You are guaranteed enrollment in a Medicare Supplemental plan until six months have passed after your part B enrollment date.
You want to make sure that you take advantage of this window of opportunity. Once the 6 months has passed after signing up for part B, an insurance company has the right to decline coverage. However, during guaranteed enrollment, they have no choice but to accept you for coverage. For those who have been on disability and are turning 65, you have the same open enrollment period.
So, with all the choices in coverage and all the companies offering coverage, which one should you select?
There are two philosophies – both have different advantages.
All Medicare Supplemental plans (A thru N) are standardized by the Federal Government. What does that mean? Each company will provide identical benefits for each plan. You cannot be singled out for cancellation – No matter how many claims you file.
Most people select plan G since it provides comprehensive coverage and it will cover excess charges doctors may charge their patients. Did you realize that a physician can legally charge 115% of the allowable charges outlined by Medicare? Plan G pays those excess charges. Now that you understand that coverage is identical for Plan G from each company....
What company to choose? Why not select the company with the most reasonable premium?
Premiums for plan G range from just over $120 per month to $200+ per month for the same coverage of a 65-year-old insured. (You should read page 19 of the Shoppers Guide to Choosing a Medigap Policy) I can provide a copy of this guide for you.
We represent just about every company authorized to do business in the state we are licensed. As a broker, I choose to represent just a few – those with the lowest premiums.
We used to make a selection based upon the lowest overall premium for your lifetime. However, with the Adopted rule change “The Birthday Rule” we want to go with the lowest premium, because with the “Birthday Rule” law – you will have the opportunity to change plans each year for 30 days beginning on your birthday with no medical underwriting and no preexisting conditions.
With most companies when you enter a plan your rates are locked in for twelve months with no increase.
You can purchase directly from a company or you can go through agents like us for the same price and have a service-oriented batter to step up to the plate if a problem ever occurs.
The Other Philosophy is the Medicare Advantage Health Plan.
There are several Preferred Provider (PPO) and HMO plans out there. I recommend staying away from them. If you step out of the service area with some of these plans you could wind up paying much more than expected. While I certainly get paid more for selling these Medicare Advantage plans, Med Sup G is far superior coverage. Remember – Medicare Advantage plans do a change in benefits each year and you may need to change doctors occasionally.
I strongly recommend staying away from these plans since they are costing the taxpayer much more than those on Original Medicare and a Supplement; and the passage of the healthcare reform bill in 2010 dramatically cuts funding for Medicare Advantage plans. Plan N Medicare Supplement to me is a very viable choice rather than a Medicare Advantage Plan.
In some circumstances a Medicare Advantage Plan may work better for an individual than a Medicare supplement plan. We would need to talk with you first to determine if you are one of those individuals.
To select the best choice for YOU - there are two key factors
-
Health: now and family health history
-
Ability to pay premiums
Plan G is superior coverage and if premiums are paid you have little to no out of pocket expenses after the annual Medicare Part B deductible is met ($257 in 2025) – easy to budget your health care expenses. Plan G doesn’t change every year on you other than the annual deductible that is determined by Medicare – the deductible is tied to an index that rises very slowly.
PFFS PPO & HMO could have lower premiums but you have co-pays many steps along the way. If you like these types of plans I think you will be happier in a Plan N Medicare Supplement.
I do many enrollments for Medicare Supplements and many feel the time I spend with them valuable to help sort out the Medicare questions they have.
What about Prescription Drug Coverage?
Most likely your largest expense in retirement.
With all the choices out there – Which one should you choose? You will need to select one now, since Medicare penalizes you later on if you don’t get one when first eligible.
There are three factors that affect your choice. 1. Premium of the plan 2. Schedule of Benefits 3. and the most important: the price you will pay for the prescriptions you take. This is where I really go to bat for my clients.
Employer plans used to offer retirees an advantage because of their Prescription benefits – but now that Medicare has Prescription Drug Plans, employer plans are not as attractive. Don’t be afraid to look around - leaving the employer umbrella might be a good thing.
The secret to getting the best bang out of your dollar - is not to go out and buy the first plan you see or from the first agent that says they have what you need.
The preferred sequence of events is for you to send a list of prescriptions that you are taking so I can do the research in my office, then I bring the solutions to you. Click here for a form to send me your information for me to research plans for you and make a recommendation.