Medicare is incredibly confusing. All the plans…the letters…and the parts!
On one side, you’ve got Medicare supplement plans or Medigap plans. So confusing, they had to give it two names!
And on the other side, you’ve got Medicare Advantage plans, and Joe Namath on TV telling you how great those are!
After getting thousands and thousands of comments from people, I decided it was time for me to write an article covering everything when it comes to the basics of Medicare, and Medicare Advantage vs. Medigap.
So grab a cup of coffee, sit back and relax and get ready to become an expert.
Click below to learn more!
What is Medicare?
Well, Medicare is a federal program put out by the United States government to provide health and prescription drug coverage for people aged 65 and older, as well as to those on social security disability who qualify.
At the time they knew there was a need for additional Medicare plans to help people pay for expenses not covered by regular Medicare.
So Medicare Supplement plans were created right along side Medicare, and later Medicare Advantage plans also came into play.
The question of Medicare Advantage vs. Medigap comes up quite a bit, and I’m going to cover that below!
If you’re younger than 65, and on disability or perhaps have end stage renal disease, you can also qualify for Medicare.
But I’ll be discussing each one of these topics in detail, so be sure to watch to the end of the video.
My name is Russell Noga, and i’m the founder of Medisupps.com.
And after years in business and helping over 10,000 people with their Medicare Supplement Insurance, I want to thank you for visiting our website!
My goal is to make this as easy as possible for you.
The core of Medicare is made up of various parts. And this simply means who pays what bill for you.
Those parts are designated by letters.
Those letters are Medicare Part A, Medicare Part B, Part C, or a Medigap insurance plan and Medicare Part D.
Now, let’s briefly discuss what each part of Medicare covers.
The Parts of Medicare:
- Medicare Part A
- Medicare Part B
- Medicare Part C
- Medicare Part D
Part A and B together are called “Original Medicare“
Medicare Part A – Hospital
Part A covers things like:
- Inpatient hospital stays
- Care in a skilled nursing facility
- Hospice care
- Home health care.
Medicare Part B – Doctor’s services
Part B covers things like:
- Doctor services
- Outpatient care
- Medical supplies and preventative services.
Medicare Part D
This is a prescription drug coverage plan that goes along with Original Medicare.
Medicare Part C
You could opt-out of Medicare Part A and B and enroll in a Medicare supplement plan, or enroll in a Medigap plan that would go along with Original Medicare Parts A&B.
I’ll be covering both of these a little later in the video.
So you start out with Medicare Part A and Part B, which is also called Original Medicare.
Now remember, Part A is hospital coverage, and Part B is your doctor services.
Now those don’t cover all of your medical bills. There are deductibles as well as co-insurance to pay.
That’s where things like a Medicare Supplement Plan (Medigap) comes in. Or as I mentioned, some people choose to opt out of Medicare and enroll in a private Medicare Advantage plan.
Medicare Advantage Plans
So I’ll talk about Medicare Advantage plans first. Again, these are managed care, private plans that you opt out of Medicare to enroll.
They will then provide coverage at a minimum of what Original Medicare (Part A and B) covers.
These plans have networks, so must find a plan and a network in your area. Then you must use doctors on the list to get the full coverage from the plan.
Now beyond their base coverage which is equal to Original Medicare, they can choose what they want to cover above that.
Many of them do include prescription coverage inside the plan. Some don’t, though.
Advantage Plan HMO’s and PPO’s
So Medicare Advantage plans can either be HMOs or PPO, or what’s called private fee for service.
One important thing to remember is that you still must pay the Medicare Part B premium each month for enrollment in a Medicare Advantage plan.
In fact, I just had a woman call me the other day and say , “Russell, I swear I pay nothing. It’s a zero premium plan. I don’t even pay the Part B premium.”
And I had to remind her that it’s actually coming out of her Social Security check. She later checked and realize that it was.
So as they say, out of sight out of mind. But if you do enroll in a Medicare Advantage plan remember you still must pay the Part B premium.
So just to recap, again, there is Original Medicare, which is Part A and Part B.
And then for Medicare Part C (A Medicare Advantage Plan), you would opt out of Original Medicare, still pay the Part B premium, and enroll in a Medicare Advantage plan.
Let’s talk about some of the pros and cons of the Advantage plans.
Well, some of the pros again is that it could include prescription drug coverage, but this might not be the best thing.
There are many different drug playing companies out there with different formulas.
They can get different medications for different rates.
With a Medicare Advantage plan, if you do enroll in one, you are stuck with that drug plan.
If you take a lot of high-dollar brand name drugs this could get you into real trouble, and that zero premium per month on the plan might not look so good if you have thousands of dollars worth of co-pays on your prescription drugs.
Now, that’s not all cases of course, and maybe there’s a plan out there that will fit your needs just fine with the prescription drug coverage built in that is a good fit for what you take.
Some of these Advantage plans also include additional benefits, such as dental and hearing.
Zero-premium Medicare Advantage Plans?
And another pro might be the very low premium. As I mentioned, they do offer zero dollar premium Medicare Advantage plans.
Well, you need to check the fine print on the coverage and to see which doctors are available in your area.
That brings us to what would be considered one of the cons of a Medicare Advantage plan, and that is you have to stay within their network.
You do need a referral to go see a specialist as well.
So if you travel the country quite a bit, you’ll likely be out of your network. Whereas if you stayed with Original Medicare and a Medigap Plan, you have the flexibility of going to any doctor or specialist anywhere in the country as long as they take Medicare.
Medicare Advantage Plans and Claims
Now one other point to consider when it comes to a Medicare Advantage plan, is the fact that they don’t always pay every claim in full.
Don’t forget, they only have to provide as good coverage and what’s covered under Original Medicare. Beyond that, it’s up to them.
And we get the calls at the end of every year during the annual election period where people can switch, begging us to take them off these plans.
Many had maximum out of pocket costs that were very high during the year and they didn’t realize that a lot of things weren’t even covered.
Zero-Premium does not mean Zero Cost!
So let’s discuss how to avoid that, and that is by enrolling in a Medicare supplement plan.
Medicare Supplement Plans
Now again, back to original Medicare. Remember, everything starts with that.
We have Medicare Part A and Part B.
And there you would add in a Medicare Supplement or Medigap Plan, they’re called the same things.
Medicare supplement plans are designed to help pay most or all of the gaps or expenses that are not paid by Original Medicare Part A and Part B.
So let’s talk a little bit about the differences in the Medicare supplement plans.
And yes, we’re back to the letters again.
Keep in mind these are plans and not parts of Medicare, but don’t worry we’ll know what you’re talking about if you don’t get it perfect!
One of my clients called me the other day, she said, “You should have made them numbers, not letters.
I agree, that probably would have been easier! But let’s talk about the different popular Medicare supplement plans.
And again, they are lettered.
The most popular Medicare supplement plans are:
- Medicare Supplement Plan G
- Medicare Supplement Plan F
- Medicare Supplement Plan N
What is the Most Popular Medicare Supplement Plan?
Well, it’s going to be Medicare Supplement Plan G by a long shot.
Now, that doesn’t mean we shouldn’t look at the other plans, and we certainly will. I’ll go into those in detail here.
But Medicare Supplement Plan G offers great coverage, and you simply have to pay one small deductible.
Let’s talk about what a deductible is it’s very simple. A deductible is just a certain amount of money that needs to be paid by you typically, before insurance will kick in and begin paying their portion.
So the deductible that you’ll need to keep in mind is the Medicare Part B deductible.
Again, that’s doctor services.
Now, Part A has a deductible as well if you go into the hospital, but all the Medigap plans I already mentioned Plan F, G and N pay that for you.
Medicare Part B Deductible
So Part B deductible is the one that we’re going to be focusing on.
Now that’s a once-per-year amount that you would pay prior to Medicare Part B beginning to pay its portion. Then your supplement would come in and pay the difference.
So here’s a quick example of how that deductible would work.
- Mary enrolls with Medisupps.com and gets a Medicare Supplement Plan G and pays $102 a month for the supplement. Her coverage begins on January, 1.
- Mary goes to the doctor on January 5, and the total bill is $298.
- In 2021, the Medicare Part B deductible is $20211.
This means Mary will owe the first $203 of this bill.
After that, Medicare supplement plan will pay the rest.
The deductible is what you are required to pay before your insurance starts paying.
Plan G Medicare – One expense
So the reason why Medicare Supplement Plan G is the most popular plan is because you only have that one expense, which is the Medicare annual Part B deductible.
Like Mary, she paid $198, for the rest of the year. She didn’t have to pay a dime for any of our approved expenses.
Medicare Supplement Plan G
This premium varies by region and a couple of other factors, so give us a call at 1-888-891-0229, and we can go ahead and find out how much Plan G is for you in your area.
You would also pay the once per year Medicare Part B deductible.
Now in 2021, this deductible was $203, but it will be slightly higher in 2021.
Once you pay the deductible, you will get 100% coverage for all of your Medicare approved expenses for the rest of the year.
Plan N Medicare – A Great Alternative
So the next most popular plan behind Plan G is a Medicare supplement Plan N.
Plan N is very similar to G but it has a few additional out of pocket expenses, but the premiums for Plan N are much lower than G so it makes it worth looking at.
Medicare Supplement Plan N
Now, the difference is with Plan N, after you meet that deductible, you might have a small co-pay per doctor’s visits throughout the year as you continue to go.
Now, the co-pay will never be more than $20.
In fact, it could be less.
Or there could be no co-pay, it just depends on how they code the visit.
Medicare Plan N co-pays
As well with Plan N, if you visit the emergency room and you’re not admitted, there’ll be a $50 co-pay.
So while hearing about Plan N and some of these possible additional cost you might have, you might be saying…
“I just want to go with Plan G!”
And that’s fine, you could. That’s why Plan G is the most popular plan.
However, there are some benefits to Plan N that we should look at and you should consider.
One of them being, that the monthly premium for Plan N is always less than Plan G.
For people who are healthy and never go to the doctor, the savings could be substantial by going on Plan N rather than Plan G.
Another thing is each year Medicare Supplement Plan N has consistently had lower annual rate increases over Plan G.
Every single company as well as every single plan has rate increases each year.
Medicare Supplement Rate increases
This probably isn’t a huge surprise but I’m just going to give you a heads up… you’re probably going get a rate increase every year.
Sorry to be the bearer of the inevitable. Great news though!
We watch those rate increases for our clients each year.
You never pay us a dime. Our clients pay us nothing directly. It’s all FREE.
Yes, we watch the rate increases every year, so you don’t have to, and we shop the market.
And Plan N historically has always had lower rate increases than Plan G.
Now if you are somebody who does visit the doctor quite a bit throughout the year for various things, Medicare Plan N co-pays might add up and it might not be worth it.
In that case, Medicare Supplement Plan G might be the way to go.
Allow us to check the rates though and do the math and see which plan is going to be better for you.
So just to recap, with Medicare Plan N, you pay the Medicare annual Part B deductible each year just like you did on Plan G.
Once that’s met on Plan N, you might have a small co-pay per doctor’s visit each time you go for the rest of the year.
However, that co-pay will never be more than $20 and you might not get a co-pay at all. Or it might be less, it just depends on how they code the visit.
Now another thing to consider on Plan N is that if you visit the emergency room and you’re not admitted, you will get charged a $50 c-opay.
This is just to keep people out of the emergency room for things like the sniffles.
Medicare Part B Excess Charges
Another thing on Plan N to consider is that it does not cover what are called Medicare Part B Excess Charges.
Now I will tell you after years in business, I have never had a client get an excess charge.
These are extremely rare, and not something to worry about at all.
However, I do need to tell you about them.
What Excess Charges are, is if a doctor does not accept what are called the
assigned rates for Medicare, they can charge up to %15 extra.
Now it’s estimated that over 97% of the doctors in this country do take the assigned rates. So again, it’s probably something you will never see.
There are some states however that are not allowed to even charge excess charges.
So if you’re in one of these states, it’s another great reason to consider Plan N.
The states that are not allowed to charge excess charges are:
- Rhode Island
- New York
Medicare Supplement Plan F
So the last point we need to talk about is Medicare Supplement Plan F.
If you were eligible for Medicare on January 1, 2020, or later, you’re not even allowed to enroll in a Plan F. Medicare has removed it for new beneficiaries.
If you are on Medicare prior to that and have a Plan F or are wanting a Plan F, you can still get it.
I would highly advise against this though as Plan F is too much money for too little benefits. It also has higher rate increases as well, because it’s a closed-risk pool.
Keep in mind that the only difference between Medicare Plan F and Plan G is that Plan F pays the Medicare Part B deductible for you, and in 2020 this amount was $198.
However, if you do have a Plan F you’re probably paying $3-400 or more extra dollars a year, just to have the plan and get a $198 benefit.
So that is money down the drain as far as I’m concerned, you can write the deductible check yourself on a Medicare Plan G and save a substantial amount of money in premiums.
Medicare Plan G!
So Medicare Plan G is definitely where you should be looking if you currently have a Plan F, and we can help.
But just to recap the benefits of Medicare Plan F…
Anyone who enrolled in Medicare on January 1 of 2020 or later may not enroll in a Medicare Plan F.
Those who still have Plan F pay your monthly premium for the plan just like you do all the others, and you get 100% coverage of all the gaps in Medicare.
However, it does have the highest premiums of all the plans as well as the highest rate increases every year of all the plans. Instead you would save a lot of money by going with Plan G and just paying the Part B deductible yourself.
Now if you do have a Plan F or you are considering one, please give us a call, at least let us check the rates and help you see how much you could save by going with Plan G.
You can call us directly at 1-888-891-0229.
There are some very important things to remember when we’re talking about Medicare supplement plans.
The number one thing is that every single insurance carrier has the exact same coverage within each plan.
This means a Plan G from one company is identical coverage to Plan G with another.
Their premiums however, are all entirely different.
That means one company could charge $110 for Plan G, and another company could very easily be $170 or more.
At Medisupps.com we’re an independent agency that represents all the top carriers.
We shop all of the rates from all the top companies for our clients, and then make sure you get the lowest premiums with the best company.
Another thing to note is, nearly every company has a rate increase every year.
That means regardless of where the premiums start, they’re all going to go up.
We watch those rates for you so you don’t have to, and you never pay us a dime for our services.
Part D Drug Coverage
So that brings us to the last part of Medicare, which is Medicare Part D.
This is Medicare prescription drug coverage, not quite as easy to choose a plan as say, a Medicare supplement.
This is because there are many, many different drug plans available in your area and they all have different premiums and co-pays for different medication.
Now the number one tip I can give you when it comes to choosing a part D drug plan…
You Must do research before enrolling in a plan!
If somebody recommends to you a plan out of thin air without asking you what medications you take, run for the hills!
With all of the different plans available and all the formularies, each insurance carrier and plan can offer your specific medications for a different price.
That means your neighbor might say their plan is great, but that’s based on what they’re taking.
So you need to look up the plans, or have somebody like us help you.
We don’t sell the Part D plans, but we make sure all of our clients get the right drug plan. Because it’s very easy to overpay.
Now, as I mentioned earlier when it comes to Medicare Advantage plans, your plan might actually have prescription drug coverage built in.
But if you’re staying with Original Medicare with a Medigap Plan, you will need to enroll separately in a part D drug plan.
Now many people ask us, “Well, gee, I don’t take any drugs, do I have to enroll in a plan?”
No, you don’t. But unfortunately, the government will give you a penalty if you finally do enroll in a plan one day.
So a lot of people will just get a low cost plan at that point, and you have what if you need it and you’ll avoid the penalty as well.
Changing Part D Drug Plans
Medicare Part D drug plans can be changed only once per year, whereas a Medicare supplement plan can be changed anytime during the year.
With a Medigap Plan remember you do not have to wait until that annual election period which happens October 15th through December 7th every year.
But with a drug plan, you do have to wait until that time.
If you want to make a change on a drug plan during that time, your changes will go into effect January 1st of the following year.
If you are just turning age 65 now you would simply enroll in a drug plan and the coverage would begin the same day that Medicare and your Medicare supplement plan begins as well.
Medicare Plans – Frequently Asked Questions!
So those are the many parts of Medicare, as well as a description of the different Medicare supplement plan letters that are the most popular.
This brings us to the very popular “Most frequently asked questions” section.
#1 – Why do insurance companies all have different rates for the same Medigap plans?
That’s a great question. Now, insurance carriers do in fact have different rates for the same Medigap plans in your area.
And this is why people love our service because we simply shop all of the rates every year for our clients to make sure you don’t overpay.
It’s extremely easy to do that. In fact, everybody we switch, who comes to our website and wants to get quotes for another plan, finds out that they were paying too much for that same Medigap Plan already.
And again, we do this for our clients every year. We never let you get to that point with our annual rate review.
We make sure that you’re always paying the least amount possible.
#2 – How much do you charge for what you do?
Another great question. We don’t charge anything. We simply get paid by whatever insurance carrier you go with. And we don’t work for them, we work for our clients.
Now, I will tell you, if you go direct to an insurance company, they’re never going to tell you the rates with other companies, they just want to sign you up with them.
You would pay the same whether you go direct or not. So it’s a no brainer using our service because it’s free, and we watch the rates for year over year. But we check from all of the top companies to make sure that you don’t overpay.
#3 – If I want to switch companies in the future, do I have to get approved?
If you’re looking to change medicare supplement companies in the future to save monies, which is why most people do it, then yes, you will have to answer medical questions on the application.
They’re not as stringent as you might think. We do this probably times a day for people to save them money, but you will have to answer the medical questions and then get approved.
Many people often ask me…
“Russell, what if I have a condition and I’m stuck and it’s a major medical condition something serious, and I can’t move?”
In that case, I say try not to stress and consider that you have outstanding coverage. Just focus on getting well, not saving a few bucks a month on your premium.
But if you do want to change, yes, you’ll have to answer the medical questions. But no, it’s not as hard as most people think.
#4 – I’d like to change from a Plan F down to a Plan G and save money, but will my doctor accept the Plan G?
Absolutely, your doctor will accept Plan G. Keep in mind Medicare’s a federal program and Medicare Supplements just follow Medicare wherever it goes.
Therefore, you can use your coverage anywhere in the country, whether it’s a Plan F, G and any Medicare supplement plan.
All you have to ask is if the doctor accepts regular Medicare and in that case, they’ll take your Supplement Plan.
Keep in mind, Medicare supplement plans are not like Advantage plans where you have a network.
# 5 – How much are the rate increases each year?
The fact is, we don’t know what they’re going to be next year, and that’s why we watch it for our clients every year. In fact, I just signed a woman up just prior to making this video. She’s out in Ohio, and she said that another agent called her and told her that the rate increase was only going to be 3% next year.
Folks, if you hear this, again, run for the hills because no agent and not even the insurance carrier can predict what their rate increases going to be next year.
They simply don’t know. So we check it every year because we don’t know, and we make sure that you’re always paying the least amount possible. And again, you never pay us a dime for what we do.
Give us a call now to get started in the best Medicare supplement insurance today, and for years to come!