MedicareBob

This Rate Watch Wednesday is focused on Medicare Supplement Plan G, for a male and female, ages 65 thru 75 in Tucson, Arizona (zip code 85704). 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.

One question that has been asked regularly is “What does the Medicare Supplement Plan G cover?” The Medicare Supplement Plan G offers almost exactly the same coverage as the Medicare Supplement Plan F. One of these coverages is Medicare Part B Excess Charges. The Medicare Supplement Plan G does cover Part B Excess Charges.

Every provider and doctor that excepts Medicare has one of two contracts with Medicare. They can accept what’s called “Medicare Assignment”, meaning that they will not negotiate with Medicare on prices. Medicare will dictate what they can charge for a service such as lab work, MRI, CAT scan etc. Doctors or providers that do not accept Medicare Assignment are permitted to charge more than what Medicare allows, however they can not charge more than 15% of the assigned rate.

If you have just Medicare Part B, you are susceptible to those charges but with the Medicare Supplement Plan G, you have nothing to worry about because the Medicare Supplement Plan G pays for you.

The Medicare Part A deductible is a hospital deductible. Every time you go to the hospital, Medicare will charge $1,340 if you only have Original Medicare Parts A and B. It is important to understand that this IS NOT an annual deductible, it is per coverage period or per occurrence. If you are hospitalized you will have to pay the $1,340; if you are hospitalized 3 months later, you will have to pay the $1,340 again.

One important factor of this deductible that you need to know is that if you go to the hospital, are released but go back for the same reason within 60 days; they cannot charge you that deductible again. However, if you go back to the hospital for the same reason outside of that 60-day period, the hospital will most likely charge you that deductible of $1,340 again.

Medicare does cover the Endoscopy procedure. Endoscopy is considered an outpatient procedure. Medicare Part B (Medical Insurance) covers medically necessary diagnostic and treatment services you get as an outpatient from a Medicare-participating hospital. If you just have Original Medicare, Medicare will pay 80% and you generally pay 20% of the Medicare-approved amount for the doctor or other health care provider’s services, and the Part B deductible applies.

If you have a Medicare Supplement like Plan F, Plan G or Plan N; Medicare will pay 80% and your supplement will pay the 20%. As long as you have met your Part B deductible with Plan’s G and N, you will not have any out of pocket cost.

This Wednesday Rate Watch is focused Medicare Supplement Plan G, for a male and female, ages 65 thru 75 in Sun City, Arizona (zip code 85345). 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.

Medicare does cover the Endoscopy procedure. Endoscopy is considered an outpatient procedure. Medicare Part B (Medical Insurance) covers medically necessary diagnostic and treatment services you get as an outpatient from a Medicare-participating hospital. If you just have Original Medicare, Medicare will pay 80% and you generally pay 20% of the Medicare-approved amount for the doctor or other health care provider's services, and the Part B deductible applies.

If you have a Medicare Supplement like Plan F, Plan G or Plan N; Medicare will pay 80% and your supplement will pay the 20%. As long as you have met your Part B deductible with Plan’s G and N, you will not have any out of pocket cost.

This Wednesday Rate Watch is focused on Medicare Supplement Plan G, for a male and female, ages 65 thru 75 in Phoenix, Arizona (zip code 85001). 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.

Medicare Supplement Plan G covers everything that Medicare covers, so it does cover care in a Skilled Nursing Facility. For Medicare cover you in a Skilled Nursing Facility you have to have a qualifying 3 days or more admission to a hospital. If you are transported to a Skilled Nursing Facility, Medicare will cover the first 20 days. However, starting day 21, you would normally have to pay out of your own pocket to continue care. If you have the Medicare Supplement Plan G, it will pay the per day co-pay that Medicare does not pay starting day 21 to day 100. With Medicare and Medicare Supplement Plan G, if you should need the care of a Skilled Nursing Facility, you will be covered for 100 days of care at no cost to you.

It’s August and many of you have hit the dreaded Donut Hole either recently or within the last couple months. People have been asking the questions, “When can I change my drug plan?” or “When do the 2019 Part D drug plans come out?” This is how the dates work:

• Medicare has what is called an Annual Election Period or Annual Enrollment Period. The official date that you can change your drug plan is October 15th through December 7th. However, the change will not take effect until January 1st 2019.

Here is some information that some of you may not know. The new drug plans are actually released on October 1st. You can either go to Medicare’s website, enter in your medications and Medicare will sort which Part D drug plan is the most cost-effective for you or you can speak with an agent and they can walk you through it. Now keep in mind, you will be on your drug plan for the remainder of 2018 because your new drug plan will not take effect until January 1st 2019.

If you take Humira or another prescription that you can get administered by a healthcare professional you are better off getting it done that way. Some prescriptions like Humira have the option to have it ordered through your Part D drug plan or you can go to a doctor’s office and they’ll administer it for you.

If you do it yourself, you will have to order it through your Part D drug plan, which can be very expensive and put you into the Donut Hole. If you have the option of getting it administered by your doctor through their office, it will be billed as a Medicare Part B service. So, if you have a Medigap or Medicare Supplement plan, Medicare will pay 80% and the supplement will pay the remaining 20%. Humira would be at little to no cost to you.