Comparing Medicare plan options that fit your needs and budget can be tricky. The good news is that Bobby Brock Insurance has been doing this exact thing every day for years. We’ve helped thousands of Medicare beneficiaries successfully choose their Medicare plans. The best part? We do it for free!
No matter if you’re new to Medicare or are a seasoned beneficiary, Medicare is confusing to everyone. Plans change each year, and new laws and regulations are constantly changing. But we also know that having the right health insurance is critical to getting the care we need without breaking the bank.
Today, we’re going to discuss the steps you’ll need to take to compare Medicare plans. Remember, you don’t have to do this alone. However, understanding how to choose Medicare plans will help you ensure you’re getting the coverage you need.
How to Compare Medicare Supplement Plans
Medicare Supplements, also known as Medigap plans, are one of the ways beneficiaries can choose to “supplement” their coverage under Original Medicare (Parts A and B). Medicare Supplements act as secondary insurance and pick up some or all of the costs you’d otherwise be responsible for paying.
While there are about 10 Medigap plans to choose from, the most popular plans are Plans F, G, and N.
Medicare Supplement Plan F
Plan F was the most popular Medigap plan until recently. Its popularity was due to the fact that it offered the most comprehensive coverage. It picked up all the costs left over by Parts A and B – all your deductibles, copayments, and coinsurance costs. Of course, that also means that Plan F has the highest premiums compared to other Medigap plans.
Unfortunately, Plan F is only available to beneficiaries who were enrolled in both parts of Medicare prior to 2020. Newly-eligible beneficiaries can’t enroll in Plan F, but those who meet the cutoff date can still apply or keep their current plan.
Medicare Supplement Plan G
Plan G has quickly overtaken Plan F in terms of popularity. It does not have the same eligibility requirements as Plan F but has nearly the same benefits. Between the two the only difference is that Plan G does not pay the Part B deductible.
Since Plan G has slightly fewer benefits, it also has lower premiums. In fact, most people will save more money by enrolling in Plan G and paying the deductible than they would if they enrolled in Plan F and didn’t have to pay a deductible. It’s certainly worth considering, even if you are eligible for Plan F.
Medicare Supplement Plan N
Plan N is another popular Medigap plan. We’re seeing more and more people choose Plan N due to its lower monthly premiums. On average, annual premium increases for Plan N are lower than those of Plans F or G.
Like Plan G, Plan N does not cover the Part B deductible. There are two other differences. First, it does not pay any Part B excess charges. Excess charges are amounts that are over and above the Medicare-approved amount. Providers who do not accept Medicare assignment can choose to tack on an additional 15% to the approved fee. This is known as an excess charge. However, it’s rare to see excess charges, and there are even eight states who prohibit this practice.
The biggest difference between Plan N and Plan G is the copays. Plan N requires up to a $20 copay for visits to your doctor and up to a $50 copay for visits to the emergency room. Emergency room copays are waived if your visit results in an inpatient admission.
Choosing a Medigap Insurance Company
Once you’ve decided which Medicare Supplement is right for you, the next step is shopping for the plan at multiple insurance companies.
What many people don’t realize about Medigap plans is that they offer standardized coverage. This standardization means that no matter where you purchase a plan, the benefits are the same. For example, you could purchase Plan G from Aetna or Plan G from Cigna, and you’d have the same coverage. The only difference you’ll see is the monthly premium.
That’s not to say you should pick the cheapest insurance carrier. It’s still important to find a reputable insurance company with strong financial ratings. Bobby Brock Insurance works with all the top carriers in the country. We’ll be able to find the most competitive rates for you, rather than you having to call a bunch of companies yourself!
How to Compare Medicare Advantage Plans
Choosing a Medicare Advantage plan takes a little more effort than Medicare Supplements do. However, sometimes that extra work pays dividends when it comes to saving money and enjoying extra perks.
Medicare Advantage plans are an all-in-one alternative to Original Medicare. Instead of acting like a secondary insurance, they take the place of Parts A and B. All your medical claims are sent to the insurance carrier instead of the Medicare program.
In addition to covering all the benefits you’d otherwise get in Parts A and B, Medicare Advantage plans also include extra benefits. Each plan is different, so you’ll need to compare all the plans in your area. Let’s take a look at a few aspects you’ll want to pay attention to.
Type of Plan
Within the Medicare Advantage system, there are several kinds of plans. These include:
- Preferred Provider Organizations (PPOs)
- Health Maintenance Organizations (HMOs)
- Special Needs Plans (SNPs)
- Private Fee-for-Service Plans (PFFS)
- Medicare Medical Savings Accounts (MSAs)
You may not be eligible for every kind of plan, and you’ll need to learn more about the pros and cons of each. Plus, not all types will necessarily be available in your zip code.
Provider Networks
Medicare Advantage plans are similar to traditional health insurance plans in that they operate on provider networks. Some provide benefits outside of the network (PPOs), while others do not (HMOs).
To begin narrowing down your selection of Medicare Advantage plans, find out which insurance carriers your providers accept. You can do so by looking on the carrier’s website or by asking your providers directly. Of course, you can also choose to change providers if keeping your current one is not important to you.
Remember, you’ll need to do this with all your providers, including your primary care physician, specialists, dentists, pharmacy, etc.
Out-of-Pocket Costs
The out-of-pocket costs you should consider are the premium, deductible, copayments, and coinsurance costs. Medicare Advantage plans are known for their low monthly premiums – some plans are even as low as $0 per month. However, there are still other costs associated with the services you receive.
Another cost you should consider is the maximum out-of-pocket or MOOP. This is the limit on what you have to pay during the calendar year. As long as all your procedures are approved, you will never spend more than the plan’s MOOP.
Coverage and Benefits
All Medicare Advantage plans must offer at least as much coverage as you’ll find in Parts A and B. Each plan has a summary of benefits or evidence of coverage that will list all the services and procedures it covers. Be sure to review this list and look at associated costs for any treatment you think may apply to you.
Also, if your plan includes prescription drug coverage, be sure to look at the drug formulary to make sure all your current medications are covered.
Extra Benefits
In addition to the low monthly premiums, Medicare Advantage plans are also known for their extra benefits. Most plans provide benefits for things you won’t find in Original Medicare or Medigap plans.
Many plans include dental coverage, hearing and vision services, wellness programs and gym memberships, over-the-counter stipends, transportation, and meal delivery. Decide which extra benefits are important to you, and look for plans that include them. However, it’s important that you do not make your decision based on this information alone. The network and out-of-pocket costs are more important considerations.
How to Compare Medicare Part D Plans
Medicare Part D is where you’ll get your prescription drug coverage. However, if you enroll in a Medicare Advantage plan with prescription coverage, you won’t need a separate Part D plan.
Everyone should enroll in prescription coverage to avoid the Part D penalty. If you aren’t currently taking medications, your choice is easy. Simply choose the plan in your zip code that has the lowest premium. If you are taking medications, there are two basic things to consider.
Drug Formulary
The drug formulary is the list of medications covered by the plan. The formulary is divided into tiers, and most plans have four or five tiers. Prescriptions in lower tiers include common, generic medications, while those in higher tiers are your specialty and name-brand options.
You want to find the plan that includes all your medications at the lowest possible cost. Bobby Brock Insurance uses calculators that do this automatically. We’ll be able to find the most cost-effective plan based on your medications and then tell you what your costs will be over the course of the year.
Pharmacy Networks
Part D plans also have pharmacy networks. Pharmacies can either be preferred, standard, or out-of-network. You’ll get the best pricing at preferred pharmacies.
Just like your providers, if you have a pharmacy you prefer, make sure you’re taking that into consideration when choosing your Part D plan.
Get Help Comparing Medicare Plans
Sounds like a lot, doesn’t it? It can certainly feel overwhelming, especially if you are new to Medicare.
Don’t make these difficult decisions alone. Bobby Brock Insurance is here to help! We’ll talk to you about your needs and budget, then we’ll do all the shopping for you. We’ll help you compare Medicare plans and find the one that works best for you.
Our services are completely free. Call today to chat with one of our Medicare experts!
