MedicareBob

October is here and with that comes the Annual Election Period. In this video I will discuss what the 2019 Annual Election Period means for you and whatever coverage you have.

• If you have a Medicare Supplement Plan (Medigap), you can shop now to save money on your supplement plan. Just a reminder, you can actually do that all year however, now is a good time to do it because a lot of companies have their rates published for 2019.

• If you have a Medicare Part D drug plan, this is a very important time for you. The Annual Election Period is the only time in the year that you can shop your Part D drug plan. Between October 15th and December 7th, you can shop and compare your Part D drug plans with the new plans.

• If you have a Medicare Advantage Plan, again, this is the only time in the year that most people can shop their Advantage Plan. You should have received your ANOC (Annual Notice of Change) in September of any changes being made to your plan. So, you can now compare your plan and the changes made to any other plans available in your area and what they are offering for 2019.

This Rate Watch Wednesday is focused on Medicare Supplement Plan G, for a male and female, ages 65 and 70 in Ann Arbor, Michigan (zip code 48103). As I have said before, Medicare Supplement plans are all Federally regulated by the government. There is no reason for anyone to pay more for their Medicare Supplement Plan G with one carrier over another because the letter of the plan dictates the coverage, not the carrier. You are not getting any additional benefits by paying more. That’s why it is important to shop your Medicare Supplement coverage every year, and we can help you with that.

You may ask, “Why do these companies charge different prices if they are all the same?” That’s a great question. Carriers have different administrative costs and they have different profit goals. There’s tons of different reasons why these big companies charge different prices. What you need to know is, just like in your Medicare book, Medicare Supplement Plan G is the same with every carrier.

The Medicare Supplement Plan F has been the most popular Medicare Supplement plan over the last 25-30 years. I call it the "Full Coverage” plan because you can go to any doctor or any hospital in the country that accepts Original Medicare and as long as it’s a Medicare covered service, there are no co-pays or deductibles, all the bills are paid. However, in 2019 the better choice is Medicare Supplement Plan G, which I call “Greatest Value”.

The only difference in benefits between the Medicare Supplement Plan F and the Medicare Supplement Plan G is Medicare’s Part B annual deductible, which for 2019 is $185. Once that deductible has been paid, the Medicare Supplement Plan G covers exactly like the Medicare Supplement Plan F. There are two reasons why I recommend the Medicare Supplement Plan G over the Medicare Supplement Plan F.

1. The difference in premiums between the two plans will save you money. The average cost of the Plan F is $600-$800 more a year in premiums than the Plan G. If the only difference between the two plans is $185, why pay that much more in premiums to Plan F for it to only pay $185 on your behalf? For those of you that have been on the Plan F for more than a few years, you could probably save $800-$1,200 in the year by switching from the Plan F to the Plan G.

2. With the changes being made to the Plan F by MACRA in 2020, the Plan G has a much more stable premium than the Plan F and I’m anticipating that to continue.

A helpful tip during the Annual Enrollment period. This tip will help avoid confusion between you and your doctor’s office: As you’re shopping for a Medicare plan, it is very common that we ask our doctors which plans they accept. If you decide to go with a Medicare Advantage plan, if it very important to check with your provider to make sure that they accept the HMO or PPO plan of the carrier that you’re choosing. For example, if you were choosing and HMO plan with United Healthcare, you would call your doctor’s office and ask if they accepted the United Healthcare HMO Medicare Advantage Plan. Ninety percent of the time they will tell you yes or no and then you can proceed from there.

If you are choosing a Medicare Supplement plan (Medigap plan), the ONLY question you need to ask your doctor is if they accept Original Medicare because there are no networks with Medicare Supplements. Medicare is the network. For example, if you decided to choose a Medicare Supplement Plan G with Mutual of Omaha, do not ask your doctor’s office if they accept Mutual of Omaha because what they will do is look up whether or not they accept Mutual of Omaha’s HMO or PPO plan. Simply ask your doctor if they accept Original Medicare because every provider that accepts Original Medicare will accept your Medicare Supplement regardless of the carrier.

This Rate Watch Wednesday is focused on Medicare Supplement Plan G, for a male and female, ages 65 and 70 in Lafayette, Louisiana (zip code 70501). As I have said before, Medicare Supplement plans are all Federally regulated by the government. There is no reason for anyone to pay more for their Medicare Supplement Plan G with one carrier over another because the letter of the plan dictates the coverage, not the carrier. You are not getting any additional benefits by paying more. That’s why it is important to shop your Medicare Supplement coverage every year, and we can help you with that.

You may ask, “Why do these companies charge different prices if they are all the same?” That’s a great question. Carriers have different administrative costs and they have different profit goals. There’s tons of different reasons why these big companies charge different prices. What you need to know is, just like in your Medicare book, Medicare Supplement Plan G is the same with every carrier.

The increases for Medicare premiums and deductibles have been announced. Great news! The increases are very minimal.

• Medicare Part A premium: For most people this premium comes out of their social security check every month. In 2018, the premium was $134.00 a month. In 2019, the premium has only increased to $135.50. Only a $1.50 increase which is great news.

• Medicare Part B annual deductible: In 2018, Medicare’s Part B annual deductible was $183.00 per calendar year. In 2019, the price of the deductible will be $185.00. Again, more great news as it only experienced a $2.00 increase.

• Medicare Part A hospital deductible: In 2019, the deductible that beneficiaries will pay when admitted to the hospital is $1,364. An increase of $24 from $1,340 in 2018. That is a per service deductible, not an annual deductible.

We recommend Medicare Supplements (Medigap) to 95% of our clients and I will explain why. In order to better understand why, I will break down the two different types of plans that someone on Medicare can choose. The two options are a Medicare Advantage plan or a Medicare Supplement plan. Listed below is a brief, generic explanation of Medicare Advantage plans and Medicare Supplement plans:

Medicare Advantage Plan

• It is not a Supplement, it is a private company that provides a health plan that you will use instead of using your traditional Medicare. So, you replace your Medicare.

• $0 - $100 premium depending on the plan’s location. The $134 Medicare Part B premium is no longer paid to Medicare but to the private insurance company.

• Deductibles and copays up to your yearly maximum. Depending on the plan, an average of $3000 - $6000 maximum out of pocket for the year.

• Networks of doctors and hospitals for HMO plans. PPO will offer out-of-network coverage but at an additional cost.

• Requires referrals and pre-approvals

• Includes prescription drug coverage

• Depending on the area, some plans include additional benefits that Medicare does not cover such as dental, vision or gym memberships.

Medicare Supplement Plan

• Keep your Medicare. Medicare Supplements work with your Medicare. Medicare remains primary and the Supplement would be secondary.

• No networks. As long as the doctor or hospital accepts Original Medicare they have to accept a Medicare Supplement regardless if they accept the carrier or not.

• No referrals or pre-approvals

• Additional monthly premium

• Covers the 20% that Medicare does not cover without surprises. As long as Medicare covers the service, the Supplement will cover it.

Now that I’ve explained the two plans, there are two reasons why 95% of our clients are choosing Medicare Supplements and why I prefer them to Medicare Advantage plans. The major reason is if you don’t get a Medicare Supplement plan when you first turn 65, you will have to medically qualify to upgrade to a Medicare Supplement. For example: if you choose an Advantage plan because you’re attracted to the low premiums and the additional benefits (dental, vision etc.) and you are hit with a big diagnosis (COPD, cancer, heart disease etc.) that is going to cost you that maximum out-of-pocket, you might be stuck with that Advantage plan and you can no longer afford those copays and deductibles. That is the biggest risk for anyone choosing a Medicare Advantage plan.

The second reason is that it just makes sense to me. It is one of the few insurance plans that you are guaranteed to get more benefits then the premium you pay in. Let me explain. Let’s look at a 20-year period of time and your Medicare Supplement plan costs you $1,500 a year. Over a 20-year period of time you will pay in $30,000 to your Medicare Supplement plan in premiums. I can guarantee you that you will spend more than $30,000 on your healthcare in 20 years.

This Rate Watch Wednesday is focused on Medicare Supplement Plan G, for a male and female, ages 65 thru 75 in Newark, New Jersey (zip code 07101). As I have said before, Medicare Supplement plans are all Federally regulated by the government. There is no reason for anyone to pay more for their Medicare Supplement Plan G with one carrier over another because the letter of the plan dictates the coverage, not the carrier. You are not getting any additional benefits by paying more. That’s why it is important to shop your Medicare Supplement coverage every year, and we can help you with that.

You may ask, “Why do these companies charge different prices if they are all the same?” That’s a great question. Carriers have different administrative costs and they have different profit goals. There’s tons of different reasons why these big companies charge different prices. What you need to know is, just like in your Medicare book, Medicare Supplement Plan G is the same with every carrier.

Three of the most popular and most comprehensive Medicare Supplements for 2019 are Plan F, Plan G and Plan N. These plans are explained in the list below:

• Plan F “Full Coverage” – The name says it all. The Medicare Supplement Plan F covers the 20% that Medicare does not pay completely. You have no copays; no deductible and you can go to any doctor or hospital as long as they accept Original Medicare.

• Plan G “Greatest Value” – The Medicare Supplement Plan G will cover you exactly like the Medicare Supplement Plan F except for one difference; you will have to pay Medicare’s Part B annual deductible, which for 2019 is $183.00. After you meet that deductible the Medicare Supplement Plan G covers exactly like the Medicare Supplement Plan F. You have no copays; no deductibles and you can go to any doctor or hospital that accepts Original Medicare.

• Plan N “Not Fixed” – The Medicare Supplement Plan N is a really good plan. There are 4 differences between Medicare Supplement Plan F and the Medicare Supplement Plan N. Just like Medicare Supplement Plan G, you pay the Medicare Part B annual deductible of $183.00. After that is paid, you have up to a $20.00 copay per doctor visit, $50.00 copay per ER visit and you are responsible for Part B excess charges. This means that if the doctor does not accept Medicare assignment (charges more than what Medicare charges), you may have to pay up to 15% more.

MedicareBob’s recommendation for 2019 is the Medicare Supplement Plan G and these are the reasons why:

1. I like Medicare Supplement Plan G better than Medicare Supplement Plan F because it’s going to give you the same coverage at a greater value. The Medicare Supplement Plan F is going to cost you more in annualized premiums than the Medicare Part B annual deductible. On average the Medicare Supplement Plan F costs around $600 more annually than the Medicare Supplement Plan G. If they only difference between the two plans is that Part B deductible of $183.00, why pay an insurance carrier that much more a year for them to only pay $183.00 on your behalf? It doesn’t make sense.

2. I like Medicare Supplement Plan G better than Medicare Supplement Plan N because it’s going to keep your healthcare costs fixed. A lot of people are on a fixed income and one of the biggest unknown costs that any of us face, especially as we get older, is healthcare costs. The Medicare Supplement Plan G’s only out of pocket cost is going to be Medicare’s Part B annual deductible of $183.00, whether you have a good year or a bad year. The Medicare Supplement Plan N has extra costs with the copays and Part B excess charges. You don’t know how many times you may have to go to the doctor or ER in a year and you don’t know if the doctor is going to charge you Part B excess charges.

The 2019 Part D drug plans have been released and there have been a few changes made. In order to better understand these changes, you need to understand how drug plans work. Most drug plans have 4 levels of coverage: Deductible Level, Copay Level, Coverage Gap and Catastrophic Level.

The updates made to the Part D drug plans are as follows:

1. The standard deductible is $415. Keep in mind that a lot of carriers are offering a “Tiered Deductible”, meaning that the deductible does not apply to Tier 1 and Tier 2 medications. So, one would pay a small amount for Tiers 1 and 2 from the start.

2. The copay level, the plan pays 75% of their negotiated cost and the client pays 25% as their copay. Different plans get certain medications for lower and higher costs (formulary). This is one reason it is important to shop your Medicare Part D plan every year.

3. Coverage Gap (Donut Hole): Once the client and the Medicare Part D Plan have paid $3.820 for the medication costs, the client enters the Donut Hole. Great news! The Bipartisan Budget Act of 2018 moved up the date for closing the Donut Hole for brand name medications to 2019. This means, that for brand name medications, even when you enter into the Donut Hole, your copay will stay 25%. This should save many people a lot of money. Clients will still pay 37% of the costs for generic medications, but this is usually still a relatively small amount because most generic medications are affordable.

4. Once the client enters the Catastrophic level, when both the client and the Medicare Part D plan have paid $5,100, the plan will pay 95% of the cost and the client will be responsible for only the remaining 5%.