Medicare-Medigap Preparation Question

[Murph]

I'm going with either Aetna or Cigna Plan N in Ohio this July. For those of you with Plan N experience, how exactly does the whole process work once I have the coverage? Assume a scenario where I use a doctor or lab and I've exceeded the deductible amount on the first visit; I also assume that the doctor's office may request the $20 co-pay up front.

1. Do they bill Medicare directly for their 80%?
2. Do they bill the Medigap company directly for their share?
3. Do I pay them everything and then have to file claims with Medicare and/or the Medigap company?

4. (side question): Are the monthly premiums really billed separately by Medicare, the Medigap company, and Part D company? Seems like a lot of bother.

Thanks in advance!

 

[zl55lz]

I'm going with either Aetna or Cigna Plan N in Ohio this July. For those of you with Plan N experience, how exactly does the whole process work once I have the coverage? Assume a scenario where I use a doctor or lab and I've exceeded the deductible amount on the first visit; I also assume that the doctor's office may request the $20 co-pay up front.

1. Do they bill Medicare directly for their 80%?
2. Do they bill the Medigap company directly for their share?
3. Do I pay them everything and then have to file claims with Medicare and/or the Medigap company?

4. (side question): Are the monthly premiums really billed separately by Medicare, the Medigap company, and Part D company? Seems like a lot of bother.

Thanks in advance!

No experience with Plan N, but in general:

1. Yes
2. I believe it is sent directly to Medicare first, which then forwards to Medigap.
3. No, should not have to do so.
4. Yes

 

[teej1985]

Why did you choose Aetna or Cigna?

 

[Murph]

Why did you choose Aetna or Cigna?

Price, mainly.

 

[Texas Proud]

I have paid the $20 upfront before but also have had them bill me....

The interesting thing is sometimes when billed it is $18 somethinig... not $20..

Other questions have been answered...

 

[teej1985]

Price, mainly.

They are both as notorious as Mutual of Omaha for the close the book game...so it might not continue to be a good price in the long run.

 

[Murph]

So do you have any recommendations?

 

[Texas Proud]

Mine is UHC/AARP.... it was only a few dollars more and they do not close the books...

 

[teej1985]

So do you have any recommendations?

USAA, Statefarm, UHC/AARP...

 

[Dash man]

I have Plan N and never have been asked to pay the $20 up front. It can be slightly less, especially if seeing a CRNP or PA.
I recommend AARP/UHC. USAA is probably good too. I’ve no experience with State Farm.
Note that you can change your choice of plan or provider for the six month period beginning with your birth month.