Medicare Supplement Insurance & Medigap Plans

In this short video Mike explains Medicare Supplement | Medigap Insurance.

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Medigap plans A-N, also known as Medicare Supplement plans, play a crucial role in helping individuals cover the gaps left by Original Medicare. When comparing these plans, it’s important to understand that they are standardized by the government, meaning the basic coverage remains the same across different insurance companies that sell them while having access to any doctor or hospital that accepts Medicare. The key difference lies in the premium cost, the history of their rate increases, and additional benefits offered by each plan. The popular plans are plan F, G, and N.

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Plan F pays all the gaps. It is only available for people who turned 65 prior to Jan. 1, 2020, and consequently is seeing high rate increases.

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Plan G pays all the gaps except for the Medicare Part B calendar year deductible ($240 in 2024). Hence your out-of-pocket maximum is equal to the part B deductible.

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Plan N is like plan G in that it does not cover the part B deductible. Plan N usually has lower premiums than G but adds a $20 co-pay for in-office doctor visits and $50 co-pay for ER visits that don’t result in an inpatient admission. Plan N does not cover part B excess charges, while plan G does. A very small percentage of doctors may charge excess charges up to 15% higher than Medicare rates.

Understanding your specific healthcare needs and budget is crucial when choosing a plan. Another factor to consider in the comparison of Medigap plans is the pricing structure. Insurance companies may employ different methods to determine premiums, such as community-rated, issue-age-rated, or attained-age-rated pricing. Community-rated plans charge the same premium to everyone, regardless of age, whereas issue-age-rated plans base premiums on your age at the time of purchase. Attained-age-rated plans, on the other hand, may start with lower premiums but increase as you get older. It’s essential to carefully evaluate these pricing mechanisms to ensure that the plan you choose aligns with your long-term financial considerations.

In conclusion, when comparing Medigap plans, individuals should weigh the trade-offs between comprehensive coverage, premium costs, and pricing structures, and the pros and cons of individual insurance companies. Each plan comes with its unique set of advantages and potential drawbacks, so it’s crucial to align your choice with your health needs and financial situation. Call Mike at 281-787-7358 to help you navigate the complexities and find the most suitable Medigap plan for your individual circumstances.