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Medicare Supplement Plan G

Get the Facts on Medicare Supplement Plan G and compare rates

How Does the Medicare Supplement Plan G compare to Plan F?

Medicare Supplement Plan G provides all of the same benefits that plan F provides with the exception of one benefit. If you choose to enroll in the Medicare Supplement plan G, you will be responsible to pay the standard annual Medicare part B deductible.  The Medicare Part B deductible is determined each year by Medicare and will likely go up small amount each calendar year.  Last year it was $166 and is $183 for the year of 2017.

When you start comparing the rates for Medicare Supplement Plan G vs Plan F, most of the time it’s more than the Medicare Part B deductible.  The older you are, the larger the spread.  I’ts not uncommon for someone in their 70’s to be a able to get a G plan for more than $500 less per year than an F plan.  Most consumers are willing to accept a $183 per year out of pocket expense to save $500 per year on premiums. The only down side to a Medicare Supplement Plan G is that you will need to pay attention to your medical bills and keep track of how much you have paid out since the beginning of the year.

You will need to pay the provider what ever amount that Medicare does not cover for Part B Services (20% of Medicare approved charges) up to $183 for 2017. Sometimes you will get bills for small amounts, but if you have a more costly expense right around the beginning of the year, you may have to pay the full deductible all at once.  The important thing to remember is that once you have paid out the $183, you should not pay anything else for Medicare approved Part B services.

 

 

 

 

 

 

 

 

 

 

 

It’s not uncommon for a provider to send out bills that exceed the annual deductible partially because the Medicare system has not been updated with previous claims, or due to a common error by the provider’s office.  If this happens, simply call the provider and let them know they need to re-bill the service because you already met your deductible.  This is why it’s important for you to keep track of your medical bills especially at the beginning of the year.

If you already have an F plan, and are having trouble finding another company that’s has a lower premium for plan F, it’s well worth considering the Medicare Supplement Plan G instead.  The plans are truly identical and you’re really not decreasing anything significant.

Rate increase trends for the Medicare Plan G

Another reason to consider the Medicare Plan G instead of the Plan F, are future rate increases.  Most companies are imposing a lower percentage rate increase for their G plans than the F plan.  There are many reasons why the increases may be less for a G than F, but one of the biggest factors is that the insurance company is not paying 100% of the claims from day one.  That $183 that Plan G policy holders pay first helps to keep the claims ratio down.  With the F plan, the insurance company pays all the claims.

When can you enroll in  Medicare Plan G?

You can purchase a Medicare Plan G when you first become eligible to enroll in a Medicare Supplement by either turning 65 first enrolling in Medicare part B. These are open enrollment periods which allows you to choose any Medicare Supplement offered by any insurance company operating in your resident state with out answering any health questions.

The Medicare Supplement Plan G is available to anyone at anytime if you are willing to be medically underwritten.  In other words you would have to answer the health questions and allow the company to investigate your medical records, prescription history and MIB (Medical Information Bureau) report.  In addition you may also be required to do a telephone interview.  We can help determine if you will qualify medically by talking with us for a few minutes.

You CANNOT enroll in a Medicare Supplement Plan G if you are using Guaranteed Issue enrollment privileges. Medicare Supplement plan G is not required to be made available for Guaranteed Issue unless a company wants to offer it.  There is a major Medicare Supplement Company who currently does not offer the G plan at all.  We anticipate this company to add the G plan in the near future, and if they do, it will likely be available even for Guaranteed Issue Applicants.

Don’t confuse Guaranteed Issue and Open Enrollment

Guaranteed Issue

Typically if you are not in one of the Federal Open Enrollment Periods,  then you will have to be medically underwritten, or be eligible to purchase a Medicare Supplement plan due to one of the following SEP (special election period) in which case Plan G is not available.

  • You were terminated from a Medicare Advantage plan because you moved out of the service area
  • Your Medicare Advantage plan was discontinued
  • You were terminated from  Individual plan on or off  Market Place plan for any reason
  • Your employer group coverage ended for any reason (voluntarily or involuntarily)

If you were terminated from a Medicare Supplement or Medicare Advantage plan due to non payment of premiums, you will not qualify for a SEP to enroll in a new Medicare Supplement or Medicare Advantage plan.

Open Enrollment

The Federal Open Enrollment period occurs if you recently enrolled in Medicare Part B by the end of the 3rd month after you either turned 65 or became eligible to enroll in Medicare Part B. Once you are enrolled in Medicare part B, you will have six months to enroll in a Medicare Supplement without having to answer any health questions.  You can choose any company that offers any Medicare Supplement plan and any plan the company sells.  If you choose to enroll in Medicare for the first month you are eligible, you will have six months to purchase a Medicare Supplement policy.  Let’s use the following example:

  • Mary turned 65 in February 2016, but was currently employed and had group coverage so she did not want to add any extra expense for Medicare Part B until she had to.  One year later, Mary started incurring high medical bills  and decided to sign up for Medicare Part B to be effective July 1, 2017 to pick up the medical expenses her employer plan was not paying but did not choose to purchase a Medicare Supplement because she still had the employer plan.  Mary remained employed for the rest of the year but decided to retire December 31, 2017 because her health continued to decline. Because Mary’s employer group coverage ended on December 31, she now has to use Guaranteed Issue because her health is so poor that none of the companies would approve her and she is no longer in open enrollment due to it being longer than 6 months since she elected Part B.  Mary really wanted plan G, has to pay the higher price for plan F to get the coverage she needs.

As you can tell, it can be a sticky situation.  Please don’t try to do this alone and miss your opportunity to get the plan you really want or need.  We are there to help you all along the way.

 

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