Medicare-Prescription-Drug

NOTE: Medicare Supplement (Medigap) Plan F and Plan C and High Deductible Plan F cannot be sold after January 1, 2020 to people who qualify for Medicare on or after January 1, 2020. If you have one of these plans you may keep it. If you want one of these plans and can medically qualify you may apply if you qualified for Medicare before January 1, 2020.

If you have a question about this please reach out to us and ask at 630-398-3329, fill out the ask us a question form, or schedule a quick appointment.

Medicare Supplement (Medigap) insurance plans are offered by private insurance companies and can help you pay for out-of-pocket costs for services covered under Original Medicare. Medicare Supplement plans are standardized in most states. What does this mean for you? All Plan Plans must cover Original Medicare gaps the exact same way. A Plan G is a Plan G now matter the carrier concerning coverage. There can be big difference in the premium that is charged for these plans. This is stated over three times in Choosing a Medigap plan 2017, 2018, and 2019 edition that Centers of Medicare and Medicaid Services (CMS) puts out each year.

Plans F, Plan G and Plan N are 3 of 12 types of Medicare Supplement plans offered in most of the states.

  1. Plan F covers 8 of the 9 (gaps) at 100% and 1 Gap with a $250 deductible then 80% up to $50,000 lifetime.
  2. Plan G covers 7 of the 9 (gaps) at 100%, 1 Gap is not covered (Part B deductible), and 1 Gap with a $250 deductible then 80% up to $50,000 lifetime.
  3. Plan N covers 5 of the 9 (gaps) at 100%, 2 Gaps are not covered (Part B deductible and Part B excess charges), 1 Gap has co-pays of up to $20.00 and $50.00, and 1 Gap with a $250 deductible then 80% up to $50,000 lifetime.

Excesses Charges allows a doctor that does not accept assignment to charge up to 15% above what Medicare approved for a covered service. An example is if the Doctor charges $150.00, but Medicare says that service is only allowed to be covered at $100.00; then the doctor could only bill you up to 15% of the $100.00. The remainder cannot be billed as this is called balance billing. You will normally be responsible for paying this excess amount out-of-pocket unless you have a Medicare Supplement insurance plan that pays this. Plan F and Plan G may cover Medicare Part B excess charges.

Note on doctors:

  1. Providers must tell you if Medicare would pay for the service if you got it from another provider who accepts Medicare
  2. Provider must tell you if he or she has been excluded from Medicare.
  3. Kaiser Family Foundation found that 96% of all Original Medicare providers accept assignment.

Look closely at each of the plans and see what plan you may want for your future health insurance needs and wants. We recommend that you pick two options when pricing out plans so you have an idea of what the price will be.

No recommendation was made on what plan may suit you for a reason. David stresses to look at plans that fit your needs and wants. None of these may fit those needs and wants, and that is alright. With over 711 different combination choices in many states, you want to work with people that look out for you.

David Cheatham

Founder & President of Family Financial Solutions Group, Inc.; Lead teacher and developer of a Medicare insurance education system “Your Medicare GPS”. He has taught over 10,000 people on Medicare or going onto Medicare concerning Medicare insurance and the many different options. David Cheatham has also spoken on national stages and has been seen on Fox, CBS, NBC, and ABC. Dave may be reached at www.yourmedicaregps.com

This is for educational purposes. Choosing a Medicare plan is not cookie cutter. You should always consult with a professional that works in the field of knowledge and be sure they are not treating you as everyone else. Your health and how you want your health insurance covered is unique.