MedicareBob

Medicare Supplement Plan G, also known as Medigap G, is a Federally standardized plan and it’s a true Medicare Supplement Medigap. The way that the Medicare Supplement Plan G works is that Medicare Parts A and B is your primary insurance. Because Medicare remains primary, you have nationwide coverage, even with your Medicare Supplement. So, you can go from one county to another or one state to another and have full coverage. Your coverage will remain exactly the same is every county or state you are in, as long as you go to a doctor or hospital that accepts Original Medicare. You will not need referrals or any prior authorizations.

The only out-of-pocket costs you have if you have a Medicare Supplement Plan G is Medicare’s Part B small annual deductible of $183.00. Once you’ve met that deductible you have no further out-of-pocket costs for Medicare covered services nationwide.

A Medicare Advantage Plan is not a Supplement Plan, it is a private alternative to Medicare. A Medicare Advantage Plan will not pay the bills that Medicare would normally pay, instead a Medicare Advantage Plan will charge you a different deductible, different copays and different co-insurance compared to Medicare.

Medicare Advantage Plan Summary:

• Low monthly premium. (Sometimes advertised as $0.00 per month)

• You will usually have to pay a fee every time you use the plan. ($15.00 copay for PCP visit, $300.00 per day each day you are in the hospital, etc.)

• You have to go to certain Doctors, Hospitals and Providers. (HMO or PPO Network)

• You will have to get prior authorizations for some procedures.

• You will have to get referrals to go see a specialist.

When Congress passed the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, Medicare went through a huge change. Among other things, this act started the beginning of Medicare Part D prescription drug coverage. Since Medicare Supplements can no longer be sold with prescription drug coverage, the Medicare Supplement Plan G does not offer prescription drug coverage.

The supplements all use stand-alone drug plans, Medicare Part D. The great thing about using a stand-alone drug plan is that you can shop for the drug plan that is the best value and covers your medications the best. Every Part D plan is different based on the medications you're taking at that time. There is no way to list an exact cost for these plans. The good thing is you can shop these plans every year during Annual Enrollment (starting Oct. 15th and ending Dec. 7th) and we do that for our clients every year as a service to them.

Medicare and Medicaid are two separate, government-run programs that were created in 1965 in response to the inability of older and lower-income Americans to buy private health insurance. They were part of President Lyndon Johnson’s “Great Society” vision of a general social commitment to meeting individual social, economic, and health care needs. Medicare and Medicaid are social insurance programs that allow the financial burdens of illness to be shared among healthy and sick individuals, and affluent and lower-income families. Medicare and Medicaid are different in several respects: they are run and funded by different parts of the government and primarily serve different groups.

This Wednesday Rate Watch is focused Medicare Supplement Plan G, for a male and female, ages 65 and 70 in Cook County Illinois (zip code 60005). 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.

As long as you are working for an employer that has more than 20 employees and you have active group insurance through your employer, you have the option to defer your Medicare and you can start your Medicare when you retire and you will not have a penalty.

If you are turning 65 and you’re retired, you have to take Medicare Part B otherwise you be penalized in the future.

If you are still working but you work for a small company that has under 20 employees, you will most likely have to take your Medicare Part B because your group is not larger than 20 or more.

If you are still working and your company has a group that is larger than 20 people, but you didn’t take their health insurance because you retired from a previous job and you have retirement health insurance benefits through your former employer; you would have to take Medicare Part B or join your current employer’s group plan.

This Wednesday Rate Watch is focused Medicare Supplement Plan G, for a male and female, ages 65 and 70 in Dekalb County Georgia (zip code 30002). 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.

You can use your home health benefits under Part A and/or Part B. Medicare covers medically necessary part-time or intermittent skilled nursing care, and/or physical therapy, speech-language pathology services, and/or services if you have a continuing need for occupational therapy. A doctor, or certain health care professionals who work with a doctor, must see you face-to-face before a doctor can certify that you need home health services. A doctor must order your care, and a Medicare-certified home health agency must provide it.

Home health services may also include medical social services, part-time or intermittent home health aide services, durable medical equipment, and medical supplies for use at home.

Medicare covers many medically necessary surgical procedures, so as long as the cataract surgery is medically necessary, Medicare will cover it.

For surgeries or procedures, it's hard to know the exact costs in advance. This is because no one knows exactly what services you'll need. If you need surgery or a procedure, you may be able to estimate how much you'll have to pay. You can:

1. Ask the doctor, hospital, or facility how much you'll have to pay for the surgery and any care afterward.

2. Find out if you're an inpatient or outpatient because what you pay may be different.

3. Check with any other insurance you may have to see what it will pay. If you belong to a Medicare health plan, contact your plan for more information. Other insurance might include:

• Medicare Supplement Insurance (Medigap) policy

• Medicaid

• Coverage from your or your spouse's employer

4. Log into MyMedicare.gov, or look at your last "Medicare Summary Notice" (MSN) to see if you've met your deductibles.

This Wednesday Rate Watch is focused Medicare Supplement Plan G, for a male and female, ages 65 and 70 in Jefferson County Alabama (zip code 35005). 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.