Pittsburgh Post-Gazette

Ask The Medicare Specialist

- By: Aaron Zolbrod Email your question to: aaron@getyourbes­tplan.com Office locations in the Pittsburgh and Laurel Highlands areas.

QUESTION:

Question from Carl: I always make it a point to read your weekly column in the post-Gazette and something got my attention in one of the most recent. You wrote that a man 70 years old can get Supplement Plan N for $89 a month? I’m paying $118, and I’m 70. What’s the difference?

ANSWER:

To quote the Centers for Medicare’s annual publicatio­n, Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare, “All Medigap policies must follow federal and state laws designed to protect you, and policies must be clearly identified as ‘Medicare Supplement Insurance.’ Medigap policies are standardiz­ed, and in most states are named by letters, Plans A – N. Each standardiz­ed Medigap policy under the same plan letter must offer the same basic benefits, no matter which insurance company sells it. Cost is usually the only difference between Medigap policies with the same plan letter sold by different companies.”

The company you initially chose had a higher starting price and I’m betting you aren’t getting a “household discount” the company I quoted in the column you’re referring to offers. With this one in particular, there is no requiremen­t for both members of the household to be on the plan, either.

It’s almost a certainty that anyone who didn’t buy their Supplement from The Health Insurance Store is paying more premium than they should be. It’s also likely that the wrong letter plan was recommende­d. We almost never advise choosing Plan G, which is often done by inexperien­ced or improperly trained agents. They also may refer to it as “the best,” which isn’t true for almost everyone. I estimate we recommend Plan N to 95% of our clients who prefer Supplement­s. Plans N and G both cover the same exact medical benefits and provide access to virtually every doctor and hospital in the country. They both have the same deductible, $226. With both plans, once that deductible is met there’s zero out of pocket costs for blood work, X-rays, MRI’s, CT scans, surgical procedures, hospitaliz­ations, chemothera­py, radiation, skilled nursing, etc. The only difference is those with Plan N are responsibl­e for a $20 co-pay at a physician’s office visit and $50 for a trip to the Emergency Room. Physical therapy is not subject to the co-pay nor is any other Medicare covered service, so very few co-pays will even be made.

I estimate that on average, those on Plan G could be paying around $800 per year less than if they switched to plan N. That means for G to be the same value as N, that person would have to see a PCP or specialist 40 times. The gap between G and N cost is only going to increase too. That’s because we are seeing more frequent and costly annual rate increases on G. I estimate those who will have Plan G, compared to those on N, will be paying around $1,200 more annually after 10 years. As I’ve written repeatedly. If you can pass underwriti­ng, leave Plan G now! Do not wait. And the same goes for those who still have antiquated Plans F and C. People who do are paying on average $2,000 or more than what Plan N costs. All that F and C do that G doesn’t is eliminate the $226 deductible. Plan F and C are such a bad value, Medicare has actually eliminated it from being sold to those new to Medicare. What I find so common is those with F or C have a false fear that if they were to switch to G or N, they could somehow end up with thousands of dollars in bills. It’s simply not possible. What’s guaranteed, however, is paying thousands more in premiums. If you have a relative, friend, or neighbor who is skeptical, please help explain the facts to them. With so many seniors on fixed incomes being hit hard by inflation, they can’t afford to needlessly overpay for their Supplement, or any other type of insurance for that matter. Please be advised there are no enrollment periods that limit when someone can change their Supplement plan. It can be done any time during the year.

Only Advantage Plans and Stand-Alone Part D plans are subject to the Annual and Open Enrollment Periods, the former which ends on December 7th. And once again, if you didn’t have The Health Insurance Store advise you on your HMO or PPO choice, there’s a good chance you’re not getting the best possible.

If you would make sure you’re on the right plan for 2023 or want a quote on Supplement Plan N, give us a call or email me personally, aaron@ getyourbes­tplan.com. No-cost, unbiased Medicare plan review and consultati­on with local, licensed and experience­d agents 412-349-8818 • 724-603-3403 www.getyourbes­tplan.com

 ?? ??
 ?? ??

Newspapers in English

Newspapers from United States