Which Medigap is best? This question was posed to the folks at Consumer Reports and here is their view.
Which Medigap is Best? It depends on your criteria.
Q. No matter where I look, I find an overwhelming amount of data about Medicare Advantage but very little about Medigap. Where can I find ratings on Medigap policies?
A. Unfortunately, nowhere. Although a lot of people confuse Medicare supplemental (Medigap) plans withMedicare Advantage plans, they’re nothing alike. Medigap plans essentially begin where original Medicare leaves off, picking up some or all of out-of-pocket expenses such as the $1,156 deductible for hospitalization under Part A or the 20 percent coinsurance for outpatient and physician care under Part B. With most Medigap policies, this coordination is automatic: after Medicare has paid its share of the bill, it forwards the claim to your Medigap carrier to pay its share.
In all but three states, Medigap is sold in 10 standardized flavors designated with letters. Plan F, which picks up pretty much every out-of-pocket expense for Parts A and B, is by far the most popular choice among the nearly 10 million Americans who buy Medigap plans, with 51 percent of the market, according to the most recent data from America’s Health Insurance Plans, the major health insurance industry trade group. The runner-up, Plan C, which is slightly less generous, has 14 percent of the market.
Medicare supplement plan F may be the most popular but that does not answer the question, “Which Medigap is best?“.
Medigap plan F is the most comprehensive, and also the most expensive. Agents that promote plan F are more often than not, motivated by the compensation on that plan which is higher than on lower premium plans such as C and G.
Medigap plans C and G are virtually identical, but G covers Medicare excess charges while C does not. Yet with many carriers plan C is more expensive!
An age 65 male in Macon, GA would be $117 per month while plan G is only $98.
You tell me. Which Medigap plan is best?
Medigap plans don’t have provider networks or get directly involved in whether to cover a treatment or test, there’s little to rate them on. To top things off, the cost of a plan can vary greatly depending on which company you buy it from, the premium pricing method the company uses, how old you are when you buy it, and whether you have any pre-existing conditions.
Consumer Reports consider this a bug. I consider it a feature.
The absence of networks means you don’t have to worry about referrals or wonder if you will pay more because you saw Dr. Smith (out of network) than Dr. Jones (in network). Also, Medicare supplement plans are secondary to Medicare, so Medicare, not an insurance company, decides which claims to approve.
If Medicare denies your claim, in most cases you are not liable for the bill unless your provider has given you an ABN (Advance Beneficiary Notice) that the treatment in question may not be covered by Medicare.
While some seniors may appreciate the lower premium Medicare Advantage plan the “sticker shock” when they have to pay the medical bills for their out of pocket share may not agree with them.
Medigap plans are more predictable, with far less out of pocket (typically less than $300 per year) and seem to work best for those on a fixed income budget.
Which Medigap is best? That is a question only you can answer. Compare Georgia Medigap plans and rates by following this link.