To decide which Medicare Supplement Plan is right for you, you must first determine how much out-of-pocket cost you’re willing to tolerate after paying your monthly premium. Those on a Medicare Supplement Plan F don’t have to worry about any out-of-pocket costs for their medical care (except custodial or long-term care) because it’s covered by their plan.
Seniors on a Medicare Supplement Plan G enjoy the same benefits as those on a Plan F, but they’re required to pay their own annual Part B deductible of $185 (in 2019). Sometimes the difference you’d pay in additional premium to have your plan cover that cost for you, is multiples more than just paying the $185 yourself. You just have to ask yourself: is it worth paying (or overpaying) the insurance company to pay that deductible for you?
Seniors on a Plan N also are responsible for a $20 doctor copay and a $50 ER copay per visit, in addition to the Part B deductible – after those costs, the plan operates exactly like a Plan G. Since Ohio banned balance billing for Medicare providers, seniors in the Buckeye state who have Plan N don’t have to worry about excess charges – whereas seniors in other states that haven’t banned excess charges could be liable for 15% additional in charges for medical care.
How much out-of-pocket costs will I be responsible for?
When it comes to out-of-pocket costs, you’re either choosing no out-of-pocket costs with a Plan F, paying just the Part B deductible ($185 in 2019) with a Plan G, or being responsible for the Part B deductible plus doctor and ER copays with Plan N. In exchange, you’ll pay a higher monthly premium for a Plan F, less for a Plan G, and even less for a Plan N, so it makes sense to weigh potential out-of-pocket costs and monthly premium payments when you’re considering the overall cost of a Medigap Plan.
What other extras come with my plan?
Some companies, like Medical Mutual, offer a FREE membership to Silver Sneakers when seniors enroll in one of their Medicare Supplement plans. This program allows seniors to visit one of more than 15,000 participating locations including YMCA and city recreation clubs, that allow free membership through Silver Sneakers.
Another program that select health insurers (like Medical Mutual) offer seniors through Silver Sneakers membership is CollegeSave, which allows seniors to earn points that can be traded for tuition dollars for a family member. Seniors earn 1,000 points just for enrolling, and another 250 points for going to a participating Silver Sneakers location at least 7 times a month. Each point is worth a dollar of tuition for one of your family members. Ask your broker for more details.
What if I get sick?
One thing many seniors don’t think about when choosing a supplement is: “What happens if I get sick? Does it impact my ability to change plans later? Can my plan kick me off altogether?”
The answer is: Certain conditions could impact your ability to pass the health underwriting questions if you want to change plans later on. Why would you want to switch Medigap companies in the future? Because not all companies stay competitive forever – sooner or later they all start raising rates. That’s why it’s important to choose an insurer that has a history of stable rate increases – so that, if you develop a chronic condition at some point, you’re not stuck with a company that continues to jack up your rates. Of course, there will always be rate increases – the trick is to find a company that prices its supplements competitively but modestly, so that when rate increases happen, they’re only 3-7% higher, as opposed to 9-13%.
If you have a few health conditions, but still qualify to change supplement insurers, definitely research your options or have your insurance broker research your options – so in case your health gets worse, at least you’ll be with an insurer that won’t make things even harder on you by raising your rates unnecessarily.
Remember – even if you can’t pass the underwriting questions to change plans, rest assured that your insurance company can never kick you off your plan or cancel your coverage as long as you pay your premium. And no matter how sick you may get; your company cannot single you out to raise your rates.
Do I qualify for any discounts?
When shopping for a Medigap Plan along with your spouse, keep in mind that some insurers offer discounts of almost 5% if you both apply at the same time. Not every company offers these “Household Discounts” – and not all of those that offer the discount have the same rules.
Some companies just require two seniors to be living together, while other companies require them to be legally married to qualify for this discount. Some companies grant the discount just for applying, while other companies require both seniors to actually take the policy in order to get the discount – so if one spouse is declined due to health, those companies may not offer the discount. That’s why it can be beneficial to work with a good insurance broker who can correctly identify which companies offer Household Discounts, and understand their rules for obtaining the discount.
In addition, some insurance companies may offer discounts if you pay your premium quarterly or annually instead of monthly.
