So, this is Medigap. Which, again, is often called a "Medicare Supplement" by our industry.
We like calling it Medigap so that it’s clearly distinguishable from Medicare Advantage plans.
Medigap is an insurance contract that is paired with Original Medicare’s Parts A and B. There are various “letter names” to these contracts. Conceptually, understand that these insurance contracts will provide coverage AFTER Medicare pays its portion. Simply, Medicare will pay your medically necessary charges at their 80% obligation and your Medigap policy will pay the balance according to its own contractual obligations. (obligations differ by contract letter)
Information in this section will drill down into the details.
Medigap Open Enrollment
This is extremely important to understand. When you are NEW to Medicare’s Part B (regardless of your age), you are able to purchase a Medigap contract from any carrier that you choose regardless of your health. You will not need to answer any medical questions and carriers cannot deny you coverage .
This enrollment opportunity will happen one time – when you are new to Part B and it will expire in six months.
This is NOT anything tied to the Annual Election Period (in the Fall). You do not have a yearly opportunity to change to Medigap necessarily. Remember, after six months, you may only purchase Medigap coverage based an approval with health underwriting.
** If you started your part B BEFORE age 65 due to Social Security disability, you will get a NEW Medigap open enrollment period that occurs 6 months before and after your 65th birthday.**
List of Medigap Plans
Currently, there are 10 different Medigap plans available for purchase. These plans are identified by the letters A-N (for example, Plan G).
The button below, shows the chart from the Medicare & You 2019 handbook which highlights the benefits of the different Medigap plans. We will also breakdown the options in the video to the left.
Medigap Plan Benefits ARE Standardized
So, we just covered that all of the different Medigap plans are identified by a different letter designation.
Although this may seem overwhelming, we will now discuss how helpful this actually is! Each Medigap plan with the same letter designation has exactly the same benefits.
This is exactly why you will often hear us saying "a G is a G is a G". Simply speaking, this means that a plan G with company X has the EXACT same benefits as a plan G with company Y.
Now, this doesn't mean that finding a plan is as simple as picking the cheapest plan, and we will cover that in more detail later.
Plan F vs Plan G
Plan F vs Plan G... this is seemingly the endless debate in the Medicare community.
Surprisingly, the choice between these two plans may be easier than it initially seems. These documents will show the differences between Plan G and Plan F...
You'll notice the ONLY difference is the part B deductible of $185/year.
It is no secret that we recommend the Plan G vs. the Plan F but click on the article button below to see a summary of why!
What is Happening to Plan F and C?
One of the biggest headlines when it comes to Medigap plans is in regards "Plan F and C going away in 2020".
This section will answer every question you need to know when it comes to what is actually happening to Medigap plans in the coming years.
It is important to note that Plan F and C will still be available to individuals that turn 65 before January 1st, 2020. However, this does not necessarily mean you will want to keep those plans!
Fortunately, for anyone concerned who is turning 65 AFTER January 2020 there are still many (and, in our opinion better) Medigap plans that will still be available to you.
Let's Look at Plan G vs Plan N
Now that many conversations will subside about Plans F vs Plan G..... we need to pivot to looking into Plan N!
Plan N introduces some more "moving parts" if you will. In exchange for dealing with some moving parts, you can save a little bit in monthly premium.
Understand the details before you choose Plan N.
How to pick a Medigap Insurance Company
Carriers may come into the market and offer low prices and large agent bonuses to obtain business. What does that mean for you? Example: 2 years after you enroll, you may see a large rate increase or the carrier ceases to write new business in your area.
Why Agents and Consumers Choose the Wrong Plan
There are many Medigap companies on the market (often 30+). With each plan offering standardized benefits, it is easy to fall into the trap of buying the one that comes with the lowest monthly premium.
Please, do NOT fall into this trap! It is not to say that low priced Medigap plans are inherently bad, but there are factors that go into recommending plans. This video summarizes why some agents offer the lowest cost plan from new companies. Price is just as important as stability - choose wisely!
When can I change Medigap Plans?
You can change Medigap carriers at any time during the year. It’s very similar to your home or auto coverage, you may change annually. With Medigap, you will however be subject to medical underwriting most of the time.
The real question for Medigap plans is not WHEN you can change plans, it is IF you can change Medigap plans (will you qualify, medically).
How Changing Medigap ACTUALLY Works
When you want to change carriers, you call our advisors.
You’ll have a phone consultation where they will review carriers and prices in your zip code according to your age and smoker/non-smoker status.
You’ll review the carriers that we feel are best for you, review why we advise that and can then begin the application process.
What does that process look like? It consists of obtaining your legal information (name, address, Medicare ID#, etc), your answering medical questions from that particular carrier, and then inputting your payment information.
You’ll sign documents electronically (via email).
After that, our advisor will follow up with the insurance carrier until you are approved for new coverage.
Once a new policy is issued and received by you, you may cancel your “old policy” with the prior carrier. If you are leaving a Medicare Advantage plan, when you are issued a standalone Part D plan, the new plan will cancel your Medicare Advantage plan. It’s actually a rather simple process.
Underwriting is a fancy way of saying that in order to switch Medigap plans, an insurance company will ask you a series of questions regarding your current health to determine if you can qualify for their Medigap coverage.
Underwriting is one of those topics that usually only comes up after individuals want to switch plans after several years with Medicare coverage.
However, we feel that this is one of, if not the most, important topics when it comes to choosing a Medicare plan. Even if you are only just turning 65, make sure you fully understand this section and how it may impact you in the future.
In this video we will go over a list of ACTUAL health questions from a Medigap provider, so you can see actually what we are referring to.
How Does Medigap Work at the Doctors/Hospital?
If a doctor’s office accepts Medicare; they take your Medigap plan.
You do not need to ask “do you take the ABC carrier?”.
Medigap pays after Medicare pays. It's that simple.
You will show the doctor’s office your Medicare ID card from the government and your Medigap plan card from your insurance carrier.
What Does Medigap NOT Cover?
Medigap will not cover things that Medicare does not cover.
If Medicare pays, your Medigap plan pays.
We have people on occasion tell us that their Medigap plan will not pay for dental services. That is correct.
Medicare does not pay for routine dental services, thus your Medigap plan will not pay for dental services.
What are my rights with Medigap?
If you or a loved one has a Medigap plan or is thinking about purchasing one, it is important to understand how the plans contractual details work.
As a consumer, you will often have more rights than you may think.
We will use this section to best describe the different situations you, as the consumer, can use to your advantage.
Your consumer rights include:
Free look periods
Guaranteed issue rights