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Medicare is usually a brand new world after decades of private health
insurance.
New terms. News names. A whole new language (Part A, Part B, etc).
You can run your quote anywhere and needless to say, you're getting so much mail on it that a few trees have suffered as a result.
SO...let's boil down the key points to understand so you can make an
informed decision.
Here are they points we'll cover and feel free to reach out with any questions at 800-320-6269 or at help@calhealth.net
Let's get started. This is meant to be a quick
summary...definitely contact us with a personalized walk through the options
above.
We covered the How and When to enroll questions here.
Medicare basically works like an 80/20 plan with deductibles.
They're paying 80% of the allowed charges and you're picking
up 20% after two different deductibles are met.
That's the nuts and bolts of it!
Not so bad, right?
The Medicare supplement plans fill in these big holes (plus some smaller ones) with different benefits.
There's a range of plans from A to N with different levels for the deductibles and coinsurance above.
The least expensive plan on the market is the A plan and the
richest plan is the G plan.
There may be high deductible versions of the G plan which are even
cheaper.
We'll touch on Excess below since it's a very important consideration
among the plans.
Let's first dive into the big decision before looking at the plans.
We have a whole section on Medicare supplements versus Advantage plans.
Advantage plans are essentially HMO style plans designed to wrap around Medicare.
You'll get lots of mailers for these plans!
Nothing's free so what gives?
First, they are HMO in design so you're limited to the doctors/hospitals you can use (smaller networks) and the carrier has more control over medical decisions.
That's just how HMO models work to squeeze costs.
The bigger issue that never seems to be in those mailers is the backend.
With medicare supplements..especially the G plan, you can expect very little out of pocket when you're sick or hurt.
With Advantage plans, there's generally a large out of pocket maximum.
This is an amount you have to pay before the plan goes 100% in a given calendar year.
It's usually a few thousand dollars.
Here's why the carriers love Advantage plans…
At age 65, it's not exactly the best
age to take that gamble!
The carrier is more than happy to offer you a plan with shared
backend in the thousands during a time you're more and more likely to have
such events.
Let's say a G plan is $130/month at age 65. An
Advantage plan is zero dollars monthly with copays and $3K max.
If you have bigger bills and hit the $3K, that's the equivalent of
$250/month premium!
Double what the G plan is. See
why carriers love it?
The issue is that once you get past the open enrollment period, you
may not be able to change from the Advantage plan to a supplement.
You're now making this same tradeoff at age 70? 75?
See why they love it?
Again, check out our big review of Supplements versus Advantage
plans.
So...what is the most popular supplement plan...by far.
The G plan is the most popular supplement on the market.
It replaced the old F plan, which used to be the most popular option.
This means you'll pay the doctor visits for the first few hundred
(goes up a bit each year).
Otherwise, the G plan is the richest option on the market and since
we're age 65 and up, that's the right bet as healthcare costs go up
accordingly.
Let's turn to one important piece that really makes the G plan pop.
There's a term that you may not recognize if you're new to Medicare.
Excess.
This is becoming more common as Medicare is forced to squeeze costs
with budgetary issues.
The problem is that the 15% is not
capped.
We definitely want excess addressed and only the G plan covers it.
Most people (and sales literature) total skip over this because they
don't understand the ramifications.
Medicare is projected to be insolvent by 2025. They will make
changes and you can expect further tightening of reimbursement to providers.
More doctors will take the 15% which is
already the trend.
Let's say you have a surgeon that charges excess and his/her charge $10K.
You're on the hook for $1500!
Again, there's no cap or limit to this 15% charge so we want it addressed.
That basically makes the G or G high deductible mandatory.
What about medications?
There's one more key piece...RX!
A whole separate plan addresses prescriptions (outpatient like what
you at a pharmacy) and it's called Part D.
This is a plan purchased through a carrier and we can run the quote
for you.
We just need:
The online quoting tool will automatically calculate your best value
based on current medications.
We're happy to run this quote for you alongside your Medicare
supplement option.
A full review of Part D is
here.
Let's finally talk about pricing.
This is actually very frustrating to us. People are already
confused (hopefully less now!) in dealing with the newness of Medicare.
What you're basically shopping then is pricing, pricing stability
going forward, and ease of use.
Most of the carriers are pretty easy to work with since
they're all tied in with Medicare.
It really comes down to pricing!
Here's the rub...some of the carriers will offer discounts up front for
new enrolled (new Part B's...usually turning 65 or leaving employer health
plans).
When you run a quote, you're just seeing this one carrier that's 20% cheaper not realizing that you'll more than pay for it over the life of the policy.
Very similar to the Advantage versus Supplement trick above.
In terms of pricing and stability, Anthem Blue Cross and Blue
Shield of California have been dominant for some time.
They may have small discounts for first year but their longterm
trajectory is lower than other carriers.
Remember...it's not the first year that
matters with Medicare since you'll have the coverage for years!
That being said, they're usually cheapest as well which makes sense since
they have the longest track record in the supplement market.
You can run your quote above to see how it stacks out for you.
Of course, there's no cost for our assistance and we're happy to help with any questions!
800-320-6269 or help@calhealth.net
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