If you are a resident of either New York or Connecticut and are researching your Medicare options, this video is for you. Medicare in New York and Medicare in Connecticut (Medicare NY Medicare CT) are different than the rest of the country. Or, more specifically, residents of New York and Connecticut have state laws that give you Medicare rights and privileges that no one else has.
I’m Matthew Claassen with MedigapSeminars.org. In this video, I’m going to talk about the Medicare rules specific to New York State and Connecticut that give those residents special rights and privileges. Medicare NY Medicare CT special rights mean that you should approach Medicare with a completely different strategy than those professed for the rest of the country.
Medicare NY Medicare CT rules bring with them good news and bad news. But, more importantly, it means that residents of New York and Connecticut need to take a different strategy with your Medicare supplements in order to maximize your benefits and minimize your cost.
I am going to show you the strategy you need to take to get the most of your Medicare supplement plans in New York and Connecticut aka Medicare NY Medicare CT.
Medicare in New York and Medicare in Connecticut (Medicare NY Medicare CT) brings with it good news and bad news. The bad news first; Medicare supplement plans in New and in Connecticut are the most expensive in the country. These plans can cost more than twice what they cost in most other states. Why? Because they come with special rights only available to residents of those two states.
If you have been researching your Medicare options for long you probably already know that in order to get the most out of your Medicare you need a Medicare supplement plan and to avoid Medicare Advantage plans and stay with Original Medicare Parts A & B plus a Medicare supplement.
If you are not yet familiar with Medicare Parts A & B go here to find my videos on Medicare.
Medicare Advantage plans are those Medicare HMOs and PPOs that offer only local insurance coverage, so if you are a snowbird or travel at all that should disqualify them as an option. In addition, they limit which doctors you can see, which hospitals you can use and you give up your Medicare decisions to a private insurance company. Plus the benefits change every year! I have a separate video on Medicare Advantage plans linked below if you haven’t researched that yet. I am not saying Medicare Advantage plans are bad, just that they are the right option for only a very small percentage of the population and the special rights you have in New York and Connecticut automatically rule out Medicare Advantage plans as your best option.
A Medicare supplement plan is where you should focus your attention. Medicare supplement plans are national insurance coverage. They give you the freedom to see any doctor or go to any hospital in the country, as long as they accept Medicare.
Which is pretty much all of them.
So if you are a snowbird or like to RV around the country you can rest easy knowing your insurance is accepted everywhere you go. If you get sick and the best care for your condition is at Sloan Kettering or MD Anderson or Mayo Clinic, you can go with confidence that your Medicare insurance will be accepted.
There are a lot of states have specific Medicare rules that apply to only their residents. New York and Connecticut (Medicare NY Medicare CT ) are two such states and the only two states in the country where you can get a Medicare supplement plan at any time and an insurance company can never ask health questions. That’s a big deal!
With Medicare NY Medicare CT the insurance company cannot deny you coverage. They can’t charge you more because of your health history. You can get any Medicare supplement policy available to you, at any time and you are guaranteed to be accepted.
In other states that’s not the case. In most other states the only time you can get a Medicare supplement policy without having to medically qualify first is during the first six months after you enroll in Medicare Part B. After those six months, you have to qualify medically in order to change Medicare supplement plans. An insurance company can reject you based on your health history. For residents of those other states, if their recent health history includes things like a heart attack, cancer, stroke, Alzheimer’s, Parkinson’s, chronic disease, complications from diabetes they may not be able to change from the Medicare supplement plan you have. They are stuck.
According to Medicare, almost one in ten people who currently have a Medicare supplement plan are stuck in a Plan that was discontinued. The last time Medicare discontinued plans was back in 2010. This makes it very important for these Medicare beneficiaries to do what they can to get into the right plan for their needs and budget, the right decision the first time. But the special rules created for Medicare NY Medicare CT make getting stuck in a Medicare supplement impossible for residents of Medicare NY Medicare CT.
Now – Before the trolls come out; I am fully aware that some other states have specific laws that also allow their residents to switch Medicare supplement plans during certain times of the year. I help people in virtually every state in the country. I am aware of the California and Oregon birthday law, or the Missouri anniversary law. But those states are few and none are like New York and Connecticut, and this video is for residents of New York and Connecticut.
So, for residents of New York and Connecticut; you can be on your death bed and convert your Medicare supplement plan to the most comprehensive coverage available, so you don’t have any medical bills. No questions asked. This also means you can and should incorporate an entirely different strategy when shopping for a Medicare supplement plan than people in other states. That is what is most important for you to get out of this video and what I cover next.
First –Here is what you should not do;
- Don’t waste your energy trying to find the best coverage you can afford. I’ll explain that in a moment.
- Don’t worry about Medigap Plan F being phased out in 2020. People that need to worry about that are those that can get stuck in a plan because their health deteriorates and they can’t switch coverage. Your state made sure you can’t get stuck in a plan.
This is what your Medicare NY Medicare CT strategy should be:
Choose the lowest cost coverage now. This will be coverage that limits your maximum out-of-pocket liability. It makes certain you can’t have medical bills beyond what you can manage. No matter what. If something happens, you get ill and you are looking at higher medical costs in the near future, you can switch to the Medicare supplement plan with the most comprehensive coverage. You will pay a higher premium, but you will not have to deal with Medical bills. And hey, you can even switch back to lowest cost coverage later after you recover. No Questions asked.
Here is what I would do for Medicare NY Medicare CT:
The Medicare supplement plan with the lowest premium is typically your Medicare supplement Plan F –high deductible. Anyone who is eligible for Medicare prior to 2020 can get a Medigap Plan F-High Deductible. After 2020 this plan will be replaced with an identical plan called the Medigap Plan G – high deductible. Different name, same benefits. If you want to switch to that plan after 2020, you can.
Let’s take a look at rates and what you will save. Then I will talk about the benefits that the Medigap High Deductible plan offers so you will see why this is such a good strategy for you. This is what you do to save on Medicare supplement insurance.
What you should know first is that all the Connecticut and New York Medicare supplement plans are priced as Community Rated.
A Community Rated plan is a Medicare supplement priced the same regardless of your age. A 65-year old will pay the same as 75-year old or 80-year old. This pricing structure makes it easy for you to take advantage of your special rights that you get with Medicare NY Medicare CT.
However, Medicare supplement plans in New York and Connecticut can cost twice as much as they do in most other states.
With Medicare NY Medicare CT a Medicare supplement Plan F or Plan G can cost $200 to $300 or more each month. That’s $2,400 to over $3,600 each and every year whether you use it or not.
If you have pen and paper handy, right that down. Your Plan F or Plan G premium can be between $2,400 and $3,600 per year, whether you use your insurance or not. Your exact rates depend on which state and your zip code and which insurance company you choose.
Compare this to a Medicare supplement Plan F-High Deductible (Plan F-HD). With the Plan F-HD you can lower your premium down to between $600 and $800 a year. That’s one-third the cost.
The Medicare supplement Plan F or Plan G-High-Deductible is the Medicare supplement Plan with the asterisk. It is exactly like a regular Medicare supplement Plan F or Plan G except you pay a deductible before your Medicare supplement plan kicks in. You get a 100% insurance coverage after you pay the Medicare supplement deductible. Another way to look at it is that the Medicare supplement deductible is your maximum annual out-of-pocket cost.
Now This part is important; you pay this deductible before your Medicare supplement plan kicks in, NOT before Medicare pays its portion. Medicare pays anyway and pays before your supplement plan.
The Medicare supplement Plan F High Deductible has an annual deductible that is $2,490 as of 2021. Every dollar you spend in Medicare bills for inpatient and outpatient services is credited toward that deductible. Once the deductible is met, your supplement plan gives you 100% coverage.
Let’s look at an example:
Say you’re not feeling well and you go to the doctor. You have a bunch of tests taken and you go back again several times. What is your Medicare bill going to look like when you have a Medigap Plan G-high deductible Medicare supplement?
First, because this is outpatient services you will pay the annual Medicare Part B deductible. This is Medicare’s deductible, not your supplement. However, what you pay is credited to your supplements deductible. In 2017 the Medicare Part B deductible is just $183.
After you paid this deductible, your Medicare Part B covers 80% of your Medicare bills, you pay 20% up until you have paid your Medicare supplement deductible and maximum annual out-of-pocket liability of $2,490.
A typical doctor GP visit is going to be about $100 to $200. Medicare will pay 80%. That’s $80 to $160. You pay 20% or $20 to $40. Whatever you pay is credited toward your Medicare supplement’s deductible.
If you have $1,000 worth of blood tests, Medicare will pay $800, you pay $200. That $200 is credited toward your Medicare supplement deductible. The point here is that with a high deductible Medicare supplement plan you are NOT paying the first $2,490 in medical costs. Medicare still pays its portion. It would take $11,183 of Medicare bills in 2017 in order for you to have $2,490 in out of pocket expenses.
For most people that doesn’t happen often.
You should also be aware that the $2,490 annual deductible can change in the years ahead. The amount of the deductible is written into Social Security law. It can increase along with any increases in the increases in the Consumer Price Index (CPI-U).
So your choice is to go with a Medicare Supplement Plan F, or Plan G or Plan N and pay $2,000 to $3,000 or more each and every year in insurance premiums alone, whether you are healthy or sick. Or go with a Plan G or F-High deductible and pay just $600 to under $800 a year in premiums knowing that the most you will pay in Medicare bills are capped at about what you would pay in insurance premiums with other plans or less.
I have a couple videos that describe the benefits on high deductible Medicare Supplement Plans in detail if you want to learn more or see more examples. One of the videos is linked above and below, but the easiest way to find them all is to subscribe to my channel now. Just click the subscribe button below. That way you can find all my Medicare videos on my YouTube channel after you are done with this video.
The Plan F-HD video uses Florida rates as an example. But that’s no big deal. Medicare supplement premiums in Florida are almost as expensive as New York and Connecticut. The intent is to help you fully understand Medigap Plan F-HD.
I want to add one more important piece of information.
While the benefits offered by ALL Medicare supplement Plan F-high deductibles plans are exactly the same, exactly; the prices are not. Don’t just pick any Plan G-HD. Some companies charge twice the amount you should pay for the exact same benefit.
Obviously, because I am an independent Medicare insurance broker I can get you the best price with an A+ rated company. Just use the Contact Us link below or above to get in touch with me. So, as a resident of New York, your Medicare supplement strategy is different than with any other state but very simple. Go with the low cost of a Medicare supplement Plan F high deductible to keep your premiums down.
You enjoy all the benefits of a Medicare supplement plan. You can see any doctor in any state and go to any medical facility, as long as they accept Medicare. Your out-of-pocket risk is limited. If you ever believe you are about to face high medical expenses, just switch to a more comprehensive plan. Once those expenses are behind you, switch back to the lower cost plan. No medical questions asked and you are guaranteed to be accepted.
If you want to find out what the best priced Plan F-High Deductible premium is for you, let me know. My services are free to you because I am paid by whichever insurance company you choose to insure you.
I hope you found this information helpful. Please Like this video, press the thumbs up for me if you found this information useful. When you do, you help other people researching the same questions you had, find this video.
If you want more, subscribe to my YouTube channel so you can see all my Medicare videos.
Now it’s your turn. I make these videos for you.
Leave me a comment below and let me know what part of this video that you found most informative or that you plan on using as you shop for Medicare. Did you know about the special Medicare rules?
And if you have a question I did not answer, ask below and I will respond. I am really interested in what you have to say.
For Part D drug plan info visit: https://partdshopper.com
Also visit: https://en.wikipedia.org/wiki/Medigap
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.
