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FREQUENTLY ASKED QUESTIONS

What is the difference between Medicare Supplement or “Medigap Plan”?

Nothing, those two terms are interchangeable.They mean the same thing and therefore redundant.

Who is my Primary Coverage?

Your Primary coverage is and always will be Original Medicare Part A which is your hospitalization and Part B which is your doctors and specialist. Medicare Supplements are a secondary coverage and therefore not billed directly by your doctors, specialists or hospitals.

Does my doctor accept my Medicare Supplement?

If he accepts Original Medicare Part A & B, then you’re covered. Don’t let doctor’s office staff confuse you when they say they haven’t heard of or accept your Medicare Supplement because they may not be familiar with the name of the carrier. Simply state that Original Medicare is your primary and they reconcile with the carrier and not the doctor’s office. This process is called “crossover” and it is directly linked with your Medicare claim information (That red, white and blue card you recently received with all the letters and numbers on it!). The claim is filed with Medicare and then “crosses over” is completed by matching your Medicare claim information with your chosen Medicare Supplement provider.

Should I be worried about having the Plan G?

Absolutely Not! The Plan G is the “Best Value” plan in the array of Medicare Supplements. It covers everything just like the Plan F has, however it does not cover your one time annual Part B deductible. This deductible in 2019 is only $184. Many times the difference in premium between Plan F and Plan G can be double the amount of the actual Part B deductible. This can give you an additional savings of roughly $15 per month and for all intent and purpose it’s identical coverage once you pay the $184. Don’t be afraid of the Plan G … Think of it as the smarter choice!

I’m really healthy, but don’t want a Medicare Advantage Plan. What is my best option without costing too much in premium?

We recommend the Plan N for many “younger baby boomers”. The Plan N has is basically like the Plan G, where it does not cover the Part B deductible ($184 for 2019). The Plan N also requires a $20 copay for both your regular doctor and any specialist. That is it, $20! If for some reason you end up in an ER or Urgent Clinic the copay is $50, but would be waived if, God for bid, you were admitted into a hospital. It is the closest thing to a PPO that Medicare offers as a standardized Medicare Supplement. Pair it with a Part D drug plan and often your combined premiums can be in the $100 per month ballpark.

Does my Medicare Supplement cover me if I am out of the country?

Yes, you have $50,000 emergency travel coverage. As you know, Medicare is a program for the senior citizens in America, so the coverage itself does not work while abroad. However, if for some reason you eat some bad fish in Portugal or get ran over by a bull in Spain. Any medical care you need, pay for out of pocket and bring those bills back and file with your respective Medicare Supplement provider (Plan F, Plan G or Plan N only!). There is a $250 deductible, so for example … If you had $1000 worth of care, you would get back $750 … Not bad, as long as the memories are good!

My rate went up. Is it because I was sick last year?

Your rates never go up on you as an individual. It is always based on the entire ‘Block of Policyholders”. So your rate increase is the same as everyone else, regardless of what health issues you have or do not have. This is why it is important to keep yourself “fluid” and find a good Broker to help manage that cost. Your good health is your leverage!. So use it!

Do I need to do something with my coverage during the Fall? I see so many commercials.

The Government and Medicare Advantage providers have a tendency to confuse the situation during the Annual Election Period from October 15th through December 7th. You do not need to make any changes with your Medicare Supplemental provider. Your policy is renewable on the anniversary of the policy effective date. The only thing you are required to do, but still it’s only optional is make any changes to your Part D prescription drug coverage.