Medicare Choices

[REWahoo]

According to that https://www.bestmedicaresupplement.com/ website, Plan G provides no international medical coverage whereas Plan F does. I thought Plan G was simply Plan F with a small deductible, but apparently there are other potentially significant differences.

I think there is an error in whatever you saw there. I agree with your understanding of the two plans and every reliable source I've seen says the deductible is the only difference:

https://www.medicare.gov/supplement-other-insurance/compare-medigap/compare-medigap.html

 

[audreyh1]

I think there is an error in whatever you saw there. I agree with your understanding of the two plans and every reliable source I'v seen says the deductible is the only difference:

https://www.medicare.gov/supplement-other-insurance/compare-medigap/compare-medigap.html

Thanks, I was wondering if there was an error because that was news to me!

Makes me a bit nervous about the site then!

If you click on the “details” link of a plan G you get an explanation of the coverages and in the footnotes it says

Plans C, D, F, HDF, M & N cover foreign travel emergencies. There is a $250 deductible and then the Medicare supplement will pay 80% of the cost of the care. The emergency must be within the first 60 days of your stay outside the USA. Lifetime benefits are $50,000. Plans A, B, G & K do not cover foreign travel emergencies.

 

[MBSC]

According to that https://www.bestmedicaresupplement.com/ website, Plan G provides no international medical coverage whereas Plan F does. I thought Plan G was simply Plan F with a small deductible, but apparently there are other potentially significant differences.

Consider your source (a broker who receives higher commissions on higher priced plans).

"Medigap coverage outside the U.S.

If you have Medigap Plan C, D, E, F, G, H, I, J, M or N, your plan:

* Covers foreign travel emergency care if it begins during the first 60 days of your trip, and if Medicare doesn't otherwise cover the care.

* Pays 80% of the billed charges for certain medically necessary emergency care outside the U.S. after you meet a $250 deductible for the year.

Foreign travel emergency coverage with Medigap policies has a lifetime limit of $50,000."

Source: https://www.medicare.gov/supplement-other-insurance/medigap-and-travel/medigap-and-travel.html

 

[REWahoo]

Thanks, I was wondering if there was an error because that was news to me!

Makes me a bit nervous about the site then!

If you click on the “details” link of a plan G you get an explanation of the coverages and in the footnotes it says

I found this (apparently correct) chart on the site here: https://www.bestmedicaresupplement.com/benefit

 

[audreyh1]

Consider your source (a broker who receives higher commissions on higher priced plans).

"Medigap coverage outside the U.S.

If you have Medigap Plan C, D, E, F, G, H, I, J, M or N, your plan:

* Covers foreign travel emergency care if it begins during the first 60 days of your trip, and if Medicare doesn't otherwise cover the care.

* Pays 80% of the billed charges for certain medically necessary emergency care outside the U.S. after you meet a $250 deductible for the year.

Foreign travel emergency coverage with Medigap policies has a lifetime limit of $50,000."

Source: https://www.medicare.gov/supplement-other-insurance/medigap-and-travel/medigap-and-travel.html

Thanks agan for your clear information.

I edited my later post to quote the specific language and the only error seems to be G? Not sure what to think. I guess you have to be careful.

Lifetime limit of $50K? Not so high if you do a lot of international travel. I guess you have to supplement the supplemental insurance then!

 

[meierlde]

On the issue of future plan f I would be surprised if the run a different pool for f&g since for all practical purposes you can regard the deductible as something that will be paid, so you just add the deductible and overhead to G to get F. The various price differentials mean that essentially the insurance company must be assuming everyone pays the medicare deductible. It should be noted that eyeglass exams also do some tests that medicare pays for.

 

[audreyh1]

On the issue of future plan f I would be surprised if the run a different pool for f&g since for all practical purposes you can regard the deductible as something that will be paid, so you just add the deductible and overhead to G to get F. The various price differentials mean that essentially the insurance company must be assuming everyone pays the medicare deductible. It should be noted that eyeglass exams also do some tests that medicare pays for.

Yeah - I've wondered the same thing and wondered if G&F wouldn't be the same pool.

 

[REWahoo]

Yeah - I've wondered the same thing and wondered if G&F wouldn't be the same pool.

I don't think insurers can mix or combine risk pools - at least nothing I've seen regarding the closing of F to new applicants indicates this is an option. This is the typical information I keep seeing:

The existing Plan F policies will be a “closed risk pool” meaning no new members can participate. New members in good health are what help offset claims of those who are not in good health. No new members means increased premiums for the remaining members.

 

[Running_Man]

One thing that is a big favorable for Plan F & Plan G is they cover the 15% extra that insurers are allowed to charge over medicare rates that you would otherwise be responsible for, you will find doctors are more receptive and attentive when they know you can pay 15% more easily.

 

[REWahoo]

One thing that is a big favorable for Plan F & Plan G is they cover the 15% extra that insurers are allowed to charge over medicare rates that you would otherwise be responsible for, you will find doctors are more receptive and attentive when they know you can pay 15% more easily.

Doctors who do not agree to accept Medicare assignment may charge up to 15% in "excess charges" above what Medicare will pay and the insured is responsible for that amount. Plans F & G are the only two Medigap plans that pay for these Part B excess charges, and that is reflected in their higher premium costs.

So if your primary doctors don't accept Medicare assignment, F or G may be the way to go but I don't know that having F or G vs another plan will necessarily make your doctors more "receptive and attentive".

EDIT: A number of states (Connecticut, Massachusetts, Minnesota, New York, Ohio, Pennsylvania, Rhode Island, and Vermont) prohibit charging any more that the Medicare allowed amount. No need to pay for F or G in those states unless there are other provisions of those plans you want and are willing to pay higher premiums to obtain.

 

[MBSC]

One thing that is a big favorable for Plan F & Plan G is they cover the 15% extra that insurers are allowed to charge over medicare rates that you would otherwise be responsible for, you will find doctors are more receptive and attentive when they know you can pay 15% more easily.

A non-participating provider receives 9.25% more because their approved amount is set at 95% (0.95*1.15).

Medicare and the supplement send payment to the patient on non-assigned claims. But, the patient usually has to pay the non-participating provider in full up front. A participating provider is out 20% when the patient's check bounces. A non-participating provider is out 100%.

99% of physician claim volume is assigned.

In recent years, physicians nationwide have accepted assignment on nearly 99 percent of their claims.

When providers do not accept assignment, they can bill the patient for more than the Medicare approved amount and ask for full payment at the time they give the service. Medicare then pays the patient, not the provider.

Source (page 52): https://www.kdads.ks.gov/docs/defau...rmation-and-resources/2018-shick-handbook.pdf

While Plans F/G pay the Part B excess charge, Medicare does not 'crossover' non-assigned claims. This means Medicare does not forward the claim and MSN (EOB) to the Medigap. A few non-participating providers will submit the information to the Medigap but most leave it up to the patient.

 

[REWahoo]

In recent years, physicians nationwide have accepted assignment on nearly 99 percent of their claims.

This was the deciding factor in my decision to select Plan N rather than the more expensive Plan G. I can afford to self-insure for the 1% chance I'll have to pay out of pocket for the 15% above the Medicare approved rate a non-participating provider may charge.

 

[TrvlBug]

Thanks, I was wondering if there was an error because that was news to me!

Makes me a bit nervous about the site then!

If you click on the “details” link of a plan G you get an explanation of the coverages and in the footnotes it says

There is another error on the site. I plugged in my area code as I will be going on Medicare next year and it states that UHC/AARP does not offer G in my area. DH just signed up with them and they do offer G.

 

[REWahoo]

There is another error on the site.

It is obvious the site ( https://www.bestmedicaresupplement.com/benefit ) has some issues. I'd suggest it may be a good source to get an idea of the relative difference in prices insurers charge in your location but to look elsewhere for confirmation and more reliable details.

 

[TrvlBug]

It is obvious the site ( https://www.bestmedicaresupplement.com/benefit ) has some issues. I'd suggest it may be a good source to get an idea of the relative difference in prices insurers charge in your location but to look elsewhere for confirmation and more reliable details.

Definitely. I made the mistake last year of using another site where email and phone # were required. Stupidly, I input our real ones and was hounded for about 6 months.

 

[LARS]

Nothing to add to this thread other than I am not looking forward to wading through the Medicare selection process. Fourteen pages of comments pretty well says it all...

 

[REWahoo]

Fourteen pages of comments pretty well says it all...

Sadly, not yet...

 

[audreyh1]

There is another error on the site. I plugged in my area code as I will be going on Medicare next year and it states that UHC/AARP does not offer G in my area. DH just signed up with them and they do offer G.

Interesting, I noticed it listed no Plan G available from UHC in our area, so maybe that’s wrong too.

 

[meierlde]

I wish the sites that provide options would say what date their information is valid on. I find lots of sites that are getting long in the tooth with their information, i.e. several years old.


Further the sites may be most accurate in the fall.

 

[John Galt III]

I'm grateful for this thread and others like it. I've finally hammered the buzzwords and phrases into my mind and understand them somewhat. I'm leaning towards a plan F or G (not HD) supplement via AARP using UHC as insurer. Still wondering why people sign up for a Medicare Advantage plan. I know some of them and they say the supplement premiums are just too too high. One of these days I'll call SHIP (some organization that helps you with questions about Medicare) in my state. Already called then once just to make sure a human actually answered the phone. Someone did.

 

[REWahoo]

I'm leaning towards a plan F or G (not HD) supplement...

You may already be aware of this but at the moment the only HD supplement plan available is F-HD. I understand in 2020 when F and F-HD plans are no longer open to new applicants, an HD version of plan G will be introduced.

 

[Another Reader]

My inclination is to sign up for Plan F now. If, when F closes, the premiums skyrocket, I will use the California regulation that allows me to switch across or down in benefits to move to Plan G.

It looks like I will have to pay through the nose for Part B, however. Have to go to that seminar coming up to see how One Exchange/Via Benefits will handle our $270 non-taxable reimbursement. If they will just pay my Part B, that would be best, but I don't know if that's possible.

 

[REWahoo]

My inclination is to sign up for Plan F now. If, when F closes, the premiums skyrocket, I will use the California regulation that allows me to switch across or down in benefits to move to Plan G.

I read a Medicare strategy blog a while back where, even before the 2020 closure of F was passed, California Medigap purchasers without major health issues were encouraged to purchase plan F-HD initially, then switch to a non-HD plan in later years when they started using more medical services.

 

[audreyh1]

I read a Medicare strategy blog a while back where, even before the 2020 closure of F was passed, California Medigap purchasers without major health issues were encouraged to purchase plan F-HD initially, then switch to a non-HD plan in later years when they started using more medical services.

Wow - what an option!!

 

[REWahoo]

Wow - what an option!!

Actually that's what we are in the process of attempting to do - except we have to go through underwriting to make the switch. I've had F-HD since 2012 and DW since 2013 and neither of us has come anywhere close to meeting our ~$2k annual deductible. Unlike the CA strategy, we have to make the change prior to developing any health issues that would make underwriting a no go, so our potential savings by delaying changing plans are limited.