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How Do Medicare Supplement Plans Work?

Original Medicare consists of Part A and Part B, which are Hospital Insurance and Medical Insurance, respectively. Together, Medicare Parts A and B cover and pay for many, but not all, of the healthcare services and supplies that seniors will need. A Medicare Supplement plan will help pay for the beneficiary’s share of some things that Medicare does not cover.

Here are some important things to know:

• Medicare supplement plans are not the same as Medicare Advantage plans.

• Beneficiaries must pay a monthly premium for their Medicare Supplement plan in addition to the Part B premium from original Medicare.

• Private insurance companies that provide Medicare supplement policies cannot cancel the beneficiary’s coverage even if they have persistent health problems.

What Do Medicare Supplement Plans Cover?

Medicare Supplements help to cover costs not covered by Original Medicare. Each plan provides a range of benefits. Basic benefits can include the following:

• Part A coinsurance and hospital costs up to an additional 365 extra days after Medicare benefits are used

• Part B coinsurance or copayment

• Blood (first 3 pints)

• Part A hospice care coinsurance or copayment

Certain Medicare Supplement plans may include additional benefits such as:

• Skilled nursing facility care coinsurance

• Part A deductible

• Part B deductible

• Part B excess charge

• Foreign travel exchange (up to plan limits)

• Out-of-pocket limit

What Do Medicare Supplement Plans Not Cover?

While Medicare Supplement plans cover many things, there is a general list of procedures and services that they do not cover. This list includes the following:

• Long-term care (like non-skilled care you get in a nursing home)

• Vision or dental services

• Hearing aids

• Eyeglasses

• Private‑duty nursing

• Prescription drug coverage

Beneficiaries who need prescription drug coverage can find it under Medicare Part D. To get coverage for the previously mentioned products, and other goods and services, a Medicare Part C, a Medicare Advantage Plan, can be a good option.

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What is Medicare Plan F

If you are ready to enroll in a Medicare supplement, you might ask; what is Medicare Plan F?  Medicare supplement/Medigap Plan F is the most comprehensive Medicare supplement you can buy. Plan F covers both Medicare deductibles and copays as well as coinsurance.  That means you will have no out-of-pocket expenses.

Click here to learn about Plan G

What is Medicare Plan F:

Plan F has been the top selling Medicare supplement plan for quite some time. More than half of all Supplement/Medigap policies in effect are Plan F.

Medicare Supplement/Medigap plans, pay the amount left on your medical bill after Medicare pays.  This will cover your deductibles, copays, and coinsurance. These plans do not replace either Medicare Part A or Part B. You must enroll in both Part A and Part B to be eligible to enroll in any Medicare supplement Plan.  Once you add a Plan F to your Part A & B coverage you will have complete Medical coverage.  That translates to zero out-of-pocket medical expenses.

Benefits of a Medicare Supplement Plan F:

• Plan F covers your Part A hospital deductible as well as your Part B outpatient deductible.
• Medigap plan F covers the 20% of medical expenses that Medicare Part B does not pay.
• This plan also covers Part B excess charges.  This means you will not have to pay the standard 15% excess charge that doctors who accept Medicare are allowed to charge for Part B services.
• You do not need a referral to use Medicare Supplement plans. You can use any doctor who participates with Medicare.  This gives you a wide variety of health care providers to choose from.
• Your coverage can never be canceled because of medical issues; these plans are guaranteed to renew as long as you make your payments.
• All Medicare supplement Plan F coverage is exactly the same.  It does not matter which carrier you choose to purchase it from.  The only thing that differs by carrier is the price of the plan.

What is Medicare Plan F: Benefits; what does the plan cover/not cover:

All Supplement/Medigap plans cover medications that you receive while you are in a hospital or clinic.  Although, Supplement/Medigap plans DO NOT COVER prescription drugs.  You need to enroll in Part D in order to receive prescription coverage.

Supplement plans DO cover chiropractic services that Medicare approves, such as adjustments.  Medicare does not cover x-rays done in conjunction with a chiropractor.

Supplement/Medigap plans don’t cover dental, hearing or vision exams or services.  If you need coverage for any of these services, you must purchase a stand alone plan.

How much does a Plan F cost:

The costs for Medicare Plan F depends on a few different factors.  The first thing that determines the cost of your Plan F is the carrier you choose to use.  Other things that decide the cost include the area you live in(this had the greatest effect on the cost), your gender, and whether or not you use tobacco.   Some carriers charge a higher price for a male as opposed to a female of the same age.  Certain carriers offer a  household discount when both spouses use the same company for their coverage. If you would like a quote for plan in your area, please contact us either by phone at (203)796-5403 or email at edward@croweandassociates.com.

NEED TO QUOTE MEDICARE SUPPLEMENT PLANS? -CLICK HERE

Is the Plan F being discontinued:

The answer to that is yes.  In the year 2020, plan F no longer be available to new enrollees.  If you are already enrolled in the plan, you will be able to stay in it.  In 2020, new Medicare beneficiaries will no longer be able to have Medicare supplements cover their Part B deductible.

If you have questions about this or any other aspects of Medicare, please contact us either by phone (203)796-5403 or email edward@croweandassociates.com.  For more information, click here 

Medicare Supplement High Deductible Plan F

Medicare Supplement High Deductible Plan F includes cost-sharing features.  These features allow you to save on premiums while still receiving dependable coverage.

In fact, The high deductible Medicare Supplement insurance plan pays the same benefits as Plan F.   AFTER you have paid the annual deductible of $2,180.  Benefits  from the High Deductible Plan F will not begin until out-of-pocket expenses are $2,180.

What’s does Medicare include in a Medicare Supplement High Deductible Plan F?

• Your $1,260 Part A deductible and coinsurance
• The cost of 365 extra days of hospital care during your lifetime after Medicare coverage ends
• $147 Part B Medicare deductible
• Your Part B coinsurance and the cost of the first three pints of blood
• 100 percent of Part B physician charges that are in excess of the Medicare-approved amount (by law no physician may charge more than 115 percent of Medicare-approved amounts).
• Skilled nursing facility copayment
• Hospice care
• Foreign travel emergency care

Medicare Part A Coverage:

Medicare Part B:

UHC Branded Plan F Medigap Connecticut

This post will explain some of the ways that UHC Branded Plan F Medigap Connecticut can benefit your clients.  The term “Medigap” and “Medicare Supplement” mean the same thing.  They are both names for a particular plan that is secondary to Original Medicare that a private insurance company offers. In fact,  Medigap plan F and Medicare Supplement plan F are one in the same.  It is important to note that Plan F covers 100% of medical expenses that  Medicare Part A and B do not cover.  Although, Medigap plans do not cover prescription drugs.   You will need a separate stand alone Part D plan in order to obtain drug coverage.

AARP offered through United Healthcare currently has the lowest cost plan F supplement in Connecticut at a monthly rate of $220.50 a month.  This rate is lowered by 5% if a spouse also has a AARP supplement plan.  You can also lower your payment by an additional $2.00 a month if  you elect to have payments automatically deducted from your bank account.  Click the following link if you would like more information about Plan F.   INFORMATION ON PLAN F

 FOR MEDICARE ADVANTAGE AND MEDICARE SUPPLEMENT COMPARISON INFORMATION CLICK HERE

CLICK HERE FOR AN APPLICATION

Please feel free to contact us if you have any other questions.  You can either call our office at 203-796-5403 or email us at admin@croweandassociates.com.  We are here to help you feel secure with the health coverage that will best fit your medical needs as well as your personal budget.

Medicare Supplement plans (Also called Medigap plans) have been around for many years.  Plan F Supplement which is offered by a number of companies is the most popular supplement mostly because it covers 100% of medical expenses not covered by Medicare.

Utilization for people with plan F has trended much higher than that of other supplements.  If someone is paying for a plan that will cover all of their Medical expenses, they are probably going to be more inclined to go to the doctor or get a test than someone who has a cost share.   Given that Medicare is primary when using a supplement, people with a plan F supplement are utilizing more than someone without a plan F supplement.

At one point, I thought Medicare Advantage plans would be phased out over the next few years but now it is time to admit that I was way off.  Cost share plans are the ones that will be around and it is the covered in full plan F that is going to be on the chopping block.

I predict that 2014 will be the last year that Plan F will be offered.  I am sure it will be grandfathered to those that already have it but they will no longer offer it to new customers at some point in 2014.

AARP Medicare Supplment Plans had very low rate increases from 2011 to 2012.  As a result, they offers the lowest rates for most supplement plans in Connecticut and New York.  Here is a quick review of the most competative plans offered and the options Medicare Beneficiaries are choosing for 2012.

• Connecticut
• AARP Plan F Supplement-  Plan F has a 2012 premium of $216.50 ($214.50 after Bank Draft ) this represents the lowest cost plan F available in the state of Connecticut.  Plan F is the most comprehensive supplement covering the most services of any of the options.
• AARP Plan N supplement-  Plan N has been on the market for 2 years $154.75 and has quickly become the most popular supplement choice.  The plan covers the same services as plan F with 4 notable exceptions which are (Part B Medicare deductible, Part B excess, $50 charge for ER and $20 charge for doctor office visits)
• Plan K supplement– Plan K was brought into the market overpriced but is now worth taking a look at after 2 years of rate reductions.   This plan offers a much lower premium but leaves much more potential for out of pocket cost vs. Plan F and N.   Those seriously considering a plan K would likely be better suited to choose the Anthem BlueCross BlueShield Plan F High Deductible Supplement with a monthly premium of about $35.00 a month at this point
• New York
• Plan F Supplement- AARP has a rate advantage over all competitors in the NYC, Long Island, Westchester area and most all of NY.  AARP plan F is the choice in NY for those that want the least out of pocket expense possible.
• Plan N Supplement- AARP also has the lowest plan N supplement rate in NY but they do have more competition with Empire BCBS within a few dollars of the premium they offer.
• Plan K supplement-As is the case with CT, plan K is now a bit more attractive for those willing to have more out of pocket risk.  Those interested in a plan K may want to look at the High Deductible F supplement offered by First United American

Applications and full benefit summary links below

AARP Medicare Supplements Summary 2012

AARP Medicare Supplement Application CT

AARP Medicare Supplement Summary NY 2012

AARP Medicare Supplement Application NY 2012

AARP 2012 Medicare Supplement Summary and Rates CT

AARP Medicare Supplement Rates NY All Areas

Applications may be printed out and sent into United HealthCare directly or they may be sent to Crowe & Associates for processing. Crowe & Associates will review applications to ensure they are complete prior to submission to United HealthCare. Applications can be sent to Crowe & Associates by the following methods

Fax- (203)-567-6235

Email- Edward@CroweandAssociates.com

Mail- Crowe & Associates, 155 Main Street, Suite 205 Danbury, CT 06810

Additonal questions may be emailed to Edward Crowe at Edward@CroweandAssociates.com or by phone at (203)-796-5403