Aetna Inc. (NYSE:AET) serves about 38.8 million providing medical, pharmacy and dental plans, Medicare plans, Medicaid service, behavioral health programs, and medical management. Rest assured, Aetna, headquartered in Hartford, CT, is a major player in the market with 48,290 employees and a 2017 adjusted revenue of $60.7 billion. We will focus on Aetna’s Medicare business in this article, and specifically Aetna Medigap Plan N (also known as supplemental Insurance). Below we present facts and figures we hope you find useful. Prefer to chat with an expert about this topic? Please call us!
Aetna Medicare Plans
Based on the analysis of data that Medicare has made public, the chart below shows the number of Medigap Policies by letter that Aetna offered across the country. Again, we will focus on Aetna’s Medigap Plan N, noting that in 2019, Aetna offers Medigap Policy N in 26 different states/areas.
Below are the states where Aetna Medigap Plan N is offered. (Note that some large states, like, California Florida, Ohio and Texas, are broken into multiple areas with in the states (e.g., north, south, east or west) which is why there are more Medigap Policy Ns offered by Aetna than there are states depicted below.)
The only difference between, say, Aetna Medigap Plan N in California, and Aetna Medigap Plan N in North Dakota, is the price (known as a premium) that you pay for the policy. In fact, a Medigap Plan N offered by Aetna, or Mutual of Omaha or United Healthcare, or Cigna, will all have the same benefits. These benefits are standardized by the government. Again, the only difference between any Medigap Plan N offered is the premium. Use our quote engine to understand what your premium might look like in your area!
Medigap Plan N Benefits
Medicare Supplement Plan N requires you pay the annual Part B deductible. After that is met, you may have a co-pay of up to $20 per doctor’s visit. What determines whether plan N pays for the visit? How you doctor visit is coded by the doctor’s office determines if there will be any copay at all, and how much. However, your copay can never be more than $20 per visit. Yes” means that Plan N covers 100% of the benefit listed. “No” means that Plan N does not cover that benefit.
Notice the “***” in the chart next to the benefit “Part B coinsurance or copayment”. Importantly, Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don’t result in inpatient admission. Medicare can be complicated. If you would benefit from talking to someone about these benefits, call us toll free! 1-888-891-0229.
What Doesn’t Plan N Cover?
No Medigap plan covers dental. And neither does Medicare. Additionally, Plan N does not cover outpatient medications from the pharmacy. Outpatient medications are covered through Part D plans. However, Plan N will cover Part B medications, which typically includes drugs that are administered in a clinical setting, like injections you receive in the doctor’s office for chemotherapy or autoimmune diseases. The only other item that Plan N does not cover when you incur expenses with in the US, is the Part B deductible, which was $185 in 2019.
Are There Other Medigap Plans I Should Consider?
We can walk you through the benefits of other plans, so feel free to reach out and talk to a real person at 888-891-0229. Generally, seniors interested in plan N should also look at Plan G. In Plan G, you pay the Annual Part B deductible each year. In 2019 this deductible is $185. Once that is met, Plan G pays 100% of the costs in Medicare Part A and B. You may have also heard about Plan F. Plan F technically covers more than any other Medigap Plan, but it comes at a cost as the premiums are going to be higher. Also, Plan F is being discontinued on January 1st 2020. Those who have it may keep the plan, however those eligible for Medicare A and B on January 1, 2020 and beyond will not be able to enroll in a Plan F.
Which Seniors have a Medigap plan?
The American Health Insurance Plans analyzed demographics of seniors who have Medigap plans. 34% of seniors in 2016 who had original Medicare (Part A & B, not Medicare Advantage) had a Medigap plan. Interestingly, 61% of seniors in 2015 who had Medigap insurance were women, but this can vary by state. Who is buying Medigap plans? Younger beneficiaries! 48% of seniors 65-74 years of age have a Medigap plan, compared to 25% for 75-84% and 10% of 85 years and older. Also, the share of seniors with a Medigap plan in 2015 varied widely by state: from 3% in Hawaii to 51% in Kansas. This means not every senior is aware of the benefits of Medigap insurance. You can find quotes online using our FREE quote engine, or better yet, call us! 1-888-891-0229. We can walk you through the details!
The bottom line is, plan benefits are standardized within each letter, but premiums are NOT. Every Medigap policy must follow federal and state laws designed to protect you, and the plan must be clearly identified as “Medicare Supplement Insurance.” Insurance companies can sell you only a “standardized” policy identified in most states by letters. You have a lot of choices, and we can help you determine which Medigap plans offer you the unique balance of benefits and cost. Call us today!