly $1,400. So far, I'm loving Medicare!

 

[REWahoo]

I'm curious if you have any evidence to back that statement up? Relying on the kindness of strangers doesn't give me a warm & fuzzy feeling when it comes to medical bills.

No evidence other than while doing my research on Plan N I saw a number of references to the waiver of excess charges when the supplement doesn't pay. Might be urban legend, might not be.

EDIT: Here is one of those references I saw that makes mention of waiving excess charges at 3:45. Note that the video also explains how the 15% additional that can be billed as an excess charge actually works out to be 9.25%, not the 9.5% I mentioned earlier:

Since asking in advance if a doctor/service provider accepts medicare assignment is something we always do, I don't plan on being hit with any Part B excess charges. This should help me avoid "relying on the kindness of strangers" to help pay my medical bills - other than those who are generous enough to donate to my Go Fund Me account.

Could we get hit with excess charges? Sure, but I believe the risk is very small, plus we do have the resources to pay if we had to do so. If we did not, I would almost certainly go with Plan F or G.

Last year, my Bronze ACA plan had a $6,550 annual deductible with a monthly premium for a 64 year old nearly $1,400. So far, I'm loving Medicare!

+1

Like you, we had some serious deductibles and ugly premiums before turning 65. This is my 7th and DW's 5th year on Medicare and we are happy customers!

 

[MichaelB]

I continue to be confused by the terms used these summaries, in particular “Part C” and “Plan C”.

My understanding (I’m no expert so take this with a grain of salt) is that “Part C” is Medicare Advantage while “Plan C” is a supplement (Medigap). The video references “Plan C” at about 7:13.

It’s relevant to me because, although I’m not yet Medicare-eligible, the retiree benefit from my former employer is an Advantage plan so I’m very interested in following changes that may affect coverage.

Your understanding is correct. Medicare Part C is Medicare Advantage. Medicare Plan C should be termed Medicare Supplemental Plan C or MediGap Plan C. The video reference is Medicare Supplemental / MediGap Plan C.

 

[steelyman]

Your understanding is correct. Medicare Part C is Medicare Advantage. Medicare Plan C should be termed Medicare Supplemental Plan C or MediGap Plan C. The video reference is Medicare Supplemental / MediGap Plan C.

Thanks for clarifying. One thing these (very informative) threads on Medicare and related issues - really, health insurance in general - make clear is the importance of trying to stay informed and up-to-date on what seems to be a constantly shifting playing field.

 

[omni550]

There is no annual renewal period for supplements at the federal level. The federally mandated annual enrollment periods apply to Parts C (Medicare Advantage) and D (drug plans).

Agree.

At the same time, I revisit my Supplemental and Drug (Part D) plans annually (in the 4th quarter) to decide whether to stay with current providers or to switch for the coming year, based on premiums.

omni

 

[CardsFan]

Agree.

At the same time, I revisit my Supplemental and Drug (Part D) plans annually (in the 4th quarter) to decide whether to stay with current providers or to switch for the coming year, based on premiums.

omni

And some states, mine included, have an anniversary policy, at which time I can change providers (within the same class) with no underwriting. So we can "always" pick the lowest cost provider in that plan (I think).

FWIW, we intend to use Plan G. Megacorp will pay $100/month (each) if we go through Via. So, we will pay less than $100 each per month.

Looking forward to it. DW starts in 6 months, and the me 6 months later.

 

[gayl]

Does anyone have a quick sheet on what the letters mean? I know A=hospital, B=doctor, C= HMO, D= drugs but now it's all the way up to N? [emoji15]

 

[omni550]

Does anyone have a quick sheet on what the letters mean? I know A=hospital, B=doctor, C= HMO, D= drugs but now it's all the way up to N? [emoji15]

The ones you reference^ are PARTS (A, B, C, and D).
BTW, Part C is called Medicare Advantage, and Advantage plans work like a PPO or HMO.

PLANS A thru N (minus a few letters) are Supplemental insurance plans that can be purchased to cover the 20% (aka Medigap) that Original Medicare (Parts A & B) doesn't cover.
(Currently Plans F and G are the most popular.)

From https://www.medicare-savings.org/info/medicare-supplement

omni

 

[steelyman]

The ones you reference^ are PARTS (A, B, C, and D).

PLANS A thru N (minus a few letters ) are Supplemental insurance plans that can be purchased to cover the 20% that Medicare doesn't cover. Currently Plans F and G are the most popular.

From https://www.medicare-savings.org/info/medicare-supplement

omni

I’d have liked to have that succinct list a while ago and only add that the Supplement plans are also referred to as “Medigap” (as in the table).

Sooooo confusing...

 

[REWahoo]

Does anyone have a quick sheet on what the letters mean? I know A=hospital, B=doctor, C= HMO, D= drugs but now it's all the way up to N? [emoji15]

You are confusing Medicare Parts (as you described) with Medicare Plans (supplemental insurance/Medigap).

This might help:

There are four main “parts” of Medicare insurance: Part A, Part B, Part C, and Part D. Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) together make up Original Medicare. Medicare Part C, also known as Medicare Advantage, and Medicare Part D (prescription drug coverage) programs that let you get Medicare plans through private insurance companies that contract with Medicare. There is also Medicare Supplement insurance (also called Medigap), which is sold by private companies.

The various Medigap "plans" are shown here: https://www.medicare.gov/supplements-other-insurance/how-to-compare-medigap-policies The current Medigap plans are A, B, C, D, F, G, K, L, M, & N. Each has different coverages, deductibles, etc.

 

[kaneohe]

No, they are more.

....................................................................

Switching to N increased each of our annual premiums by $220 compared to what we paid for F-HD. We felt that was a bargain since our deductible is now $2,000 less. Our use of medical services is steadily increasing as we age, so the benefit of low premiums and high deductible no longer makes financial sense.

What was price difference between N & G..........and the likely amount of copays for N?

 

[REWahoo]

What was price difference between N & G..........and the likely amount of copays for N?

G was ~$25/mo higher than N, so $600/yr more for DW and I. Note that this will vary based on your location, choice of insurers, etc.

Copays are a max of $20 for office visits, $50 for emergency room visits (waived if you are admitted).

DW and I changed to N a little over a year ago and have since had office visits with five separate doctors. Not sure why but only one of those docs charged the $20 copay. I suspect that may change if Plan N becomes more popular.

 

[CRLLS]

I have not seen a similar prognostication for what will happen to F-HD premiums. Anyone seen any? I know that the age group will grow older. However since F-HD in my state is age related premiums, I would guess that having no young blood in the system will not have any affect. (?) Maybe I'm ignoring the inevitable. So far F-HD has been a good choice for us including one shoulder surgery.

edit: I really don't understand why F-HD will be closed to new applicants. It has a much higher deductible (almost 10x) than Plan G, which is continuing. Especially if Plan G is changing to guaranteed issue.

 

[John Galt III]

I'd pick Plan N only for those states that prohibit excess charges.

Here I'd pick Plan G, because the premium savings from picking Plan N aren't enough to risk the excess charges.

I was thinking of going with Plan N since I am in a no-excess-charges-allowed state. But.... since I don't want to pay the $120 per month for it I went with a Medicare Advantage plan with CapBlueCross (which is zero dollars per month premium and large copays for some things). I am testing out the MA plan now. Used it for a dental cleaning and xrays, and also for a blood test. No completed claims to look at yet, still waiting. The grapevine says that the supplements are hassle-free and there is no need for calling up the insurance company for everything, to look for all the gotchas. So, I'm still looking for all the gotchas, but I guess the $120 savings per month makes it worth it.