Whether you are new to Medicare and want to be sure you make the right choices from the start, or you have been with Medicare for years and simply want to be certain that you are getting the best coverage and value for your money, this article is for you. In this article, I will go over the ten things you need to know to get the best Medigap plan coverage at the best price and value available to you.
Free Government Resources
There are free resources available to you that will help you better understand your Medicare coverage and make better decisions. The two publications that every person on or shopping for Medicare should have are the current Medicare & You guide and the guide Choosing A Medigap Policy.
The Medicare & You guide includes details on what is covered by Medicare, how and when to enrol and information about your Medicare rights. A new Medicare & You guidebook is published each year with information to help you understand Medicare Part A, Part B, Part C (aka Medicare Advantage plans) and Part D. If you are new to Medicare, you can access an online copy from the links provided and order a hard copy from Medicare.gov.
Choosing a Medigap Policy is also an important publication and one most forgotten by Medicare beneficiaries. This publication goes into detail about Medigap (aka Medicare Supplement) policies that is not found in the Medicare & You guidebook.
Lastly, the Medicare.gov and Social Security websites are great resources full of information you need. In fact, the Medicare.gov website offers the only tool allowed to compare and shop for the best Part D prescription plan.
Want to learn more? Visit our index of links and articles for more resources .
Standardized vs. Regulated Medicare plans
Medicare supplement plans are standardized, Medicare Advantage plans are not.
This is an important distinction that cannot be understated. All Medicare Supplement plans are standardized so that within each plan type, the benefits offered are exactly identical regardless of the insurance carrier. Medicare Supplement types (aka Medigap plans) are identified by a letter. For example, Medicare Supplement Plan F, Plan G and Plan N.
Because they are standardized, the benefits offered by all Medigap Plan F’s are the same, the benefits offered by every Plan N are the same and so on. The only difference between one carrier and another is the plan price, and prices will vary widely. For example, in some areas of the country, there are more than 30 different companies offering a Plan F, each company offering the same plan at a different price. The premium for the most expensive plan is often twice that of the best-priced plan. These are the exact same benefits!
Even more, once you have a Medigap plan it cannot be changed or canceled unless you fail to pay your monthly premium. Your plan is a private contract between you and the Medigap company that binds the insurance company to the terms and conditions for as long as you pay the premium.
Medicare Supplement plans contrast greatly with Medicare Advantage plans in that Medicare Advantage plans are NOT standardised. They are regulated by Medicare and must meet certain minimums, but that is all. These plans vary greatly in their benefits offered from one insurance company to another. The plan benefits and costs can and do change every year as well. They can change benefits, doctors, and fees. This means the Medicare Advantage plan beneficiary needs to shop their insurance coverage every year during the annual election period from October 15 to December 07th.
To get the best value, you have to shop both companies and prices.
Not only are prices for the same Medigap plan wildly different from one insurance company to another, but insurance companies that offer Medicare Supplement plans do not offer all the plans available to you. If you call up an insurance company and ask them which plan is best for you, they can only talk about the Medigap plans they have to offer. Some of the largest companies, for example, only offer Medigap Plan F and Medigap Plan N. If it so happens that Plan G is the best value for you, they won’t tell you.
In Florida, Medicare Supplement pricing is such that Medigap Plan F-HD is often the best value. Although there might be twenty different companies offering Plan F in any one zip code, only three offer Medicare Supplement Plan F-HD.
In Pennsylvania, Medigap Plan N is often the best value. There are areas of Pennsylvania where thirty-three insurance companies offer a Plan F Medicare supplement, but fewer than twenty offer Medigap Plan N.
Want to know more about who offers Medigap plans in your area and at what monthly cost? Simply complete this quote comparison request and we will email you the list of companies and prices.
At a minimum, shop these four plans:
Depending on the state you live in, either Medigap Plan F, Plan N or Medigap Plan G will be your best value. In Florida, Medigap prices are unusually high making Medigap Plan F-HD (Plan F-High Deductible) the best value. As you shop plans, at the very least shop the prices and review the benefits of Medigap Plan F, Plan G, Plan N and Plan F-HD.
According to the latest statistics, more than 53% of Medicare Supplement policyholders have either a Medigap Plan F or a Medigap Plan C. Both those plans are being discontinued as of 2020. Only people eligible for Medicare prior to January 01, 2020 will be able to purchase these plans. Medigap Plan N and Medigap Plan G are being aggressively priced by some insurance companies to attract Medicare beneficiaries that are switching plans. This is creating some great pricing opportunities for medicare beneficiaries of all ages.
Know who has your best interest in mind.
You can get invaluable advice and guidance from an experienced insurance professional without paying a dime. However, you may need to weed out the salesperson from the consultant.
Insurance agents who work for an insurance company can only represent the best interest of that insurance company, their employer. They seldom offer all the products from which you should choose as their products and prices are limited to what the insurance company allows them to show you. Nothing more.
Independent insurance brokers have access to multiple insurance companies and offer all Medicare Supplement plans available to you and sometimes Medicare Advantage plans. Because they are independent, they work for your best interest. A good insurance broker will be open and forthright about how and how much they are paid.
Although Medicare Advantage Plans often charge no premium above your Medicare Part B fee, they are the highest paying commission product in Medicare and offer the lowest insurance protection to the client. On average, commissions on a Medicare Advantage plan are more than twice that of a Medicare Supplement. Sometimes a Medicare Advantage plan is the right answer to a person’s insurance needs, but only in two out of ten cases. Beware the insurance agent who presents a Medicare Advantage plan before going over the advantages of Original Medicare and a Medigap plan. They may be more interested in their commissions than your needs.
Want to learn more? Read Do I Need an Insurance Agent for Medicare?
Know your state specific Medicare laws!
With Medicare supplement plans there are two ways that your policy premiums can increase over time. Thirty-eight of our fifty states allow for an Attained age pricing structure. With Attained-Age your policy premium can increase every year because you are a year older. This is typically a price increase between 2.50% and 3.50%. In addition, your price can increase due to medical cost inflation.
Four states (AZ, FL, GA, and ID) require Medigap prices to be “Issue Aged”. The issue age policy cannot increase in price due to your new attained age, but can still increase in price due to medical inflation.
Eight states require Community Rated pricing, where everyone pays the same price for the same plan regardless of age. These states are AR, CT, MA, ME, MN, NY VT and WA. A community-rated policy also cannot increase in price due to you’re getting older each year, but price increases due to medical cost inflation are common.
In addition, there are also eight states that have enacted a law that overrides some of Medicare billing rules. These laws are called the Medicare Override Measure (MOM) and forbid or reduce Medicare Part B excess charges. In these MOM states (PA, CT, MA, MN, NY, OH, RI and VT) the value of Medigap Plan N is enhanced and should be considered more favorably because Plan N does not charge for Medicare Part B excess charge insurance. Medigap Plan F and Plan G do charge extra to insure against Part B excess charges, which are forbidden or reduced in these states.
If you live in either Wisconsin, Massachusetts or Minnesota; these three states have standardised Medicare plans that are completely different from those available in the rest of the country. Check your state department of insurance website for detailed information on plans and prices.
You can change your Medicare Supplement plan any time of year, as often as you choose.
Many Medicare beneficiaries mistakenly believe that they have to wait for the Annual Election Period, October 15 through December 07, to switch to a better or more cost-effective Medicare Supplement. The Annual Election period only pertains to Medicare Advantage plans and Part D prescription plans.
Medicare Advantage and Part D plans can change every year and thus you need the Annual Election period to evaluate the changes and decide if you wish to keep or change insurance plans. Because Medicare Supplement plans are standardised and cannot change from year-to-year there is no need for an Annual Election Period.
If you have a Medicare supplement and have been experiencing uncomfortable rate increases, you may be able to find a better price or value by shopping your coverage. You don’t have to wait for an Annual Election period.
Medicare is governed by Social Security law.
You must use the same zip code for both your Social Security Income check and your Medicare /Medicare Supplement. Medicare is governed by Social Security laws. Because prices change by county and zip code, you must use your permanent address to set your Medigap price and Medicare Advantage plan availability. Your permanent address is defined by the address used to vote, pay taxes and receive your Social Security Income check. If you attempt to use a different zip code, you run the risk of the insurance company cancelling your plan for contract fraud when you need it most. This, of course, is critical for Florida Snowbirds and others who spend several months each year living in two different states.
The company that offers you the best price and value when you are 65 is not likely to be that same company with the best price and value when you are over 70.
There are two different Medicare Supplement markets; the 65-year old new to Medicare and the 70-year-old Medicare shopper. When you are new to Medicare you can get any plan you choose without medical underwriting. As a result, many people who have a health history that would otherwise pay a higher rate or even be denied coverage are pooled in with the healthiest people, all at the same rate. The insurance companies that target this market know they will have to raise their rates later to account for higher medical costs. They also know that most people are hesitant to change policies and will tolerate annual price increases without shopping. By the time you are over 70, these policies are the often some of the more expensive Medigap plans. If you shop for a better price, you can often save hundreds of dollars per year.
The group of insurance companies that target the 70-year-old Medicare shopper intentionally try to avoid the 65-year old new to Medicare who will get a policy without underwriting. Instead, they price their Medigap plans to be among the best values for those over 70 knowing that most people at that time will have to go through medical underwriting to get a policy. Medical underwriting weeds out those who demand higher medical expenses. The result is a pool of healthier seniors with lower than average medical expenses. Lower medical expenses mean lower Medigap prices and fewer rate increases. It’s a win-win to shop for a new Medigap plan and lower your rates.
Armed with knowledge, take these four steps outlined on Page 25 of Choosing A Medigap Policy to get the best value and price:
Step 2: Find out which insurance companies sell Medigap policies and that particular policy in your state.
Step 3: Call the insurance companies that sell the Medigap policies you’re interested in and compare costs.
Step 4: Buy the policy
Of course, you don’t have to call all the companies to find out which company offers plans in your area and at what price. We have all that information at our fingertips. Simply complete a Quote Request form and we will provide you with the best prices available to you for whichever plan(s) interest you.
Our role as an independent insurance broker is to make certain you have the information you need to make an educated and informed decision about Medicare. We share our industry experience to help you avoid the common and mostly mistakes and give you confidence in your choices.
Call us today at 1-800-847-9680 extension 2 or use the quote request form below to get the information you need to find the Medigap plan and insurance company with the best price and value.
Matthew Claassen, CMT - Independent Insurance Broker
Florida License #W176030 | National License (NIPR) #765847
Medigap Seminars Insurance Agency
110 Front St., Suite 300, Jupiter, FL 33477
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Independent Medicare Insurance Broker
Matthew Claassen is an independent Medicare insurance broker specializing in Medicare plans. Neither Mr. Claassen nor MedigapSeminars.org are employed by, endorsed or represent CMS, Medicare or Medicaid or the US Government. We are insurance representatives and not a government organization.
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He is an independent Medicare insurance broker servicing all of Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Michigan, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wyoming. Our most recent Florida clients come from Palm Beach Gardens, Sarasota, Port Saint Lucie, Stuart, West Palm Beach, Broward County, Miami, Tallahassee, Orlando, Gainesville, Tampa, Clearwater, Saint Petersburg, Fort Myers, Delray, Lake City, Martin County, Manatee County. Boca Raton, Fort Lauderdale, Naples, Cape Coral, Daytona Florida and more.
It doesn’t matter if you are just turning 65 and learning about Medicare for the first time, or have an existing Medigap plan. If you want to be certain you have the right Medigap plan coverage and are paying no more than you have to, we can help. We can help you through either our public Medigap plan and Medicare online seminars or through private no-obligation consultation. Get the best Medigap plan for you at the best price possible.You can also visit my agency website at ShieldInsuranceSolutions.com or call at 800-847-9680. Florida License #W176030 – National Producer # 765847