Key Takeaways:
Tennessee Medicare Supplement Plans are a lower price than most other states.
Medicare supplement plans in Tennessee are price as Attained Age.
Medicare supplement Plans for those under age 65 may be cost prohibitive.
Medicare beneficiaries in Tennessee have the option of choosing an Advantage Plan.
The most popular Medicare supplements in Tennessee are Plan G and Plan N.
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For many, Tennessee offers everything they need as a place to retire to. There are no state taxes, a relatively low cost of living and beautiful scenery.
The major population centers in Tennessee are their own attractions. Places like Nashville, Memphis, Knoxville and Chattanooga offer world class dining along with music and other entertainment.
All in all, it’s surprising that Tennessee is not a more popular destination for those wishing to spend their retirement years active and enjoying life.
Of course, quality healthcare and health insurance is an important need during retirement. Great healthcare can be an important part of staying healthy and active.
Medicare Supplement Plans in Tennessee
As part of Tennessee’s generally lower cost of living, Tennessee Medicare supplement plans are generally priced lower than found in most states. For a male turning 65, a Medicare supplement Plan G from a large, reputable insurer can be found for around $125 a month, less for a woman or with the family discounts that are so common these days.
As we discuss Medicare supplement plans in Tennessee in more detail, let’s start with Medicare Supplement Plans ( aka Medigap Plans) for those under 65, who qualify for Medicare through permanent disability.
Under 65 Medicare in Tennessee
There is no federal mandate requiring Medigap insurance companies offer Medicare supplement plans to Medicare beneficiaries under the age of 65. As such, if a Medicare supplement is available for those under 65 it will be directed through state laws.
Medicare requires that a person under age 65 be on Social Security Disability Income for a full 24-months prior to being automatically enrolled in Medicare.
Tennessee law requires that all insurance companies offering a Medicare supplement
plan to people aged 65 and over must offer the same Medigap plans to Medicare beneficiaries under age 65*** with one caveat. The under age 65 Medicare supplement insurance policy must be applied for within the first 180 calendar days (six-months) of their Medicare Part B start date.
The caveat in Tennessee is that the under 65 Medicare beneficiary must show they no longer have access to alternative forms of health insurance due to termination or action not within the individual’s control. For example, failure to pay the premium of an alternative form of health insurance will disqualify a person from obtaining Medicare supplement Plan A. This also includes being involuntarily disenrolled from Medicaid or Title XXI State Children’s Health Insurance Program.
Alternative forms of health care coverage referred to above include Medicare Advantage Plans, employer sponsored group health plans and accident & sickness policies, the latter of which may not be creditable coverage.
*** Medicare supplement plans C, F and F-high deductible are not available to people who first became eligible for Medicare on or after January 01, 2020. in other words, to purchase a Plan F in Tennessee you must have been eligible for Medicare before 2020.
Under Age 65 Medigap Plan Prices in Tennessee
Unfortunately, while there is a law requiring that Medigap plans be available to those under 65, the prices of such Medigap plans in Tennessee are very expensive. In fact a Medigap plan for those under 65 in Tennessee are about three to four times higher than the same Medigap coverage offered to those who are age 65. The Medicare coverage is exactly the same, but the prices are not.
Because of this, we advise an under age 65 Medicare beneficiary first consider the Medigap Plan G high deductible premiums. If this Medicare supplement plan is outside of your budget, you might wish to consider a Medicare Advantage plan, or just keeping Original Medicare Part A and Part B. In which case you should also add a Part D prescription drug plan.
Can You Have Two Initial Enrollment Periods?
Keep in mind, everyone who qualifies for Medicare when under the age of 65 will have a second Initial Enrollment Period in the seven month window around their 65th birthday, as if they were new to Medicare. At that time, they can apply for any of the Medicare supplement plans in Tennessee with no health questions asked.
With all states that offer Medigap plans for those under 65, the applicant must apply for the Medicare supplement plan within 180-days (six months) of the start of their Medicare Part B. After that period, the insurance provider can reject your application.
Tobacco Rates for Medigap Plans in TN
It may also be worth noting that for people new to Medicare, regardless of age, Tobacco rates do not apply toward a Tennessee Medicare supplement plan, if you are new to Medicare. An insurance provider cannot charge you more for using tobacco when you purchase a Medigap plan during your Medicare supplement Initial enrollment Period (the first 180-days on Medicare Part B).
Medicare Supplement Plan Pricing in Tennessee
Throughout the country, Medicare supplement plans can be priced using one of three methods; Attained Age, Issue Age or Community Rated. The Medicare publications often lead consumers to believe that a person shopping for a Medicare supplement plan will have a choice among all three pricing methods. That is not typically the case. More on that below.
In addition, and this is important, it’s a common misconception that one pricing Medigap plan method may offer Medicare beneficiaries a lower lifetime cost than another Medigap Plan pricing method. That is not true at all.
There is no pricing method that will turn a for-profit insurance company into a philanthropic organization.
Each pricing method offers the insurance provider the ability to increase your premiums by simply applying to the state for a price increase. No insurance company will price a policy in such a way as to intentionally reduce profitability.
Some states have laws that require all Medicare supplement plans to be priced as Issue Age, Community Rated or either of those two methods. States without a law mandating the pricing method are called Attained Age states because that is how most policies will be priced when not mandated to use one of the other two methodologies.
Keep in mind that according to the CDC, approximately half of those that live to age
65 will live past age 80. Insurance companies are aware of the statistics and know that using a pricing method for medigap plans where the premium is higher early to save money in later years will mean higher prices for most consumers who will never experience the later years.
As I mention in a number of videos, the most important factor that impacts your policy pricing is not the pricing method or which Medigap plan you decide is best for you. The most important factor for your lifetime monthly premium is the insurance provider you choose to manage your plan.
That is where Medigap Seminars Insurance Agency comes in. We help you choose the insurance provider with the best probability of maintaining a stable price over your lifetime. You can get a free price quote and personal recommendation by using our Medicare Supplement Quote Request form.
Warning: If, in an Attained Age state you find Medigap policies priced as Community Rated or Issue Age, caveat emptor. In some cases the alternative pricing is offered to mislead the consumer into believing they are getting something they are not. Please see the specific pricing method details below.
Tennessee is an Attained Age Medigap Pricing State
An Attained Age Medigap policy is the easiest pricing method to understand. Each year, on your policy anniversary, the price of your Medigap policy will automatically increase by a small amount, usually between 2% and 3%. With this method, a company can better price a policy for its specific demographic risk and inflation.
If state law does not mandate a Medicare plan pricing structure of Issue Age or Community Rated, then the state is an Attained Age state.
It is also still possible that in some years your insurer will seek approval for an additional price increase from the state.
Attained Age policies will typically start at much lower monthly premiums than any other pricing method. With the right company, the Attained Age price increases should be very manageable over your lifetime. For example, at a 3% annual Attained Age price increase, the policy premium would double over 24 years.
Medicare supplement companies can also apply to the state for a price increase as long as the price change fits within federal guidelines. When a price increase is approved, most of the insurance companies we work with will not adjust your Medigap policy price until your policy anniversary and only after providing you a 45-day notice.
Beware of Medigap policies priced as Community Rated or Issue Age in an Attained Age state. In these cases, the pricing structure is most commonly a sales technique to get the consumer to believe they are getting a policy with fewer price increases. That is not the case. In fact, one popular insurer I am aware of will call their policy “Community Rated” yet they have mandatory 3% annual price increases with other price increases, resulting in often two price increases a year.
Contact Us for our personalized recommendations.
The Most Popular Medicare Supplement Plans in Tennessee
Medicare supplement Plan G offers the most comprehensive coverage of any Medigap plans in Tennessee. With Plan G your out of pocket expenses for inpatient and outpatient Medicare is limited to the amount of the Part B deductible. That’s it. Everything else is paid for.
Medicare supplement Plan N is the second most popular of the Medigap policies in Tennessee. It is often considered the best value because it offer full coverage similar to Plan G, but much lower monthly premiums. You pay the Part B deductible, plus small office visit copays.
Plan F in Tennessee is not available to everyone. But if you qualify for a Plan F, it
should be considered. It has more coverage even than Medicare Plan G because all Medicare bills except for prescription drug coverage are paid by Plan F and Medicare.
Which is the best Medicare supplement? Well, that depends on your needs and budget. I put together a video on how you can determine the best Medicare supplement plan for you that is well worth watching.
Excess Charges in Tennessee
Tennessee does not have any rules that restrict medical providers from charging excess charges. That said, fewer than 2% of doctors across the country have a contract with Medicare that allows them to charge an excess charge. 40% of those doctors in Tennessee are mental health professionals.
The bottom line is that Medicare beneficiaries in Tennessee may go through their entire Medicare experience without ever coming across a doctor that can charge an excess charge.
Medicare Advantage Plan in Tennessee
Medicare Advantage plans ( aka Medicare Part C) are a pseudo-privatized rendition of Original Medicare (Medicare Part A and Part B). They are managed by a private for-profit insurers and intended to provide Medicare benefits similar to Original Medicare, but with an annual maximum limit on out-of-pocket expenses for Medicare services approved by the insurance company. A Medicare Advantage plan replaces Medicare.
You may hear some agents claim that an Advantage plan must offer all the same Medicare benefits as Original Medicare. That is a common misconception and is not accurate. Advantage Plans must offer benefits from the same category as Original Medicare, but not the same benefits.
Within the US, approximately 99.7% of Medicare beneficiaries have access to at least one Medicare Part C plan. The leading insurance companies in the Medicare Part C market are United Healthcare and Humana, followed by the 36 BCBS companies, CVS Health (owner of Aetna and Accendo).
As of 2023, Medicare reported the existence of 3,998 different Advantage Plans in the United States. Each of these plans are different. They offer distinct benefits and costs. While various types of Advantage plans exist, about 98% of them are structured as Preferred Provider Organizations (PPOs) or Health Maintenance Organizations (HMOs).
We encourage individuals considering Medicare Part C to watch two informative videos as part of their research. The first video, “Medicare Explained; the Secrets of Who & Why,” delves into the demographics of those selecting between Medicare Advantage and Medicare supplement plans. The second video, “Medicare Advantage Plans Explained,” provides an in-depth exploration of the pros and cons of Advantage Plans.
Medicare Part C Plans are most suitable for budget-conscious individuals with minimal plans for extensive travel, as Advantage plans often have low or no additional premiums.
However, it is important to note that Medicare Part B monthly premiums must always be paid, even for zero premium plans.
Zero premium Part C Plans may be available in every county in Tennessee, along with Special Needs plans for low-income individuals or those with select chronic illnesses or conditions.
Medicare Advantage Enrollment Periods
You can purchase Part C Plans during the Initial Enrollment, the Annual Election Period, the Annual Medicare Advantage Plan Open Enrollment, or Special Election Periods. There is no medical underwriting or pre-existing condition exclusions.
The Initial Enrollment Period
The Initial Enrollment Period is a seven-month window around the month of one’s 65th birthday, with exceptions for individuals born on the first day of a month. The Annual Election Period takes place between October 15 and December 07 each year, with changes becoming effective on January 01 of the following year. The Annual Medicare Advantage Open Enrollment lasts from January 01 to March 31, allowing one change in the Advantage Plan or a return to Original Medicare with a Part D plan.
Improving on Your Medicare Advantage Benefits
To match Medicare Part C plan coverage to that of a Medicare supplement, ancillary insurance products can be added. For example, Cancer Protection Insurance can be obtained to cover 20% of cancer treatment costs up to the maximum out-of-pocket limit. Hospital indemnity insurance policies can also be added to provide cash coverage for inpatient hospital stays.
How To Shop For Medicare Advantage
When shopping for a Medicare Part C Plan, it is essential to provide a list of regularly visited doctors, not just the primary one, to ensure they are in-network. Additionally, a list of prescriptions is needed to determine prescription costs. Health benefits, costs, and network compatibility are the primary factors considered when helping individuals select Advantage plans, followed by a review of extra benefits such as dental, hearing, vision coverage, and fitness programs.
At Medigap Seminars Insurance agency, advanced Medicare Part C tools are utilized to match the most suitable plan to individuals’ needs and situations. This process involves considering doctors, prescriptions, health benefits, costs, and networks, as well as evaluating additional benefits. The agency’s software streamlines the process, matching you to the Advantage plan that best suits your needs and budget.
To get started, contact us and let us know how we can help. Our personal guidance is free. Check out our reviews too!
Part D Prescription Drug Plans in Tennessee
There are two ways you can get Medicare Part D prescription drug coverage in Tennessee. The first is through a plan bundled with a Medicare Part C Plan. Most Part C Plans come with a bundled Part D prescription drug plan.
The second method is a Stand-Alone Part D Prescription plan (PDP) that is used when Original Medicare is your primary healthcare, like when you have a Medicare supplement.
The Part D structure and rules are the same regardless of how you purchase your plan.
It is important to understand that if your Advantage HMO or PPO does not come with a Part D plan, you may not purchase a stand-alone PDP plan. Doing so will cancel your Advantage plan.
When Can You Apply for Part D?
You can apply for Medicare Part D during your seven-month Initial Enrollment Period or during a Special Enrollment Period. If you are changing from an Advantage plan back to Original Medicare you can also use the Annual Election Period (October 15 – December -7) or Advantage Plan Open Enrollment (January 01 through March 31) to apply for a Part D plan.
Medigap Seminars created https://partdshopper.com/ to help clients search for and enroll in a stand-alone Part D plan that fits your needs.
Your Tennessee Medicare Independent Insurance Broker
Medigap Seminars has a thriving business across the country and in Tennessee. In fact, Tennessee is one of my favorite states for Medicare.
We would be excited to help you with your Medicare decisions and make certain you know all your choices so you can make an informed decision. We can compare Medicare supplement plans in Tennessee and choose from the many health insurance companies offering plans.
Contact Us today, you will be glad you did.
If you haven’t already, please check out our five star reviews.
Sources:
https://www.kff.org/medicare/issue-brief/medicare-advantage-2023-spotlight-first-look/
https://medicareadvocacy.org/ma-and-selling-extra-products/
Agent Medicare supplement guides from Mutual of Omaha, Allstate, Aetna and other insurance companies.
Matthew Claassen
Matthew Claassen, CMT and CEO of Medigap Seminars Insurance Agency. Medigap Seminars is an award winning premier national Medicare Insurance Brokerage, ranked among the top in the U.S.A. Matthew is considered a leading national expert on Medicare and Social Security. Mr. Claassen is a distinguished member of the Forbes Business council, an invitation only organization of business leaders and entrepreneurs. He and his team have received awards from many of the countries largest insurance companies including Mutual of Omaha, Aetna, Humana, Cigna, United American, United Healthcare and others. His videos have become the most popular Medicare educational videos on YouTube with millions of views. As a financial analyst Matthew lead a team of researchers to win the 2009 Best Equity Research & Strategy Award from The Technical analysis magazine.
