Plan F, Plan G, or Plan N?

For those of us who already have a Medicare Supplement (otherwise known as a Medigap), you were shopping for coverage that would supplement your Medicare Part A&Part B medical coverage. There is tremendous confusion, as many people in the radio and TV media, medical staff, and even government staff, will call everything a Medicare Supplement. Even certain company retiree health plans will label themselves a Senior Supplement. Let’s be clear, a Medicare supplement is, and only is, a Federally-Standardized Medigap plan.

Let’s review the aspects of each of these plans, as not all Medigaps are the same. Therein lies the confusion. Certain insurance carriers that offer these plans will push one plan over another. So, this is a “Buyer Beware” moment in your life! With Medigap, remember that Medicare is your insurance company. The medical provider bill will go to Medicare first, where it will be processed, and Medicare will pay its portion of the bill. Medicare will then electronically send the balance of the bill to your Medigap plan carrier where they will pay the balance of the bill. “Or will they?”

Plan “F” is the top of the line and will cover the balance of your medical bills including the yearly Medicare Part A and B deductible. Currently, in 2018, the Medicare Part A deductible is $1340 per occurrence, and Part B is $183 annually.

Plan “G” is exactly like Plan “F” with the one exception where you pay the once-a-year $183 Medicare Part B deductible.

Many carriers are starting to push Plan “N”. This is where there is a big difference in coverage.With Plan “N”, not only do you pay the Medicare Part B deductible, you will also be responsible for all “Excess Fees”. This is when a Medical provider charges more than what Medicare allows. Here’s an easy example. Doctor charges $140.00 for a medical service. Medicare processes the medical claim and states that the medical service provider has a “Medicare assigned” charge of only $100. Medicare pays 80% of the $100, or $80. Your Plan “N” will only cover the difference in what Medicare says the bill is worth, so Plan “N” pays the $20 of the $100. Now there is still a balance of $40 that you will be responsible to pay. Plan “F” and “G” cover this excess charge for you. Another missing coverage issue with Plan “N” is that you will still be responsible for certain co-pays for medical services, whereas with Plan “F” and “G” those co-pays are paid for you.

Why are these facts important? For two reasons: First, each of these plans have various monthly premiums and differ greatly depending on which carrier you purchase your plan from. The premium variance can be over $100 difference per month, so it pays to shop. Second, you can switch your Medigap plan monthly anytime you wish. However, Medigap carriers require you to answer medical questions in order to qualify. If you have a “Chronic Condition” many will not accept you. So, you could be stuck!

As with all things, education is the key. Meet with an experienced Medicare Advisor to make your initial decision. For example, in Maricopa County, Arizona, there are as many as 61 carriers offering these various Medigap plans. Plans are titled Plan A through N. All have different and varying degrees of medical coverage.

It’s not a question of “Best”, but which one is most appropriate for you. Call us! We can help!