Medigap Plan G
Why we like Medigap Plan G!
Medigap Plan G pays all left over Medicare Part A and B costs (except for the Medicare Part B annual deductible)
This means your annual Medicare covered health costs are limited to your plan’s monthly premium plus the annual Part B deductible.
Equally important, you have a choice of all doctors/hospitals/other providers in the USA that accept Medicare. Be aware, prior authorizations for Medicare covered health care are also minimized.
Advice for people moving to Idaho (or planning to move here soon).
- If you have a Medicare Advantage plan now you can switch to a Medigap plan without going through underwriting. There is a timeframe you need to get this done. We can guide you through the process.
- If you presently have a Medigap plan, we recommend you compare your current monthly premium to the same plan available in Idaho. For example, Plan G is available for $220/less. Plan F is available for less than $250. Call us if you want a quote for a different Medigap plan.
- If you have chosen to stay with Original Medicare (Part A and B), we recommend you consider adding Medigap Plan G H-deductible. Why? Because you presently have no ‘cap’ on your share of the left over costs when you use Part A and/or B services. Call us for details.
What else you need to know about Medigap Plan G
Your exposure to the high cost of Part B Medications is minimized
A refresher on Part B medications is available here. Please take the time to read this.
You and I do not know when we will be diagnosed with a health issue when these medication(s) will be needed.
A recent publication by the Kaiser Family Foundation pointed out the importance of having good insurance coverage for these med’s. It also points out your financial exposure if you have a Medicare Advantage plan or inadequate coverage for this important service. Please take a few moments and read this article. Having this coverage could save you a significant part of your retirement savings.
‘Excess charges’ are covered
Medigap Plan G and Medigap Plan F cover ‘excess charges‘. The other 8 Medigap plans do not. We feel the value of this benefit will continue to grow in the future.
Having these costs covered minimize your out of pocket costs and give you more flexibility in the physicians you choose.
Coverage for emergency health care outside of the United States is included
Plan G includes $50,000 of emergency health care coverage outside of the United States. Your policy will cover 80% of actual charges; this means you are responsible for the remaining 20%. You also have a $250 deductible for each claim. Read your policy for additional details.
We recommend individuals also consider getting travel health care insurance for any trip outside the US.
When Can I enroll?
Enrollment rules are defined here. This is important information to understand.
If you miss this window (and do not have a ‘guaranteed issue‘) you will have to answer the health history questions on the application. Depending on your answers, your application can be denied.
How much will Medigap Plan G cost?
There are two parts to this answer. First, you need to be enrolled in Medicare (Part A and Part B).
Most people get Part A at no cost. Check these rules to see if this includes you.
There is a monthly premium for Medicare Part B. People in higher income brackets will pay more for Medicare Part B and their Medicare Part D monthly premium. Be aware of this as it will affect your retirement budget.
Medigap Plan G Premiums
There are 3 different rate charts for all Medigap plans available in Idaho. One is for people that do not use tobacco, the 2nd is for those that do, and the 3rd is for people under age 65 that are enrolled in Medicare.
Each company offering Medigap plans set their own premium for each plan and for each of the 3 rate charts.
Current monthly premiums are available here.
Did you notice the monthly premiums vary by 100% to 200%+ for each plan from all companies?
Why such a wide variation?
Two reasons come to mind. First, each company sets their own premiums when then enter a market, like Idaho. Companies that want to grow their market share may set their premiums at a competitive level. More conservative companies may set them higher. Sometimes rates are much higher. Since each plan provides the same coverage, the monthly premium may be the key differentiator in your choice of companies.
A few companies include services not covered by Medicare. These could include a gym membership, a ‘household discount’, or other extras. If these features are important, they should be factored in the decision on which company to do business with.
Be aware of the details each ‘extra benefit’. For example, does the gym membership include facilities I presently use; are they close to me? If a plan includes limited dental coverage are the dentists you prefer in that plan’s network? Are a variety of dental skills available in the network? If a ‘household discount’ catches your attention, look at the net premium and compare it to your other alternatives. Also recognize the company can drop these extra benefits
Why would a company purposely set their initial rates high?
Keep in mind with the recent Idaho law change, people can change companies and get the same plan at a lower rate. This can be good for the policy holder and may not be so good for the company. Why? Because people with higher medical claims will be attracted to the company(s) offering their plan at a lower premium. If a company has more policy holders with higher claims experience than projected, they may need to ask for a larger annual rate increase.
Annual Rate changes
Remember, monthly premiums for Medigap Plan G can go up annually.
What variables influence this increase?
Inflation, the cost of providing health care services and the claims experience the company has with existing plan members. The effectiveness of the insurance company and how it manages expenses is also important.
Annual rate increases can go up higher than 7 – 13%.
Underwriting…should I be concerned?
Maybe. There are different rules you should be aware of. They depend on your specific goals.
If you want to get the same plan from a different company offering a lower premium, you can make the move during your annual ‘birthday window’ WITHOUT going through underwriting. Your ‘birthday window’ starts on your birthday and lasts for 63-days.
If you want to make a change outside of your ‘birthday window’, you will have to answer the underwriting questions and your application could be denied based on your answers. Also, if you wish to switch to a ‘more comprehensive’ plan, underwriting also comes into plan.
Please read the rules (and answers to frequently asked questions) here.
How long should you keep your plan with your current insurance company?
Compare your current plan’s monthly premium to the other companies offering the same plan. Do this during your birthday window. We help you with this.
When the difference between your current premium and what another company is offering is meaningful to you, consider changing companies. Again, we can help you thru this process.
We feel this difference in premiums is better in the pocketbook of the policy holder than an insurance company’s bank account.
If you work with us, we will notify you about 30-days before your birthday window if you can save money by switching plans. If you want to make the change, we will guide you thru the process. It takes about 15-minutes to change companies and enroll in the same plan.
What other Medigap plans we recommend Idaho residents consider
Medigap Plan G, the HI-deductible version of Plan G, Plan F, Plan N and in certain situations Plan A, B, C and D.
Plan G Hi-deductible often gets overlooked. This option can be very attractive to some individuals. Characteristics include healthy people that want lower premiums and coverage that gives them protection from high health care costs. Don’t forget about flexibility of doctor and hospital choices too. This means any doctor/hospital that ‘accepts Medicare’ in the USA…that is your network.
This is how this plan works. When the plan member uses Part A and/or Part B services, Medicare pays its share. The left over costs that Medicare doesn’t cover the plan member pays. When the plan members out of pocket costs for Part A and B services hits the plan’s deductible for the year, that is all the plan member pays. The deductible starts over on January 1 each year. We like this plan.
We encourage people to think twice before joining Medigap Plan K, L, and M
Medigap Plan K, Medigap Plan L, and Medigap Plan M are NOT on our list of ‘Medigap plans people should consider’. Why? Because of their low levels of national enrollment. We encourage Idaho residents to avoid these plans. The above-mentioned report notes that the combined 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 recommend Idaho residents consider either Plan G Hi-deductible, F Hi-deductible or Plan N in lieu of K, L, and M. Look at the monthly premiums of these 3 alternative plans and your out of pocket costs when you use plan services.
Your Medicare prescription drug plan
We offer annual reviews of our customers prescription drug plan too. This is another area were those not paying attention to plan changes can cost people. We typically see a 300% +/- difference in the annual out of pocket costs (monthly premium + refill cost) between plans available in Idaho. Again, we feel savings generated by switching plans, are better off in our customers pocket.
Idaho residents interested in a Medigap Plan
Call us at (208)-867-0296 if you would like help with your Idaho Medicare insurance choices. We have been helping Idaho residents since 2012 with Medicare decisions, enrollment, and ongoing annual reviews.
Working with an independent agent which resides in Idaho and specializes in Medicare/Medigap makes good sense.
Learn more about us before you call.
We are here to help.
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