Medigap Plan C
Medigap Plan C – is on our ‘proceed with caution’ list
Is your Medicare Part A and B effective date 1/1/2020 or later?
Medigap Plan C and F are not available for people new to Medicare on/after January 1, 2020. This means if your Part A and B effective date (on your Medicare card) is 1/1/2020 or later you can no longer enroll in either of these 2 Medigap plans. This is a Federal law change.
What should you do? Consider Medigap Plan G. Learn more here.
Is your Part A or B effective date prior to 1/1/2020?
If yes, please review the enrollment guidelines for Medigap plans on pages 14 – 16 of the document found here. If you do not meet these requirements, learn if you have a ‘guaranteed issue’. Information on this topic is on pages 21 – 23 of the same document mentioned above.
If you want help understanding this information, call us.
Other important information about Medigap Plan C
Monthly Premiums for Plan C vary by over 200% between the companies offering this plan to Idaho residents
Check current monthly premiums for Medigap Plan C (and Plan G and the rest of the Medigap plans) here. Notice the rate tables are broken down by 5 year age differences and there is a separate table for people that use tobacco and those that do not.
Note Idaho is an ‘Issue Age’ state; this means each company has a monthly premium for each age and each plan they offer in Idaho. This also means the rate tables mentioned above will give you the rates at 5-year intervals. We can help you with specific rates for all ages.
Notice the monthly premium difference between Medigap Plan C and Plan G. When you annualize these rates the Plan G annual premium is still less than the Plan C annual premium. This is why many people favor Plan G over Plan C. You get the same coverage for a lower annual out of pocket cost.
Insurance Companies with the lowest monthly premiums
We have always been cautious about recommending an insurance company with the lowest monthly premium for any Medigap plan. The Federal Government published a report about Medigap premiums and what the characteristics of ‘outliers’ are (companies with above normal increases in monthly premiums). If you have an interest in learning about these findings please read this information.
Annual Medigap Plan C Rate changes
Remember, monthly premiums for all Medigap plans can change annually. Budget 7-9% and be pleased if it comes in lower. Personnel in the Idaho Department of Insurance review each company’s financials before approving any annual rate increase request. Applications for a specific rate increases can be denied if the financials do not justify the request.
Your initial monthly premium will not change for 12-months. Be aware if the company you choose has their annual rate increase during your initial 12 month rate guarantee period, you will feel the affect of the interim rate increase on day 1 of your 13th month you are with that company.
Who are the top rated Insurance companies offering Medigap Plan C?
Financial ratings and the trends of these ratings (going up or down) are monitored by financial rating firms. This is one of the factors we use to add company’s to our ‘recommend list’.
Medical loss ratios change from year to year too. These change both at the state and national level (national level includes all states the company offers Medigap plans). If a specific company’s ratio is 3 points above the national average for all companies offering Medigap policies (prior years figure) or goes up noticeably when compared to last year, a ‘red flag’ goes up. We keep track of this information. This is the 2nd of 8 factors we use to rate companies.
If you want help selecting an insurance company for your Plan C (or any of the other Medigap plans), call us. We will help you with this and enrollment in the company you choose.
We encourage Idaho residents to avoid these Medigap Plans
Medigap Plan K, Medigap Plan L, and Medigap Plan M are NOT on our list of ‘Medigap plans Idaho residents should consider’ because of their low levels of national enrollment. Total Idaho membership in plans K, L, and M is less than 2% of all Idaho Medigap enrollees. Nationally, these three plans had similar enrollment numbers. We encourage Idaho residents to avoid these plans.
Should you get your prescription drug plan and your Medigap plan from the same company?
It is easy to say yes to this question. However, there there is a process for selecting a prescription drug plan and we encourage you to consider the points below before you agree to enroll in any plan. These are:
if the plan covers all of the medications you take;
the plan’s Medicare star rating (learn more here); we do not recommend plans whose star rating is below 3 and prefer plans with at least a 3.5 star rating;
which pharmacies in the plan’s network offer the lowest fill/refill rates (pay attention to this);
if the plan offers a mail order pharmacy whose 90-day refill rates are lower than you going to the counter to get refills;
consider the plans meeting the above criteria that have the most medications in their own formulary; in 2020 the plans available to Idaho residents varies by over 900 medications in their respective formularies. This information is available here and was checked on 1/19/2020.
consider the 3 plans with the lowest annual out of pocket cost for the med’s you take and meet the above criteria; we encourage you to do this annually because insurance companies can and do change their plan details annually. These changes will affect your out of pocket cost.
We have noticed the annual cost for the same set of medications can vary by as much as 300% or more between prescription drug plans (PDP). If you do not compare your annual cost for a PDP before enrolling in a plan, you open up yourself to paying more for your medications. When you work with an independent agent that covers both Medigap and prescription drug plans, they should be able to help you find the insurance companies offering the lowest annual cost for the medications you take and have the pharmacies in their preferred network (they offer lower cost than ‘network pharmacies’) that are close to you.
If you want help selecting a prescription drug plan and are a resident of Idaho, call us.
Idaho residents interested in a Medigap Plan
Call us at (208)-867-0296 if you would like to learn more about Medicare Plan C coverage and benefits.
We are here to help.
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