Medicare Supplement Plan N – Big News

In this brief video I have some big news on current events and their impact on Medicare supplement Plan N.

If you have a Medicare supplement Plan N or are currently researching Medicare supplement plans, this information will be important to you.  So, stay tuned.

For those who have watched any of my 40 plus videos or read my articles on the various Medicare supplement plans you will know a few things about how I approach advising people on their Medicare.  First and foremost is that there is no bad or good Medicare supplement plan.  All Medicare supplement plans are good because they allow you to keep the benefits of Original Medicare.  You can see any doctor, go to any medical facility as long as they accept Medicare.  ……..In addition, no insurance company has a say in your coverage.  Medicare makes all the decisions.

Please see our other videos in our New To Medicare series

As you evaluate Medicare supplement plans your goal should be to first find the plan that you believe is the best value. The right plan for you is the one that meets your needs and your budget.  After you know which plan is right for you it’s important to identify an insurance company whose prices are competitive and stable.   All that said, as I make this video in late March of 2020 there are two new developments that will likely increase the value of Medicare supplement Plan N.

Let’s take a look……..

First, is a big change by Mayo Clinic and their Florida facility.  For people in Florida one of the drawbacks of a Medicare supplement Plan N has been that Mayo Clinic in Florida has charged a Medicare Part B excess charge.

     Many people view Mayo Clinic as one of the nation’s top cancer treatment facilities, especially for blood cancers.  Unfortunately, the Mayo Clinic in Florida charged an excess charge for many outpatient services. .  That would leave the Medicare Plan N policy holder liable for the extra 15% billed on most outpatient services.  The good news is that Mayo Clinic in Florida no longer charges an excess charge.  They now accept Medicare assigned rates.

The only state where Mayo Clinic  still charges an excess charge is in their Arizona facility.  You can find this information by going to the MayoClininc.org website and looking in the FAQ (frequently asked questions) section.

This news is big news on several levels.  Obviously, it’s big for Florida residents and those in nearby states who might wish to travel to the Mayo Clinic in Jacksonville Florida for treatment. But it goes beyond that.  It is an important part of a growing trend.    To the best of my knowledge, Mayo clinic is the last of the major medical facility holdouts that charge an excess charge.  There are a few doctors here and there, but fewer each year.    You see, Medicare penalizes doctors that choose to have a contract with Medicare allowing them to charge Medicare Part B Excess Charge.  …..Medicare pay. them less than those who accept assignment and Medicare won’t be their one-stop biller.  This means the doctor or facility that charges an excess charge cannot bill your supplement.  ………In most cases they ask you to pay upfront for the service and then submit your bill to your supplement company for reimbursement.  Not exactly consumer friendly.

So Mayo Clinic’s retreat from excess charges in Florida is a big deal.

There are also forces within the insurance industry that are lobbying your state insurance commissioners to simply outlaw excess charges in your state.  That is already the case in numerous states like Pennsylvania, Ohio, New York and others. But if each insurance commissioner would do the same, we can get rid of Medicare Part B excess charges everywhere.  That would really make Plan N a great value.   Don’t be afraid to write a letter to your state insurance commissioner asking that Medicare Part B excess charges be outlawed in your state.   It will help.

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Alright, that’s the first piece of big news.  The second piece of big news has to do with developments resulting from the COVID-19 / Novel Coronavirus outbreak.

A couple days ago, mid-March of 2020, the US Government announced an unprecedented expansion of telehealth services for Medicare.  This will impact both those on a Medicare Advantage Plans as well as those with Medicare supplement Plans.

The announcement, and I quote:

““Medicare patients can now visit any doctor by phone or videoconference at no additional cost, including with commonly used services like FaceTime and Skype,” Drumpf said during a White House press briefing. “A historic breakthrough — this has not been done before.”

from CMS, Seema Verma said, they would exercise “enforcement discretion when it comes to collecting copays, so that costs won’t be a barrier.”

Now, there are two parts to why this is important.

The first part is that telehealth is very likely to see a permanent boost in its availability and usage from this event.  The government is putting a lot of many in to making telehealth meetings more available. Doctors and other healthcare professionals are “breaking the ice” starting to use telehealth meetings out of necessity and will find it easier to manage than they expected.     And, of course, it is a very efficient way of working with patients that have any infectious disease.  It keeps the healthcare workers safe while providing meaningful convenience for the ill…….they no longer need to get in their cars and drive to an office to wait for an appointment to see a healthcare professional.

As a result of this virus and the government response, we are likely to see a lot more telehealth in the years ahead.   It’s a natural progression of using technology to become more efficient in business and reduce the risk of spreading infectious diseases   But how does this impact Medicare supplement Plan N policy holders specifically?

Good question!

As you likely already know, one of the drawbacks, minor drawbacks of a Medicare supplement Plan N is that there is a co-pay of up-to $20 per office visit.  These are visit with a doctor or nurse practitioner for diagnosis, evaluation and management.  There is no copay for physical therapy or lab work etc.  Just doctor visits.

Well, as you may have guessed.  There is also no copay for telehealth doctor visits.   Let me repeat that.  There is no copay for telehealth doctor visits.  When CMS published their guidelines for Medicare supplement Plan N back in April of 2010, they published the specific billing codes that allowed for a copay.  That way there is no confusion among healthcare providers.  In item six of the CMS (Center for Medicare and Medicaid Services) guidelines it specifically reads:

“6. Would online, telephone, or telehealth services constitute “office visits” for purposes of 

determining whether a Plan N subscriber is subject to the Part B coinsurance or copayment of up to $20? 

Providers do not code these services as office visits, office consultations or evaluation and management visits in their Part B billings. Therefore, these services would not be subject to the Plan N coinsurance or copayment. “    

So there you have it. As telehealth becomes more mainstream in usage it offers the Medicare supplement Plan N policy holder a way to visit a doctor for evaluation, diagnosis and management WITHOUT a copay.

The fact that fewer medical professionals are charging an excess charge along with the mainstreaming of telehealth meetings in Medicare I believe combine to make a Medicare supplement Plan N an even better value in the years ahead………

Please don’t misunderstand me.  All Medicare supplement plans are good plans.  Choosing the right plan for you will depend on your personality, your needs and your budget.  But as you make that decision, consider what we covered in this video.

If you would like my recommendations for a plan and insurance company in your zip code, please complete the quote request form linked below.  Our services cost you nothing.  In addition, you get our services in helping you with your Medicare claims and benefits or if you just want to re-shop a plan in the years ahead.

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