Ask The Medicare Specialist

QUESTION:

I know that Supplement plans Question from Nancy P: are all the same as far as coverage goes, but are the rates the same for each company regardless of how they’re purchased? For example, does Supplement Plan N with United Health Care cost the same regardless of which broker it’s purchased from, or if it’s bought directly from the insurance company? Does Aetna or other Supplement companies have the same prices as United for Plan N?

ANSWER:

Before I get into this excellent question, I want to remind everyone that a Supplement is one of the two choices those on Medicare have to protect themselves from possible catastrophic medical costs that Original Medicare alone exposes people to. The other is a Medicare Advantage Plan HMO or PPO. Most agents, brokers, or even the insurance companies, when called directly, don’t give both options, all the differences, pros and cons, or risks versus rewards on Supplements and Advantage Plans. The choice one makes when going on Medicare for the first time or choosing to leave a Supplement for an Advantage Plan can have lifelong consequences. Supplements plans can only be sold labeled with letters A through N. For those who turned 65 after January 1st, 2020, there are only 9 choices: A, B, D, G, K L, M, N, and High Deductible G. Nancy is correct. There is no difference on what is covered by different Supplement companies selling the same letter plan. In other words, Plan N is N is N and G is G is G regardless of what company sells it. There’s also no difference in what doctors and hospitals that can be used. Any who accept Medicare Assignment also accept Supplements from every company. This means the only difference between companies selling the same letter plan is cost. So, to answer one part of Nancy’s question, premiums ARE NOT the same from company to company. They can actually vary quite a bit for people of the same age and gender.

The answer to the second part of Nancy’s question, prices don’t vary based on what broker you use and are also the same if you go directly through an insurance company. However, it’s very important that you choose a licensed agent who’s experienced and knowledgeable because there are close to 20 companies selling Supplements in Western Pennsylvania and only a handful have a good reputation for keeping rates down long term.

There are also new and valuable discounts available that only the most knowledgeable brokers are aware of. Every agent here at The Health Insurance Store can be relied upon to explain all options correctly, ensure that all discounts are applied, and the differences between letter plans understood. We also take great pride in taking care of clients after a policy is purchased. Our staff is always available to answer questions and step in to fix billing errors or claim issues as well as help find financial relief in the event of the need for expensive medications. We also provide an annual plan review and recommendation. Some very common mistakes made by inexperienced brokers is recommending Plan G to everyone, simply explaining “It’s the best,” leading people to believe choosing N, which we recommend to over 90% of those who prefer Supplements, could somehow expose them to thousands of dollars in medical bills, which simply isn’t true. Over time, Plan N saves thousands upon thousands of dollars versus G. Most agents also don’t understand how “Medicare Excess Charges” work and will sell Plan G because that’s covered while it isn’t with N. Coverage for Excess Charges isn’t necessary because it can only be applied by doctors who don’t accept Medicare Assignment. Every single full-service hospital in the country accepts Medicare Assignment and all doctors employed by them do as well. The bottom line is only the super-rich see doctors who don’t accept Medicare. We’ve had over 10,000 clients on Plan N and not one has ever been billed Excess Charges.

Some common mistakes made by those on Medicare is choosing a plan and paying more premium based on the familiarity of the company selling it. Again, those companies don’t provide any more coverage or access to doctors and hospitals. In addition, a well-known name on a Supplement card is no more valuable than another based on the following: Medical providers don’t even bill Supplement companies. They bill Medicare. Medicare has it on file who the beneficiary’s Supplement is with and coordinates getting the doctor or hospital paid in full. Supplement companies also have no say in what’s covered. Medicare decides that and allows treating physicians to make the call on what’s medically necessary. There is never a need for a prior approval from Medicare for services such as MRIs, CT scans, PT, surgical procedures, and virtually every other Medicare covered service. Supplement companies are basically paper pushers and check writers. They are told by Medicare what they owe and who they owe it to. They can’t argue about that or hold up payments to providers. Because Supplements are so well regulated and there’s no ambiguity in the regulations, insurance companies must be on their best behavior.

Another error those on Supplements make is a failure to move from antiquated plans F and C out of fear that Plans N or G would leave them with tens of thousands of dollars in bills. The fact is that can’t happen and the only difference between F and C versus G is the small $240 Part B deductible, and the same deductible, a $20 physician’s and $50 ER co-pay on N. Those still on the ridiculously overpriced C and F can literally save up to $2,000 per year or more moving to G or N. Supplement letter plans and companies can be changed all year round. There are no election period limitations. There is also currently still time remaining where anyone on an Advantage Plan can move to a Supplement if they can pass underwriting.

If you have questions regarding today’s column or any other Medicare topic or would like to make an appointment for a no cost consultation, give us a call. You can also email me personally at aaron@getyourbestplan.com.