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The high F Medicare supplement plan is not well understood by consumers and insurance brokers.  In the state of Connecticut this is a shame because if  people did understand it well, about 90% of those with a Medicare Supplement plan would have it.

The plan is priced tremendously well in CT at $35.00 a month.  With this price point, the math on the High F plan comes out better than the math on any other supplement including the AARP Plan F supplement priced at $214 a month.

Here is how High Deductible F works-(This is a very simplified version but you will get the point):   Medicare Part A covers hospital costs after a $1,200 deductible and Medicare Part B covers 80% of doctors and testing costs.  The anthem High F, will cover 100% of costs once a consumer spends $2,070. out of pocket in a year.  At $35 a month, the math can not be beat.  Try the math versus any other Medicare Supplement plan on the market and see how it comes out.    Keep in mind that only 1% of Medicare consumers with a high deductible F plan every actually hit their deductible.

There are very few situations when a person should have a Medicare supplement plan other than Anthem High F supplement in Connecticut.  Unfortunately,a lack of understanding from Medicare recipients and the low commission paid to brokers will limit the number of people that have this plan

Medicare supplement plan benefit are standardized in NY. This list shows all the plans offering plans in NY for 2012 and the rates for them. Please note that rates change by region. Supplements do not have Networks which means you can go to any doctor or facility that takes medicare. The company offering the supplement does not make a difference as benefits are standardized. The only difference is in the price they are charging for the supplement plan.

If you have additional questions or need benefit summaries and applications please contact Edward Crowe at Edward@Croweandassociates.com or by phone at 203-796-5403.

Medicare Supplement Rates NY 2012

Medicare Supplement plans are standardized in Connecticut which makes comparing plans very easy. The link below contains the standardized plans for 2012. This represents all companies offering Medicare Supplement plans in Connecticut for 2012.

If you have questions about which supplement to choose or need additional information of any type, you may contact Edward Crowe at Edward@croweandassociates.com or by phone at 203-796-5403.

Medicare Supplement rates CT 2012

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

People choose medicare supplement plans for a variety of reasons.  Some people choose them based on the name of the company offering them, advice from family or neighbors, and advertising on TV. Others may go with advice from a local senior center or simply go with a Plan F because it offers the most coverage.  Whatever the reasons may be, they are usually not enrolling in the most financially sound option.

High Deductible plan F should be the choice for any  person over the age of 65 taking a Medicare Supplement Plan. ( I say over 65 because it is not usually available to those on Medicare under the age of 65) High deductible F is not as easy to understand as the more popular options such as Plan F,C,D or even plan N.  However, if people did take the time to understand the plan, they would see that it is by far the best option from a mathematical standpoint.

Plan F High Deductible works in the following manner:  It will cover the Medicare co insurance and cost share once a person spends $2,000 in any given year.  In general, this means that when a person goes to the doctor, Medicare will pay 80% of allowable charges and the patient will pay the 20% left over.  It works the same way with other services such as testing and physical therapy.  If they go to the hospital, they will pay the hospital deductible and then Medicare will pick up the rest.  If these expenses add up to $2,000 in any given year, the high deductible F plan will pick up the remaining charges just like a normal Plan F does from the start.

The reason that high F makes so much sense is the math.  In Connecticut, high F costs $33.06  a month.  The lowest cost standard Plan F is $214.50 a month.  Plan F covers all medical costs (Medicare allowable) so there is no out of pocket expense, but the premium totals up to $2,574.00 a year.  Even if someone uses little or no services for the year, they will still pay this amount.   High F has a total cost of  $396.72  annual premium ($33.06 x 12 months) and a max out of pocket of $2,000 for a total of $2,396.70.  The worst case scenario leaves the person with High F saving $177.00 for the year.

The reality is that few people experience the worst case scenario.  Very few will actually hit the $2,000 deductible for the year. Some estimates show that only 5% of people accumulate over $2,000 of utilization.  There are a number of sources that estimate how much the average senior actually accrues in part A and B coinsurance and deductibles for the year but the average seems to show it is about $900 a year. Given this estimate, the average senior would save about $1,277.00 a year on plan F high deductible.   If they have a very healthy year, they will save even more.  If they have a catastrophically bad year, they will only save $177 but there is no risk involved.  At the end of the day, they will save money period.

Due to a general lack of understanding, High F will never be as popular as plan F but it should be the overwhelming choice for anyone in a supplement.  The math behind it is undeniable.

Anthem Medicare Supplement Summary of Benefits

Anthem Medicare Supplement Application CT 2012 

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

One of the biggest points of confusion for seniors seems to be making a decision between a Medicare Advantage Plan and Medicare Supplement Plan. I receive phone calls on a daily basis from people either turning 65, moving from an employer plan to Medicare or just trying to decide what to do for the Medicare Annual Election period. Often they are confused and feel overwhelmed by the amount of information and plan choices available.

The reality is that it is actually very easy to learn enough to make an educated decision. This article is going to point out the basic differences between the plans and point out the strengths and weaknesses of each. With this info, anyone will be on their way to having enough information to make a confident decision on the best plan for them. (This Article is for people in Connecticut and NY- I will write one for other states in the next few days)

First, we need to break down the differences between the two types of plans and also dispel some myths about both.

Medicare supplement plans-

-They are secondary to your Medicare A and B (In other words, providers bill Medicare first and then your supplement covers some or all of the remaining costs depending on the plan you choose.

-They are for Medical only. You buy Rx coverage separately

-There is not a network. You can go to any doctor that accepts Medicare

-There are plans A-N available but only a few are popular. They Plan F, Plan N and High deductible F

-The plans are standardized in both Ct and NY. If a company offers a plan N, the benefits are identical regardless of the company offering it. Price is the only difference. Once companies plan N is not better than other companies. Just go by the price.

-There is no medical underwriting for them and in Connecticut and New York you can change them the first of any month at any time during the year.

Supplements are a good choice for people that do not want to have any network constraints. They also work well if you have doctors that do not take managed care plans (Medicare Advantage Plans) or if you travel to other states often.

Some clients like the fact that some of the supplements basically cover all of their costs for medical care. (Plan F and Plan C, Plan J for those whom still have it)

Finally, supplements work well for people that are very sick and receiving a high volume of care such as multiple injections at an outpatient facility or in the doctor’s office or people going to a number of physical therapy visits on a weekly basis. If you are on a plan F, you will not be billed for the services

I hear a tremendous amount of incorrect information being given out on a daily basis when it comes to Medicare Supplement plans. Here are some of the major areas where bad info tends to be most prevalent.

-” Such and such a company has the best Supplement plans”- In the world of supplements, there is no such thing as one companies supplement being better than the others. Supplements are mandated to have identical benefits. If United offers a plan F supplement, it has the EXACT same benefits as every other companies Plan F benefits. Supplement plans A-N are subsidized in Connecticut and New York. All plan benefits are the same. The only difference is the price that the company charges for them. If you have decided on a supplement and know which plan you want, take the company with the lowest cost for that supplement. (Example: You decide to take a plan N, Simply choose the lowest cost plan N being offered at the time.)

– “I can’t find all the companies offering supplements and the prices” – This is easy. Each state has a list of all companies in the state offering supplement plans and the prices of them. They can be found on the insurance websites of each respective state. Here is a link to Connecticut Supplement plans and prices for 2011

https://croweandassociates.com/images/stories/Medicare_Supplement_Rates_Connecticut_2011.pdf

“Supplements have underwriting outside of the guaranteed issue period”- There is no underwriting for supplements in Connecticut and NY. Both are guaranteed issue states even outside of the election periods.

“High Deductible F is not a good plan” – This could not be more off base. In Connecticut and Ny there are plans that have very low high deductible F plans. In fact, in Connecticut, Anthem BCBS offers a high deductible F plan for $39.00 a month. This math cannot be beat by any other supplement plan offered in CT. For more information on High Deductible F go to… https://croweandassociates.com/blog/?p=223 for NY

Although there are many good things about supplements, there is also a negative or two. First off is that they do not cover RX, you need to buy a separate drug plan if you want coverage. The going rate for Rx plans is about $32.00 a month. Secondly is the price of the supplements. The lowest cost plan F in CT is about $219.00 a month. When you add your Rx cost to that it brings you to about $250.00 a month for a plan. Keep in mind that you are going to be paying $3,000 in premium for the year no matter what. Even if you have a very healthy year you will have $3,000 less at the end of the year.

Medicare Advantage Plans
Medicare Advantage plans are managed care plans being offered by private insurance companies. They give you your A and B coverage, secondary coverage and Rx coverage all in one package. With a Medicare Advantage plan, your Medicare A and B is administered by the insurance company. As a result, when you go to the doctor you show them your Medicare advantage plan instead of your A and B card.

There are many positives and also negatives about an advantage plan. Here are the positives….

-They are included in your Medical and Rx in one package. You do not need to go and purchase a separate PDP plan.

-They are very inexpensive. All major carriers even offer $0 monthly premium* plans.

-They have out of pocket maximums.

-Preventative care is covered at no cost to the member.

*They can offer you a plan for $0 monthly premium because Medicare is paying the insurance company money to handle your enrollment and care for the year.

-Some carriers have national networks and plans with out of network coverage.

Some negatives about advantage plans…

-They have networks. If you take an HMO advantage plan (Which does not have out of network coverage) and you try to go to an out of network doctor, you will NOT be covered. Many people believe that Medicare will still cover them for the usual Medicare A and B amount if they go to an out of network doctor but it does not. You will need to pay the full cost.

-They have copays for services. You need to be aware of the copays on the plans you choose. Some plans cover certain services better than others. For example, one carrier may cover Major Radiology at 80% while the other covers it for an $80 copay.

-They have pre-certification requirements for some procedures. Your doctor is responsible for obtaining pre certs but they can hold things up at times.

Advantage plans tend to work very well for people in relatively good health that see a reasonable amount of doctors. You need to check to see that all your Docs and any hospitals you go to are in the network. There are now a number of plans with out of network coverage and national networks. This is good if you have a doc or two that is out of network.* The copays on most plans are reasonable and with $0 premium plans available, they can save the right person a lot of money for the year.

*Make sure your out of network doctor will bill your insurance company for you and not make you submit yourself.

Often clients get upset when they go on an advantage plan and incur a large copay. (For example, a CAT scan which is a $150 copay on some advantage plans) They will say “If I was on a supplement, I would not have paid anything”. They tend to forget that the supplement is costing them money every month when the advantage plan is not.

The math on advantage plans actually makes sense for the majority of people but not everyone. Make sure you review the benefits and check networks prior to enrolling. Do the math and see how much you will save in monthly premium vs. how much exposure you have to copays. In the end, the advantage plan will likely win out but a little time needs to be devoted to make a comparison before you make a final decision.

*Make sure your out of network doctor will bill your insurance company for you and not make you submit yourself.

Medicare Supplement Plan N was approved for enrollment on June 1, 2010. The plan is offered at a competative price point by Anthem BCBS and United Healthcare “AARP Branded”. They both offer plan N for around $150 a month depending on availability of discounts.

Plan N is a departure from other supplements in that is allows the physician to bill up to a max of $20 per visit. It also has a $50 emergency room copay and does not cover the part B deductible (disappointing) of $155 a year. Many seniors have been willing to give the plan a try in order to save $50 a month in premium. This has been especially true of those in plan F supplements. Plan J enrollees need to be careful as plan J is a closed plan an they will not be able to go back to it in the event they try plan N and decide they do not like it.

The most suprissing part plan N has been the low number of providers that actually bill any type of excess on the plan. Providers are allowed to bill up to $20 dollars but seem not to do so often. (That has been our limited experience so far anyway)

People switching from their current plan to Plan N do not need to pay the $155 part B deductible as it has already been met for the year. They will however be subject to the Part B deductible in 2011.

AARP Supplement Changes For June 1, 2010

AARP released the new supplement changes for 2010.  Plan changes and Rates are as follows…

Supplement Plan M- Will not be offered in CT for 2010 Read more

Choosing Medicare Supplement or Medicare Advantage

Choosing Medicare Supplement or Medicare Advantage plans can be both confusing and frustrating. Many seniors simply go with a company name they are familiar with (Most commonly AARP). A plan that a relative or friend suggested or they just stay in their current plan because that is what they have always had. The end result is usually a bad choice of plan for the given situation. The reality is that there is not one “best plan” for everyone. To choose the best plan for the situation, it is important to know all the options available.

Here is a quick overview of the options available to Connecticut residents and the strengths and weaknesses of each…..

Medicare Supplement Plans:

Medicare Supplement plans are secondary plans you can purchase from a private insurance company to help cover the gaps in Medicare part A and B.  In all states, the plans offer standard benefits.  Plans provide different levels of coverage.  This depends on which plan you choose. The plan benefits cannot change.  This means any company that offers a plan must offer the exact same benefits. For Example Plan N with Anthem BCBS is exactly the same as Plan N with AARP (United HealthCare). The only difference is the rate that the private company charges for them. Please keep in mind, the rate can vary greatly.  One company in CT charges $184.00 a month for plan J while another charges over $300.00 for the exact same plan.

Supplement plans are best for a person who uses a high volume of health care services. Supplement plans tend to be costly but have very little out of pocket expense. If someone is consistently receiving a high volume of medical services, it may be wise to look at a supplement.  It may also be wise to use a supplement as some doctors that will not accept Medicare Advantage plans. In such a case, a Medicare supplement plan will provide coverage when an Advantage plan will not.

If you are in the market for a supplement plan it goes without saying that AARP should be considered.

They currently have the best rates available.  If you are considering plan F, you should purchase plan J instead. Plan J cost less, has all the benefits of F and some additional benefits as well.

The drawback to a supplement in the monthly premium cost compared to the premiums of Medicare Advantage plans. Also, supplements do not come with Rx coverage which must be purchased separately if it is needed.  If you are not a high volume user of medical services, it is warranted to look at the available Medicare Advantage plans.

One last thing to mention with supplements is that some people are simply more comfortable with them.  For some seniors the most important thing is to be able to see any doctor and not worry about copays or anything associated with managed care.  The person who feels this way may be willing to pay the extra monthly premium for this luxury.

Medicare Advantage Plans:

Medicare Advantage Plans are a low cost way to for seniors to obtain health care coverage. Advantage plans provide benefits equivalent to Medicare Part A and B with most plans providing additional benefits beyond what is covered by A and B. The plans can come with or without Rx coverage build into the plan design. Medicare advantage plan administer your benefits instead of Medicare Part A and Part B which makes the plan primary. Premiums range from $0 monthly premium to $179.00 month premium depending on the plan selected.

Medicare Advantage Plans do have some drawbacks compared to supplements such as the fact that you need to stay in network in most cases (There are PPO plans with out of network benefits)  There are also copays associates with services.  The higher premium plans have very low or no copays for many services but the lower premium plans ($0 premium) tend to have more out of pocket costs on things such as hospitalization)

Here is a breakdown of the plans available in Connecticut for 2009….

AARP Medicare Complete:

Positives– $0 monthly copay, Rx coverage build in with Medical, very low copays to primary doctors and specialists and out of network coverage.
Negatives– The network can have a lack of physicians in network in certain parts of the state, New Milford and some other key hospitals are not participating and the hospital copay is stiff at $225 a day for a total of 17 days.

Aetna Golden Medicare:

Positives-The Golden Medicare plans offer a national network which is nice for people who travel out of the Connecticut area. The Physician and hospital network is now one of the largest in Connecticut.  The $59 plan is the lowest cost plan on the market that still covers Inpatient hospitalization at 100%. There are a number of different plans to choose from including PPO options that provide out of network coverage, the $0 premium plan offers strong benefits compared to the rest of the $0 premium plans in the market.
Negatives-Some drugs fall into the 4th tier when they are only 2nd tier with other plans.

HealthNet:

Positives- Strong provider network, many high dollar drugs are on the 2nd tier.
Negatives-At current premium levels, the benefits are not competitive with other carriers in the Connecticut market. The Navy plan has weak benefits ($150 copay for 5 days inpatient hospital) for the high premium charged ($179.00)

Evercare (Secure Horizons/United Health):

Positives-$0 premium plans with low physician copays and Rx coverage, Chronic conditions plans coverage more conditions than any other in the state, only Dual Eligible Plan (Medicare and Medicaid) offered in CT market.
Negatives- High out of pocket costs for inpatient hospitalization, weak network can be difficult to deal with from an administrative standpoint, weak out of network benefits compared to AARP Medicare Complete

Be cautious of anyone who is only able to sell one or two of the companies listed above.  If they only offer a few plans, they may not know everything available that could best fit your needs.  Find someone who has the ability to work with all plans available in Connecticut in order to see all of the choices.  Although there are a number of plans available, each person has their own needs.

Image by Jose R. Cabello from Pixabay

Medicare Supplement Plans M and N for June 1, 2010

Medicare Supplement Plans M and N for June 1, 2010 Will Offer Substantially Reduced Premiums Read more