Medigap Mondays

This blog section contains information about Medicare supplement plans. You can learn more about the following:

Medicare Underwriting - Advantage vs. Supplement - Happy Seniors

Medicare Advantage vs Medicare Supplement

Compare Advantage Vs Medicare Supplement

The Medicare 2021 chart below compares Medicare Advantage vs Medicare Supplement. This chart shows positive (green), negative (red), and equal value (black). Medicare Supplement works with Original Medicare, so it provides you with nationwide coverage and access to any doctor and hospital without referrals.

However, Medicare Advantage provides you with local (HMO) or regional (PPO) coverage for doctors and hospitals in-network. For example, doctors outside an HMO network are not covered and require referrals. Furthermore, doctors outside of a PPO network are allowed but will cost you more. The 2021 chart below shows you several differences between Medicare Advantage vs Medicare Supplement.

Medicare Advantage vs Medicare Supplement - happy seniors
Medicare 2021 Chart - Advantage vs Supplement infographic
Embed and download Medicare Advantage vs Medicare Supplement Infographic

MedicareBob Video

In this MedicareBob video, Robert Bache “talks about the most important decision” people new to Medicare will make. Should you choose a Medicare Advantage or Medicare Supplement? Watch this video to help determine the right Medicare plan for you. 

Medicare Advantage vs Supplement Cost Differences

Part B Premium

Medicare Advantage and Medicare Supplement require you to have Medicare Part B. There is no Medigap Plan that pays your Medicare Part B premium. However, some Medicare Advantage Plans pay all or part of your Part B premium.

Copays and Coinsurance

Medicare Advantage charges you copays for each doctor visit or medical service. However, Advantage Plans do not charge you coinsurance.

Medicare Supplement Plans have no copays, except plans K (50%), L (75%), and N. You are charged copays for diagnostic tests, hospital outpatient, and ER visits. For Plan N, you pay up to $50 for outpatient emergency room visits and up to $20 for outpatient doctor visits.

Furthermore, Supplement Plans K and L only pay 50% and 75% respectively for Part B, Part A Hospice, and Skilled Nursing Facility coinsurance. In other words, you pay the remaining balance. For example, Medigap Plan K will cover 50% of your outpatient medicare service.

Advantage vs Supplement Plan Premiums

Medicare Advantage Plan premiums will vary based on coverage and the insurance carrier. However, CMS.gov reports, “historically low premiums in Medicare Advantage.” Furthermore, you have more than 1,600 prescription drug plans from which to choose. We can help you find the right Medicare Advantage Plan with our Advantage Plan Finder.

Medicare Supplements pay Part A and Part B coinsurance. For example, Medigap Plan G covers 100% of your hospital and medical services after you pay a $198 Part B deductible. Plan G is the most comprehensive coverage available for people new to Medicare in 2020. You can shop Medigap Plans by calling Senior Healthcare Direct at 1-855-368-4717 or get your quote.

Medical Underwriting – Advantage vs Supplement

Medicare Underwriting - Advantage vs. Supplement - Happy Seniors
Happy seniors avoid medical underwriting.

Starting in 2021, Medicare Advantage Plans accept all health conditions, including End-Stage Renal Disease (ESRD). Likewise, you can enroll in Medicare Supplement Plan without medical underwriting during your initial Open Enrollment Period (OEP). In other words, there is no medical underwriting when you are first eligible for Medicare, which includes:

  • Three months before you turn 65
  • The month you turn 65
  • Three months after you turn 65

However, anytime after your initial Open Enrollment Period, medical underwriting is required. For example, you switch to a different Medigap Plan after your initial OEP. Discover some of the most common underwriting questions and find out whether or not you can qualify.

Prescription Drugs – Advantage vs Supplement

Medicare Advantage Plans such as HMO and PPO most often include prescription drug coverage. However, Advantage Plans are not required to cover prescription drugs. If your HMO or PPO does not provide drug coverage and enroll in a separate Medicare Prescription Drug Plan, you will be disenrolled from your Medicare Advantage Plan.

Medicare Supplement Plans fills in the coinsurance and deductible coverage gaps of Original Medicare, which does not cover prescription drugs. To get drug coverage, you need to enroll in a separate Part D drug plan. Senior Healthcare Direct can help you find the right drug plan that includes all your prescriptions.

Max Out-of-Pocket Limits – Advantage vs Supplement

Forbes reports Medicare Advantage maximum out-of-pocket (MOOP) limits will increase to $7,550 in 2021. In other words, your max out-of-pocket cost will be $850 more for in-network services in 2021. Once you reach this MOOP limit, your Medicare Advantage plan will cover all costs until the end of the year.

All Medicare Supplement Plans cover most or all of your out-of-pocket costs except plans K and L. Thus, CMS.gov put the following out-of-pocket 2021 limits on plans K and L.

  • $6,220 for Plan K ($740 increase from 2020)
  • $3,110 for Plan L ($170 increase from 2020)
best medicare supplement plan 2021

Best Medicare Supplement Plan 2021

What is the Best Medicare Supplement Plan for 2021?

With 2021 fast approaching, Robert Bache gives his recommendation for the best Medicare Supplement Plan. Medicare Open Enrollment, also called Annual Election Period (AEP), begins October 15 and ends December 7, 2020. Watch the video to discover which Medicare Plan Robert Bache recommends for the upcoming AEP. In the video, you will learn:

  • Historically, his Medigap Plan recommendations have been “right on” since 2012.
  • How this most comprehensive Medigap Plan works.
  • Discover how this plan saves you on monthly premiums and is a better value than Plan F.

Furthermore, Robert compares Plan N to the best Medicare Supplement Plan he recommends in 2021. Watch the video and find out how Plan N compares. 

Medigap Plans F, N, and G

best medicare supplement plan 2021
Which Medigap Plan is best for you in 2021?

Which Medigap Plan F, N, or G is best for you in 2021? To determine the best plan for you, we will consider the following three factors:

  • Eligibility – who is and who is not eligible?
  • Coverage – what are the benefit differences?
  • Costs – what are the cost difference?

For Medicare Plans F, N, and G, we will determine whether you are eligible or not and compare plan benefits and costs.

Medigap Plan F Eligibility

Suppose you have Medigap Plan F before January 1, 2020. In that case, you can continue to buy Plan F. However, anyone new to Medicare in 2020 is not eligible and can not enroll in Plan F. In other words, if you turn age 65 in 2020, you can not buy Plan F.

However, if you turned 65 before January 1, 2020, and enrolled in Plan F, you can keep it! (Medicare.gov eligibility restrictions applies to Medigap Plans C and F.)

Medigap Plan F Eligibility - senior ladies birthday cake
Best Medicare Supplement Plan 2021 Plan N and Plan G Eligibility

Medigap Plan N and Plan G Eligibility

To be eligible for any Medicare Supplement Plan, you must have Part A and Part B. Moreover, anyone eligible for a Medigap Plan is also eligible for Plan G and Plan N. Unlike Plan F, you are eligible to enroll in Plan N or Plan G whenever you turn 65 in 2020. 

You can enroll in a Medigap Plan during your initial 7-month open enrollment period. It begins three months before you turn 65, continues the month of your birthday, and ends three months after your birthday. During this period, you have guaranteed issue rights!

When you turn 65 and enroll in a Medigap Plan, you are guaranteed the following:

  • No medical underwriting questions
  • No medical disqualification – all medical conditions qualify
  • You pay the same premium as a healthy senior – even if you have health problems

However, if you do not enroll during your initial open enrollment period, you must answer medical underwriting questions. Furthermore, you can be medically disqualified or pay more for health problems. To get your Medigap Plan quote, call Senior Healthcare Direct at 1-855-368-4717.

Best Medicare Supplement Plans in 2021

The best Medigap Plans in 2021 recommended by Robert Bache is Plan G because it has the greatest value. It provides the same comprehensive coverage as Plan F at a much lower monthly premium. If you are eligible for Plan F, it has the highest monthly premium.

Plan F is a “first-dollar” plan because Medicare pays the first dollar once you pay the expensive monthly premium. With Plan F, you do not pay the Part B deductible.

However, with Plan G, you pay the $198 Part B deductible in 2020, and you save several hundred in premiums per year. As MedicareBob says in his video, “You come out ahead” with Plan G coverage.

Best Medicare Supplement Plan 2021 - MedicareBob why plan G is a greater value than Plan F

Best Medigap Plans Coverage and Costs

The Best Medigap Plans chart compares the coverage and costs of plans F, N, and G. The green checkbox covers that benefit 100%. The red checkbox does not cover that benefit. Use this chart to compare Medigap benefits and the differences in coverage and costs.

Why Plan G is the best Medigap Plan

When you compare Medigap benefits of Plan F and G, the only difference is the Part B deductible. If you have Plan G, you pay a one-time annual Part B deductible. Since Plan G has lower premiums, you will save much more than the Part B deductible throughout the year.

So why pay more for Plan F when Plan G has the same coverage benefits? There is absolutely no reason to pay more for Plan F. Therefore, the best Medicare Supplement Plan for 2021 is Plan G.

Medigap Plan N coverage and costs

Medigap Plan N is a lower-cost alternative to Plan G. It has the same comprehensive coverage benefits as Plan G, except for Part B excess charges. Consequently, any medical provider who does not accept Medicare assignment can charge you up to 15% more than the Medicare-approved price. 

Furthermore, anytime you have an outpatient doctor’s office visit, you owe $15 copayment with Plan N. Moreover, you have up to a $50 copayment for every outpatient visit to the emergency room.

Medigap Plan N coverage and cost - Hospital Outpatient

Shop the Best Medigap Plans

As a Medicare insurance broker, Senior Healthcare Direct can shop the best Medigap Plans with all the top A-rated carriers. We save you money by comparing prices with many insurance providers. You can shop for the best 2021 Medicare Supplement Plans by calling Senior Healthcare Direct at 1-855-368-4717 or click the button to get your free quote!

Best Medicare Supplement Plan 2021 - get quote button

Switch Medigap Plans

Get a Medigap Plan for less money

In this MedicareBob video, Robert Bache explains when you can switch Medigap Plans and save money. Watch the video and find out when you can shop for Medicare Supplement insurance. Moreover, discover how Medicare standardized lettered plans make it easy for you to compare prices. For example, you could get the same Medigap Plan for less money.

Switching Medigap Plans

Alternatively, you could switch to a different Medicare Supplement plan. For example, you could save hundreds in monthly premiums by switching from Plan F to Plan G. Senior Healthcare direct makes it easy for you to shop and save on Medigap plans. Whether you want to shop for a lower price and keep your Medigap Plan or switch to a different Medicare Supplement Plan, Senior Healthcare Direct can find you the best price. 

Call 1-855-368-4717 or click the get quote button. Learn more about when you can shop for Medicare Supplement Plans.

Switch Medigap Plans get quote button

Medigap Underwriting Questions

Happy seniors can switch Medigap Plans with no underwriting questions.

You can switch Medigap Plans without answering medical underwriting questions during your initial Open Enrollment Period. The first three months before you turn 65, the month you turn 65, and three months after you turn 65, you can switch Medigap Plans. For example, two months before your turn 65, you may choose Plan F. Then, a month after you turn 65, you can switch to Plan G.

However, after your initial Open Enrollment Period, you will have to answer medical underwriting questions unless you live in a State with a birthday rule. The states of Oregon and California have Medigap Birthday Rules.

A licensed agent will ask you for your current height and weight. Anyone who is severely underweight or overweight will be denied. Another underwriting question is, “Do you require assistance for activities of daily living?” If you are unable to perform certain daily activities, you will not pass underwriting. Certain chronic, incurable health conditions may also disqualify you. Learn more about Medicare Supplement Insurance Underwriting.

In the Coffee with MedicareBob video, Robert Bache asks with customer support team member Tammy Hess questions about your insurance application. Watch the video to discover mistakes that can cause application delays.

Medicare Plan G Benefits

Does Medicare cover knee replacement?

Medicare Knee Replacement

In this Medigap Monday video, Robert Bache answers the question, “Does Medicare supplement plan G cover knee replacement?” Watch the video and discover how Medicare Supplement Plan G covers total knee replacement surgery. Then continue reading to learn how Medicare Plan G pays for your knee replacement recovery. Moreover, find out about surgical complications and inpatient costs.

Outpatient Knee Replacement

In most cases, knee replacement is an outpatient procedure. So, like every other outpatient procedure, Medicare covers 80% of your knee replacement costs.. If you have a Medicare supplement plan G, you pay $198 Part B deductible in 2020. Once you pay the annual one-time Part B deductible, the plan G supplement pays the remaining 20% of your outpatient procedures. Moreover, plan G covers your knee replacement recovery.

Knee Replacement Recovery

Recover from knee replacement often includes physical therapy rehab and doctor follow up visits. Since you already paid the Part B deductible and you have Medigap Plan G, you will not have any copays or follow up fees. As long as you go to a provider that accepts Medicare, 100% of all your outpatient medical services are covered. In some cases, knee replacement may result in surgical complications.

Does Medicare cover knee replacement - doctor and senior with knee condition
Doctor examines senior with a knee condition

Knee Replacement Complications

After outpatient knee replacement, you may have surgical complications. For example, according to Heathline, a small percentage of older adults may develop the following medical complications:

  • About 1 percent develop an infection
  • Less than 2 percent develop blood clots

 Moreover, anesthesia may cause the following adverse effects:

  • breathing difficulties
  • allergic reactions
  • nerve injury

If any of these medical conditions develop after knee surgery, a hospital may admit you as an impatient. 

Senior in a hospital bed after knee surgery

Inpatient Knee Replacement

Medicare Part A does cover 80% of your inpatient knee replacement cost after you pay the Part A deductible of $1408 in 2020. If you have Medigap Plan G, this Medicare supplement pays 100% of your Part A deductible. Furthermore, supplement plan G pays the 20% coinsurance not covered by Original Medicare. If you plan to have total knee replacement surgery, a Medicare Supplement Plan covers all the costs saving you lots of money.

How to Upgrade to a Medigap Plan

If you have Original Medicare, you can upgrade to a Medigap Plan by calling Senior Healthcare Direct at 1-855-368-4717 or get a quote. If you have Medicare Advantage, you have two Medigap Enrollment Periods.

Does Medicare cover knee replacement - before and after illustration
Knee replacement before and after illustration

Do Any Medigap Plans Cover Drugs?

Medigap plans do not cover maintenance medications, aka drugs that treat chronic health conditions. All lettered Medigap Plans: A, B, C, D, F, G, K, L, M, and N do not cover prescription drugs. However, your Medigap Plan will cover drugs while an inpatient in a hospital under Part A. Furthermore, your Medigap may pay for drugs administered in your doctor’s office under Part B.

For example, Medicare Part B covers Humira injections when administered by a licensed medical provider. Discover how MedicareBob’s advice results in a Medigap client getting FREE Humira injections.

Do Any Medigap Plans Cover Drugs

What are maintenance medications?

Maintenance medications are the everyday drugs you take to treat chronic health conditions. For example, Chronic Obstructive Pulmonary Disease (COPD) is a chronic inflammatory lung disease that obstructs airflow to your lungs. Most people with COPD use bronchodilator inhalers. This medication makes breathing easier by relaxing your airways. For people with Medigap Plans, you will need a separate Part D plan to cover maintenance medications.

A Brief History of Medicare Part D

The Medicare Prescription Drug, Improvement, and Modernization Act of 2013 adds a new Part D drug benefit program effective January 1, 2006. The act adds prescription drug coverage to Medicare Advantage plans. Furthermore, this public law allows beneficiaries with Part A or Part B to join Medicare Part D stand-alone Prescription Drug Plan (PDP). Thus, Medigap Plans sold after January 1, 2006, are not allowed to include prescription drug coverage. 

Brief History of Medicare Part D

Medicare Part D Plan

You can enroll or change your Medicare Part D Plan during the Annual Election Period (AEP) every year between October 15 and December 7. Furthermore, you can sign up for a Part D plan during your initial Medicare enrollment period. Moreover, you can avoid a late enrollment penalty by enrolling when you are first eligible.

Medicare Advantage Plan

You can enroll or change your Medicare Advantage Plan during the Annual Election Period (AEP) once a year between October 15 and December 7. Furthermore, you can switch Advantage plans or enroll in a Medigap plan during Medicare Advantage Open Enrollment.

How do Medigap Plans work?

In this Medigap Monday video, MedicareBob explains how Medigap Plans work. Robert says when you have a Medicare Supplement such as Medigap Plan G, “Medicare Part A and B is your primary insurance, and it covers you nationwide.” For example, “You can go from one county to another” or “from one state to another.” Thus, you can travel “anywhere in the United States,” and Medicare will cover any doctor or hospital that accepts Medicare. Moreover, you “do not need any referrals or prior authorizations.”

Medigap Plan G Coverage

Medigap Plan G covers you nationwide
Medigap Plan G covers you nationwide

Plan G supplements your Medicare coverage. Medicare Parts A and B are your primary insurance, so Medigap Plan G works in every county and state in the country. Medicare Supplement Plan G pays your 20% coinsurance cost, and you pay a small annual deductible of $198 in 2020. Robert Bache says after paying this deductible, “you have no more out of pocket costs for Medicare-covered services nationwide.”

George Goes to Texas

George lives in Mississippi and has prostate cancer. Since George has Medigap Plan G, he can go to any cancer hospital in the US. He researches the 10 Best hospitals for cancer care and discovers the top hospital for 2020 is the University of Texas MD Anderson Cancer Center. George travels to Houston, Texas and gets the best care for his prostate cancer.

Medigap Plan in Georgia

Knee Replacement in GA

George recovers from prostate cancer and goes to the doctor about knee pain. The doctor finds damaged cartilage and recommends a knee replacement. So George researches the best knee surgeons in the United States. He visits Dr. Scott Gillogly in Atlanta, Georgia. This surgeon specializes in cartilage restoration and does George’s knee replacement.

Best Hospitals and Doctors Nationwide

You can access the best hospitals and doctors nationwide with Original Medicare Parts A and B. However; it only covers 80% of your hospital and medical expenses. A Medicare Supplement such as Medigap Plan G pays the remaining 20%.

Conversely, a Medicare Advantage Plan such as HMO or PPO restricts access to hospitals and doctors in your network. You can switch to a Medigap Plan.

best hospital MD Anderson
Best Hospital Texas MD Anderson Cancer Center

Switch from Medicare Advantage to Medigap

You can change from Medicare Advantage to Medigap plan two times per year. October 15 – December 7, you can switch to a Medicare Supplement plan. Discover the other Medigap enrollment period.

How Does Each Medigap Plan Work?

Each lettered Medigap Plan provides the same coverage benefits nationwide. Medigap Plan G works the same in all states. For example, Plan G coverage has the same benefits in Georgia as it does in Texas. Thus, no matter where you travel in the United States, your Medigap will give you the same health coverage benefits. 

However, each letter Medigap Plan offers you different benefits. You can compare all Medigap Plans benefits side-by-side. Then call Senior Healthcare Direct at 1-855-368-4717 to shop for your Medicare Supplement Plan. 

Medigap Plan G benefits

Medicare Coverage Options

In this FAQ video, Robert Bache explains your Medicare coverage options. Watch the video and discover the two Medicare options you can choose during your annual open enrollment.

Medicare Open Enrollment

Medicare Open Enrollment also called the Annual Election Period, occurs from October 15 through December 7. According to CMS, this is a period when “all people with Medicare can change their Medicare health plans and prescription drug coverage for the following year.” Why change your Medicare plan?

3 Reasons to Change your Medicare Plan

Medicare Coverage Options

You may want to change your Medicare plan for the following reasons:

  1. The Medicare Plan is changing – coverage, costs, or service.
  2. You have health issues and want better coverage.
  3. You want a better plan now because you can medically qualify for it.

Do you know you must pass medical underwriting whenever you want to switch your Medicare Plan? Furthermore, a Medicare Advantage or Supplement insurance company can deny coverage change. So if you want to upgrade from a Medicare Advantage Plan to a Supplement Plan, you may not medically qualify. 

When to change your Medicare Plan?

The best time to change your Medicare plan is when you are healthy enough to pass medical underwriting. Even if you do not need better coverage now, it makes sense to upgrade your Medicare Plan early, so insurance carriers will not deny you later. When can I change my Medicare Advantage plan?

When can I switch from Medicare Advantage to Medigap?

You can switch from Medicare Advantage to Medicare Supplement Plan two times per year. During the Annual Election Period, you can change to a different Medicare Advantage Plan or switch from Medicare Advantage to Medigap Plan. Discover the other Medicare Advantage enrollment period.

When can I switch my Medicare Supplement Plan?

You can switch to a different supplement insurance company to save money during Medicare Open Enrollment. Furthermore, you can switch to a different lettered supplement plan during the same Annual Election Period. Discover another time when you can buy a Medicare Supplement Plan.

Your Medicare Coverage Options 

The licensed agents at Senior Healthcare Direct are happy to help you choose the Medicare Plan that best suits your needs. Our agents can compare plan prices with many carriers, so you get the best price. Moreover, our agents can suggest insurance providers who accept your health conditions, so your application gets approved. Call us at 1-855-368-4717 or get your quote

Medicare Plan G Coverage

Robert Bache answers an important Medicare Plan G coverage question in the following Medigap Monday video, “What will I pay when I go into the hospital?” Watch the video to find out what Plan G covers.

In the video, Robert Bache says Medigap Plan G will pay your Part A hospital deductible of about $1400 “every single time.” Why does Robert say, “every single time?” Because you pay the Part A deductible for each hospital benefit period.

Hospital Benefit Periods and Part A Deductible

Medicare Plan G Coverage
Judy’s Medigap Plan G pays $2,816 in Part A deductibles over two hospital benefit periods.

According to Medicare.gov, your hospital benefit period begins the day the hospital admits you. Subsequently, your benefit period ends when you have not gotten inpatient care for 60 days in a row.

For example, the hospital admits Betty, and she pays $1408 Part A deductible on April 1, 2020. Then thirteen days later, the hospital discharges her. Two months later (60 days) June 15, 2020, the hospital admits Betty, and she pays another $1408 Part A deductible. However, Betty’s friend Judy has Medicare Supplement Plan G, and it pays this Part A deductible every benefit period. Since Judy uses two hospital benefit periods this year, her Medigap Plan G pays $2,816 in Part A deductibles.

Medicare Plan G Coverage Benefits

Furthermore, in the Medigap Monday video, Robert Bache says, “if you’re admitted into the hospital normally, Medicare has a copay starting day 61 that increases starting day 91.” In other words, Original Medicare only covers the first 60 days of inpatient care in a hospital. However, Medicare Supplement plans such as Plan G cover this coinsurance costs. Judy’s Medigap Plan G pays $352 coinsurance per day from days 61 to 90. Discover all the benefits of Plan G and how it compares to Plan F.

Get your Medicare Plan G quote, call Senior Healthcare Direct 1-855-368-4717 or get your quote.