QUESTION: I am losing my group health coverage with General Motors, 1-1-2009, that I have had since I retired. Now I must find a Medicare Supplement and make sure my benefits are as good as what I had. How do I compare these plans, it is so confusing?
ANSWER: We have been contacted by MANY General Motors retirees about this very subject. Keep in mind you will only have 63 days to get your Medicare Supplement with no underwriting on a guarenteed issue basis. EVERY STATE & SUPPLEMENT COMPANY HAS DIFFERENT PRICES FOR EACH PLAN. PLEASE REMEMBER THAT THE BENEFITS ARE ALL THE SAME ON EACH PLAN NO MATTER WHAT STATE OR COMPANY YOU CHOOSE. THAT IS WHY YOU NEED A COMPARISON OF MEDIGAP PLANS SO YOU CAN FIND THE BEST PRICE IN THE STATE YOU LIVE IN, FROM THE DIFFERENT CARRIERS. Let me run down the best Medicare Supplement plans and what they do and do not cover for you.
Plan J - This is the Cadillac of Medicare Supplement Plans. Some people like to pay for all the bells and whisles even though they may possibly not need them, just to have that extra luxury. Plan J has everything all the other plans have plus the following:
Prevenative Care - This is an extra $120.00 per year for prevenative care such as a physical. However, if you have any health issues your doctor will do all the bloodwork anyway and you will end up getting the equivalent service.
Home Heath Care - This is $40 per day up to $1,600.00 of unskilled care per year, such as bathing, household chores. If you need this type of care you are probably getting skilled care as well and this is covered under other less expensive plans. You can’t get much for $40 a day these days.
Excess Charges - Plan J will cover 100% of any charges over the limit that Medicare allows for your illness that your doctor bills you. This means that if Medicare allows your Doctor to charge you $3,000 to blast away your Kidney Stones, but the Doctor charges you $3,450, this Plan J will pay for it anyway. LEGALLY, YOUR DOCTOR CAN ONLY CHARGE YOU 15% OVER WHAT MEDICARE WILL PAY.
Part B Deductible - There is a $135.00 yearly deductible on a Medicare Supplement. Plan J covers this for you, however, you may be paying more in premium for this $135 than it is worth.
Plan F - Plan F is the Oldsmobile of Medicare Supplements. It covers everything plan J covers except the following:
Home Heath Care - $1,600.00 per year
Preventative Care - $120 per year
Plan G - Plan G is the Chevrolet of Medicare Supplements. It is the most cost effective plan if paying the premium is an issue for you, yet it still has good coverage. Plan G has everything including Home Heath Care except:
Prevenative Care - $120 per year
100% Excess Charge Coverage - This plan does pay for 80% of excess charges. Which will be more than sufficient in most cases. This means that if Medicare allows the Doctor to charge $2,000 to remove your Gallbladder, and the Doctor charges you $2,300 this Plan G would cover it all but $60.
Part B Deductible Coverage - Keep in mind that if you want your plan to pay for the $135 a year deductible you may be paying more in premium than it is worth.
Plan C - is the same as the F plan, but it does not cover ANY EXCESS CHARGES.
PLEASE UNDERSTAND THAT A MEDIGAP PLAN – SELECT WILL LIMIT YOUR CHOICES OF HOSPITALS. IF IT HAS THE WORD SELECT IN THE NAME, YOU MAY NOT WANT IT.
As you can see, there are many things to consider. It all comes down to how much premium you want to pay for coverage you may not need. Some people want it all and don’t mind paying a higher premium per month to get it. All Medicare Supplements pay the 20% of all your doctor and hospital bills that Medicare does not cover with their 80%. You can decide if you want all the extras, or maybe you don’t mind rolling up your own windows or not having heated leather seats. It is up to you!!
At My Part D USA we can consult with you and help you choose the plan that would be best for you based on YOUR NEEDS and DESIRES. We can also help you get your Supplement, no matter what Plan you choose at the lowest prices.
MEDICARE ADVANTAGE PLANS should be avoided, unless you cannot pay the monthly premium on Original Medicare combined with a Medicare Supplement/Medigap Plan.
ONE THING TO REMEMBER ON ADVANTAGE PLANS IS DOCTORS SOMETIMES CHARGE THE EXTRA 15% THAT THEY CAN LEGALLY CHARGE PEOPLE ON MEDICARE OVER THE MEDICARE FIXED ALLOWANCE FOR AN ILLNESS. MEDICARE ADVANTAGE PLAN DO NOT PAY ANY OF THESE EXCESS CHARGES!!!! THAT IS WHY PEOPLE HAVE MORE OUT OF POCKET COSTS WITH ADVANTAGE PLANS AND DO NOT GET THE COVERAGE THEY THOUGHT THEY WOULD BE GETTING, PLUS THEY STILL HAVE ALL THE CO-PAYS AND DEDUCTIBLES. NOW WHY WOULD ANYONE WANT THIS??? THAT COMBINED WITH THE FACT THAT YOUR DOCTOR AND HOSPITALS WILL NOT BE CONTRACTED TO TAKE AN ADVANTAGE PLAN’S TERMS OF PAYMENT FROM ONE VISIT TO THE NEXT, IT IS NOT WISE THAT ANYONE WOULD JOIN AN ADVANTAGE PLAN UNLESS THEY COULD NOT AFFORD A MEDIGAP PLAN OR THEY WERE DISABLED AND COULD NOT GET ANY OTHER KIND OF COVERAGE.That is what we recommend and we are standing by this. Keep in mind that you will be approached by many Medicare Advantage Plan salespersons, telling you that their plan is better than Original Medicare, BUT they do not compare against Original Medicare with a Traditional Medicare Supplement. There are many co-pays and hoops to jump through.
THAT IS WHY I CALL THE MEDICARE ADVANTAGE PLANS THE FORD PINTO OF MEDICARE COVERAGE – - IT JUST MIGHT BLOW UP ON YOU!!
You have worked hard and deserve the BEST COVERAGE!
When you come off your retirement plan you only have 63 days from the end of your group plan to get a Medicare Supplement with NO UNDERWRITING. This is the only time you will have NO HEALTH QUESTIONS ASKED AND A GUARANTEED ENROLLMENT ON THE PLAN OF YOUR CHOICE!
PLEASE CALL US TOLL FREE AS WE WOULD BE HONORED TO ASSIST YOU IN GETTING YOUR MEDIGAP AND PART D DRUG PLAN FOR 2009!!
Please write to me, Karyn Blake, here at My Part D USA’s blog at kblake@MyPartDusa.org. Or you can email this article to a friend.
Published by mypartdusa on November 2, 2008 in Traditional Medicare Supplements.
