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Making Sense of Medigap Plans and MACRA

Posted on by Monika

Medicare Supplement Plans C & F are not going to be available to new enrollees from 2020. December 31st, 2019 will be the last day when anybody eligible will be able to buy Medigap policies C & F. Many Medicare recipients among who chose to buy Medigap Policies chose Plan F in past as it has been the most comprehensive Medigap Plan. The reason for these plans going away is Medicare Access & CHIP Reauthorization Act of 2015 (MACRA). Starting 2020, Section 401 of MACRA will prohibit sale of Medigap Policies that cover Part B deductibles to newly eligible Medicare beneficiaries.
Some people who know Plan F, they think it is a big deal. Medicare Plan F is well-liked because it pays for all the gaps in Original Medicare Part A and Part B, including both your hospital and outpatient deductible as well as the co-insurance. It even pays the 20% that Medicare Part B does not cover. This means zero out-of-pocket for you at the doctor’s office.
People who buy Plan F on or before December 31st, 2019 can renew Plan F every year lifelong, provided there are no further law changes.
Some Insurance carriers also offer Plan F high deductible – that means you must pay the deductible before Plan F pays. Plan F High deductible serves a different financial purpose for some enrollees and because of the deductible it is clearly not the most comprehensive plan.
From 2020 the most comprehensive plan available will be Plan G, which at this time second most comprehensive plan after Plan F, Plan G does not cover part B deductible. Plan C is in the middle tier when you talk about comprehensiveness of the plan. Plan D has almost similar coverage to Plan C except for Part B (Doctors Office and Outpatient services) deductible. Do not get confused between Medigap Plan D vs Medicare Part D – which is Prescription Drug Coverage Plan. None of the Medigap plans give you Prescription drug coverage.


As you can see in above graphic Medicare supplement Plan F has been the most comprehensive Plan as well as simplest to learn about as it has the most checks in all the Medigap plan tabulations you see. As 2020 nears you will see scare tactics from people who might tell you to switch out of Plan F as it is going away, simultaneously you will see scare tactics from other people who will try you to switch to Plan F before it goes away.
Everybody’s financial situation is different, we advise you to choose a plan that makes most financial sense to you.
Feel free to use our Quoting platform below and find out what makes sense. For calculations, 2018 Part B deductible is $183/- per year. As a reminder – Part F & G also covers 100% of Part B excess charges, which is the difference between what a doctor charges and the amount Medicare Part B will approve.

Medicare Supplement Plan Quotes
Medicare Supplement Plan Quotes

Guide to Medicare Supplement Plans

Posted on by Monika

Why Medicare Supplement?

Medicare Part A & B (referred here as Original Medicare) do not cover everything, though these pay for many healthcare services & supplies. Medicare supplement Plans, offered through private insurers, help cover certain costs that Original Medicare does not cover. These might include coinsurance, yearly deductibles & copayments. Certain Medicare supplement plans also help with coverage for a few services that Original Medicare does not pay for, such as emergency overseas travel or Part B excess charges.

Can I get Medicare supplement plan without having Original Medicare?

Medicare Supplement Plans supplement Original Medicare, you can not get Medicare Supplement Plans unless you are enrolled in Original Medicare. Original Medicare will pay first, and your Medigap policy fills in the cost gap. For example, for a Hospital visit if you are charged $10,000/- Original Medicare will pay 80% or $8000/- and Medicare Supplement Plan or Medigap plan might pay remaining 20% or $2000/-, depending on the plan coverage as you have the option of multiple different types of Medicare Supplement Plans. As these plans help cover the gaps in Original Medicare these plans are also commonly called as Medigap Plans.

What are different Medicare Supplement Plans and what do these plans cover?

Medicare Supplement (Medigap) Plans are standardized. The chart below explains the plan coverage. A check mark means the Medigap Plan covers 100% of the described benefit, a percentage denotes the percentage coverage and blank means the plan does not cover that benefit.

What is not covered by Medigap Plans?

Medigap plans generally do not cover Long-term care (care in a nursing home), Routine vision or dental care, Hearing aids, Eyeglasses, Private-duty nursing & Prescription drugs. Also, Medicare Supplement Plans are not Medicare Advantage Plans, you may want talk to our knowledgeable agents if you need information about Medicare Advantage plans.
We can assist you in getting Long Term Care Plans, Vision & Dental Plans, Hearing Plans & Prescription drug plans. Talk to our knowledgeable Agents if you need assistance with any of the above.

What else do I need to know about Medicare Supplement Plans?

To recap you must have Medicare Part A and Part B to get a Medicare Supplement plan.
A Medicare Supplement plan can only cover one person, so if you are married, you and your spouse would need to buy separate policies.
You can usually use your Medicare Supplement plan with any provider that accepts Medicare. However, some types of Medigap plans known as Medicare SELECT plans require you to only use doctors and hospitals in provider network.
Not all types of Medicare Supplement plans may be available in your zip code.
Premium amounts may vary by plan and location, even for the same standardized benefits.
In general, Medicare Supplement plans are guaranteed renewable as long as you continue to pay your premium.

This is not an all inclusive guide, however can help you in deciding what medicare supplement plan to choose. If you are wondering how much these plans cost please feel free to use our Quoting platform below. The link will open in a new window.
Medicare Supplement Plan Quotes
Medicare Supplement Plan Quotes

Guide to Medicare Plans

Posted on by Monika

 

Eligibility for Medicare Plans

You should be 65  years  of  age  and  older  OR under 65 years and receiving disability benefits from Social Security Administration (SSA) or Railroad Retirement Board (RRB).  For people with ALS (Lou Gehrig’s Disease) – Must  receive  these  benefits  for  24  months before eligibility for Medicare OR Under 65 years and diagnosed with End Stage Renal Disease.

Medicare Eligibility

Enrollment into Medicare

Enrollment  into  Medicare ie either Automatic or By Application.

AUTOMATIC  ENROLLMENT: If  already  receiving: Social  Security  Benefits , Social  Security  Disability or Railroad  Retirement  Benefits. Beneficiary  will  receive  Medicare  card  3  months  BEFORE  benefits  are  to  begin.

ENROLLMENT  BY  APPLICATION: If  not  already  receiving  benefits  – beneficiary  applies  through  Social  Security Administration either 3  months  before  turning  65 or in the month  beneficiary  turns  65  or 3  months  after  turning  65. This  is  called  the  Initial Enrollment Period.

Medicare Enrollment

You may delay enrolling  into  Medicare  if you or your  spouse is actively employed AND is covered under group health insurance policy based on active employment. This  is  called  Delayed Enrollment. You may later enroll in medicare when: Employer Group Health Insurance ends. You have 8 Months to enroll.  This Eight Month period is called the Special Enrollment Period.

If you do not enroll during the Initial or Delayed Enrollment periods that is if  you miss your Initial Enrollment Period or your Special Enrollment Period, you get another chance to enroll between January 1st to March 31st of each year. Your coverage begins July 1st.  This is called General Enrollment and in this case you may have to pay a higher premium for late enrollment in Part A and/or a higher premium for late enrollment in Part B.

Original Medicare

Medicare Part A helps pay for Hospital or inpatient stay. Medicare Part B helps pay for Doctor Visits & outpatient services.

Medicare Part A & B

 

Medicare Plans are Available through Private Insurers. In New Mexico we can help you find the best plan for your needs through Aetna, BCBS of NM, Cigna, Humana, UnitedHealthcare (AARP) and Presbyterian Insurance.

Medicare Plan Explanation Source: UnitedHealthcare

Please click below for Medicare Supplement Plan Quotes

Medicare Supplement Plan Quotes
Medicare Supplement Plan Quotes

 

For Medicare Advantage Plan Quotes & Medicare Prescription Plan Quotes Please call our agents at NM Insure Phone: 575.257.6146