Medicare Supplement Plan N Archives | Georgia Medicare Plans

What Does Medigap Plan N Cover?

Bob Vineyard · March 13, 2015 ·

What does Medigap plan N cover?

Medigap Plan N is a relatively new Medicare supplement plan that came into existence in 2010. It is now the 3rd most popular plan in Georgia behind plans F and G.

Medigap plan F is oversold for many reasons, not the least of which is the high premium and corresponding high commission. Many Medigap brokers take the easy way out and simply try to compete on price for plan F without ever explaining the value of plans G and N.

Simply stated, Medigap plan N covers 100% of your approved Medicare Part A hospital expenses in the same was as plans F and G. Approved Medicare Part B charges have cost sharing under plan N.

When you have the N plan you are responsible for office visit copay’s up to $20, ER copay’s up to $50 and any excess charges incurred when you use a provider that does not take Medicare assignment.

httpv://www.youtube.com/watch?v=2wZbLoBKceM

Does Medigap plan N include out of country coverage?

Only Medicare supplement plans F and G include some coverage when you travel outside the United States.

For the most part, original Medicare does not cover out of country charges. Exceptions would be if you had a medical emergency while in a neighboring country like Canada or Mexico and it was not reasonable to travel to the U.S. for treatment.

Medigap plans C, D, F, G and N will pay 80% of emergency medical expenses after a $250 deductible. Refer to Medicare publication 11037 for more details.

Anytime you travel out of the country you should always consider purchasing a travel medical plan as offered by HCC.

What are Medicare excess charges?

Excess charges occur when a Medicare beneficiary uses a provider that does not accept Medicare assignment. Since 96% of providers DO accept assignment it is not an issue that will come up with any frequency.

If you do decide to use a provider that does not take assignment, be aware when you have Medigap plan N you are responsible for any balance billing by the provider once Medicare has approved your claim.

Excess charges are capped by Medicare. The calculation works like this.

If the Medicare approved amount for a Part B expense is $100 (and you have satisfied your Part B annual deductible), Medicare will pay you 80% of 95% of the Medicare approved claim. The claim is initially reduced by 5% for a non-par provider which means the MAC (Medicare approved claim) is now $95. Medicare pays you 80% of $95 or $76.

Your Medigap plan N will pay you 20% of the 95% or $19.

Your doctor is allowed to bill you 15% in excess of the $95 MAC.

At this point you have received $76 from Medicare, $19 from your Medigap plan N carrier. The claim is capped at $109.25 which is referred to as the limiting charge.

In this case you will owe the doctor $14.25 out of your pocket.

Your doctor is required to submit your bill to Medicare and must wait until Medicare has adjudicated the claim and you have received payment from Medicare and your supplement carrier before they can bill you.

Why pick Medicare supplement plan N?

For many people it is a cost effective alternative to most Medicare Advantage plans. Medicare Advantage plans have doctor and hospital networks that may be inconvenient for you, the patient. The cost sharing under Medicare Advantage plans can be significant, as much as $6700 in 2018 and that is just for IN network approved charges. Your out of network charges are in addition and may not be capped at all.

It is rare for a Medicare beneficiary with plan N to have out of pocket expenses that exceed $500 per year and with most people your out of pocket is considerably less.

Medigap plan N offers more value than plans F or G for most people but it is not for everyone. If you have a chronic condition that requires multiple doctor visits over the course of a year, plan N may not be the best plan for you.

I turned 65 in September of 2015 and chose Medicare supplement plan N for myself. Next April when my wife goes on Medicare she will probably pick the same plan.

How much can you save with plan N?

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Mutual of Omaha Plan N Rate Increase

Bob Vineyard · July 31, 2014 ·

Mutual of Omaha will be raising rates on Medigap plan N. The plan was introduced by United of Omaha (a Mutual of Omaha subsidiary) in 2010 and pulled from the market less than a year later. Individuals that bought plan N either moved to another carrier (if they were healthy), kept the plan (and the rate increases), dropped Medigap completely or enrolled in a Medicare Advantage plan.

It is highly unlikely plan N enrollee’s were able to move to another Medicare supplement carrier since the United of Omaha plan N was guaranteed issue when first introduced.

Mutual of Omaha no longer offers plan N, nor do they use United of Omaha in Georgia. United of Omaha was replaced by Omaha Insurance Company in October, 2013.

Omaha Insurance Company rates were approximately 26% less than United of Omaha rates for the same plan.

On October 1, 2014 United of Omaha plan N policyholders will receive a 9.9% rate increase in Georgia.

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Proposed Medicare Changes Will Hurt Georgia Seniors

Bob Vineyard · January 28, 2014 ·

The DC spending monster is hungry and proposed Medicare changes means they expect Georgia seniors to feed them. Their solution calls for shared funding and shared responsibility. That translates into you tightening your belt while Congress pigs out. They want more of your money so they can feed entitlement programs for the poor. Congress thinks you should take fewer prescription drugs and limit the number of times you see the doctor.

Why Are Medicare Changes Being Considered?

Congress spends every dollar they take in and borrow another 40% on top of that to pay their bills and fund more free stuff. In order for them to continue giving away free stuff you need to stop spending their Medicare dollars on frivolous things like medication and needless doctor visits. Just look at this CBO report from November, 2013 that proves you are wasting Medicare dollars.

Research has shown that people who are not subject to cost sharing use more medical care than do people who are required to pay some or all of the costs of their care out of pocket.

Translation. If you pay little or nothing for your health care you will treat it like an “all you can eat” buffet.

There is a bit of truth in this. For some at least, if it costs little or nothing to go to the doctor they may be inclined to make an appointment to see the doctor rather than waiting it out or using a home remedy. Or insist on an expensive brand name drug when a proven generic may work just as well.

If you have original Medicare and Medicare supplement plan F it costs you nothing to go to the doctor, no matter how many times you go. Some people in Congress must believe you enjoy going to see the doctor. I think they need to have their head examined. Proposed Medicare changes means no more Medigap plan F and no more “free” doctor visits.

Do you have a Medigap plan from AARP (United Healthcare) or Blue Cross? If so you are probably paying too much. Shop and compare your supplement plan now. Up to 40 plans in 60 seconds. Georgia Medicare plans have some of the lowest rates in the state. Find out how you can save $700 per year or more. Follow this link to compare GA Medigap quotes.

What is Shared Funding and Shared Responsibility?

Shared funding and shared responsibility means DC believes you have too much money and need to share it with others who are needy.

“Money is like manure. It isn’t worth anything unless you spread it around”.

If Congress has their way, the proposed Medicare changes mean you will be spreading your money around by paying more for your health care.

A variety of later studies also concluded that higher cost sharing led to lower health care spending—including a 2010 study that found that Medicare beneficiaries responded to increases in their cost sharing by reducing visits to physicians and use of prescription drugs to a degree roughly consistent with the results of the RAND experiment.

I am sure this is true, but what we don’t know is WHY there was a reduction in doctor visits and prescription drug use. Could it be because seniors could not AFFORD to go to the doctor or fill their prescriptions? If you can’t afford to go to the doctor, or fill your prescriptions, is it possible you will get sicker and need MORE care?

In theory, to address the concern that patients might forgo valuable care, insurance policies could be designed to apply less cost sharing for services that are preventive or unavoidable and more cost sharing for services that are discretionary or that provide limited health benefits.

Most preventive services are now “free” under Medicare Part B.

I don’t know about you, but I have a problem when Congress feels it is their job to tell me what kind of insurance I can and cannot have. If these proposed Medicare changes don’t motivate you perhaps you need to see if you have a pulse.

Proposed Changes to Cost Sharing

Because DC has not been able to control spending they believe Georgia seniors should be restricted in the type of Medigap plans they can buy.

60 percent of people with Medigap insurance chose plans that offer “first-dollar” coverage—which pays for all deductibles, copayments, and coinsurance—and most other medigap enrollees chose plans that provide first-dollar coverage for Part A and cover all cost sharing above the deductible for Part B.

Congress thinks this is a bad thing and they want to make these plans illegal.

Most Medigap policyholders buy plan F which is considerably overpriced. Better choices would be Medicare supplement plan G or plan N.

If Congress gets their way, proposed Medicare changes mean you will no longer be able to buy Medigap plans F, G or N.

Policymakers could alter Medicare’s cost sharing and restrict Medigap coverage in various ways to produce savings for the federal government, reduce total health care spending, and create greater uniformity in cost sharing for Medicare enrollees. Those different ways would also alter how health care costs were distributed between healthier and less healthy enrollees.

More government intervention and control, restricting your choice of plans. Obamacare has already done this for health insurance under age 65, so if you think we are immune from their heavy handed interference in our right to choose insurance you are dead wrong.

Congress also wants to decide the level of care healthy people can get vs. those who have health issues.

When was the Statue of Liberty replaced with the Statue of Equality?

What Kinds of Medicare Changes are Being Considered? All the changes being considered mean you will pay more for health care.

The first alternative would replace Medicare’s current mix of cost-sharing requirements with a single annual deductible of $550 covering all Part A and Part B services, a uniform coinsurance rate of 20 percent for amounts above that deductible (including inpatient expenses), and an annual cap of $5,500 on each enrollee’s total cost sharing.

The $550 deductible may not sound bad, but how do you feel about “sharing” $5,500 of your life savings in order to bail out Medicare? Before you answer, consider this.

Almost every year Medicare raises your Medicare Part B premium. Congress also increases your Part B deductible and your Part A hospital deductible.

Do you think they will also raise this unified deductible? How long before that $5500 cap is raised to $6,000 or $7,000?

What Can You Do to Stop These Medicare Changes?

Contact your Georgia Congressman and tell them you do not support cost sharing changes in Medicare. Also call or write your Georgia Senator. If you are a member of a political action group like AARP let them know your feelings about these changes. Also consider conservative alternatives to AARP with senior groups like AMAC, or American Seniors.

You might want to lock in today’s low Georgia Medigap rates while you still can. If you buy Medicare supplement plan F, G or N now you should be able to keep it once Congress makes these plans illegal.

Shop and compare GA Medigap quotes now.

#Obamacare

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#SharedResponsibility

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#Medigap

2014 Medicare Disenrollment Medicare Advantage

Bob Vineyard · January 8, 2014 ·

Medicare Advantage enrollment topped 15 million, an all time high. So why is Medicare disenrollment in the news? How many people really know what they have in a Medicare Advantage plan?

The dis-enrollment period for the Medicare Advantage Plan runs until Feb 14. What does this mean and how can you dis-enroll?

During this time, Medicare beneficiaries can dis-enroll from a Medicare Advantage Plan and return to Original Medicare.

WBNG

Can 15 million people be wrong?

They could be, but after several years of working with seniors in Georgia I am convinced that most of them really don’t know what they bought. Even people who have had a Medicare Advantage plan for years don’t understand how the plan works. The “set it and forget it” approach might shock you when you actually use your plan.

Here are some things you may not know about Advantage plans and why you may want to consider Medicare disenrollment.

Less than half the doctors in Georgia take Medicare Advantage patients
Virtually all doctors will see you if you have original Medicare
Advantage plans give you a list of doctors and hospitals and say choose one
Doctors in the network in 2013 may not be back in 2014
Drugs covered under your Advantage plan in 2013 may not be included in 2014
Many Georgia Advantage plans do not renew forcing you to pick a new plan every year
Your out of pocket maximum does not include Rx, non-approved claims or out of network claims

You don’t have any of those issues with original Medicare. Most of your friends that bought Advantage plans will have to learn about the disadvantages of an Advantage plan the hard way. Because you are reading this, you won’t have to blow through thousands of dollars to pay medical bills. If you use your Medicare disenrollment option before Valentines day you can have all the advantages of original Medicare.

While you are at it, shop and compare our rates for Medicare supplement plan N.

Is the 2014 Medicare disenrollment for you? Give us a call. Free, no obligation consultations are our specialty.

Medicare Advantage Cuts

Bob Vineyard · August 26, 2013 ·

Reduced funding from Washington plus Obamacare rules combine to cause significant Medicare Advantage cuts from major insurance carriers. In some cases premiums will rise along with cost sharing. In other situations Medicare Advantage plans offered in 2013 will not return for the 2014 plan year.

UnitedHealth Group Inc. and Humana Inc., which together account for about 37.5% of all Medicare Advantage enrollments, said that anticipated 2014 market withdrawals will affect roughly 5.1% and 3.2% of their total Medicare Advantage members, respectively.

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If Medicare Advantage cuts mean your plan is discontinued, you may want to consider an affordable Medicare supplement plan. Georgia Medicare Plans has access to very low cost Medigap plans and can guide you through the transition to original Medicare plus a stable supplement plan. Shop and compare now.

In many cases our clients have found Medicare supplement plan N to be a good replacement for an Advantage plan. Greater flexibility, access to more providers and considerably less out of pocket.

The Medicare Advantage cuts may not seem like much on the surface, but if you are in a rural area where the number of Advantage plans is limited you might want to consider a change.

Even if you keep an Advantage plan, you may have to drive for miles to find a doctor or hospital that accepts that plan. Patients that have original Medicare and a supplement never run into network issues.

“The depth of the underfunding of these benefits to seniors is causing us to exit certain market areas, reduce the number of plan offerings and reduce benefits in the majority of the local markets we serve commensurate with our review of the competitive position and long-term sustainability of our services for each individual market,” UnitedHealth Group CEO Stephen Hemsley said

The problem of Medicare Advantage cuts is not new, but one that will only get worse going forward thanks in part to Obamacare.

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