Analysis of the new 2011 Medicare Medigap Plans
OK, more changes have arrived in 2011. So how does one figure out just which plan makes the most sense? Well that depends on a couple of issues: your financial situation, your current health care needs, and just how much risk you are willing to take on to save some of your hard earned dough. Let's look over the options below together.
A Medigap policy fills in the gaps in the Original Medicare plan, which is comprised of Medicare Parts A and B.
OK, let's look at the new Medigap plans that we have to choose from as of this date.
If you are on Medicare because you are disabled, you have a choice of Plans A, B, and C. So that limits your choices for the better or not. Click here to see, and possible print out, a copy of the new plans coverage and benefits
For those over 65, let's look at United of Omaha's Plan C & D. The only difference is that Plan C pays the Medicare "Part" B deductible for the year, a $162 value. But that plan will cost you an additional $265.48 per year, but only saves you the $162 Part B deductible. So you are better off going with Plan D by $3.48 per year.
Looking at Plan C, you will notice that it has additional coverage to pay for the Skilled Nursing Facility coinsurance that isn't covered by Plans A or B. If you need Skilled Nursing Care, Plan C would save you around $11,000 over Plans A & B, which do not cover the copays for this type of care. And finally, Plan C includes some coverage for out of country emergency care expenses. So even though the premium is higher, it helps you avoid the risk of owing a substantial amount of health care cost should you require Skilled Nursing Facility care, or emergency care outside of the country.
Now for Plans C through G for those over 65 years old in general. Plans C through G are similar enough that we will look at them as a group, saving Plans K, L, M, and N for last.
The difference with these four plans is how how and what they cover with regard to the Medicare Part B deductible, which is currently $162 per year, and any charges your doctor bills you over and above the Medicare "approved" amount for a particular procedure or visit. But first understand that according for Federal law, no provider that accepts Medicare patients can charge more than 15% more than the Medicare "approved" amount for their services. And the fact of the matter is, most do not, and simply accept what Medicare pays them.
So, Plan C pays for your annual $162 outpatient deductible, but no excess charges. Plan G doesn't cover the $162 deductible, but does pay for excess charges. Plan F pans for both the $162 deductible and excess charges. And Plan D doesn't pay for either the $162 deductible or excess charges. But like we said, most providers do not charge that excess charge, and public hospitals certainly do not.
So after all is said and done, we are dealing with minor financial issues and small premium differences. Why take Plan C when you can have Plan F for about the same amount of premium? So there goes Plan C out of the mix.
Plan D can be purchased for $197.60 a month, much less than any Plan F policies monthly premium. And Plan F is only worth paying an additional $22.15 a month if you are concerned about those "excess charge"s your doctor can charge over what Medicare "approved" for the charges, which can be no greater than an additional 15% tacked on to your bill. So, we believe that United of Omaha's Plan D runs a pretty good bargain here. If you are concerned about the excess coverage issue, look at AARP's Plan F or Humana's Plan G.
Now for the risk takers and frugal, Plans K, L, M, and N.
You can through out Plan M right off the bat because there is currently only one carrier offering that plan, and the rate of $317.65 will get you less coverage than a plan for $219.75.
Plan N is identical to Plan D, except you are require to pay a co pay of $20 for each doctors office visit, and $50 co pay for each emergency room visit with Plan N, so If you see a doctor twice a month, or have a need to visit the emergency room once in a while, your savings over the lowest cost Plan D results in $44.85 may result in a loss by a bit.
Plans K and L provide a lower premium then the others, but you have to be willing to take on a substantial financial risk, should a hospital or skilled nursing facility admission be in the cards. Both these plans are designed for those in pretty much perfect health, with the financial savings available to pay up to 25% or 50% of your deductibles and coinsurance for those inpatient stays.
And finally, there is the Plan F High-Deductible Option. This plan provides the exact same coverage as the regular Plan F, once you have satisfied your deductible of $2,000. So you consider Anthem's "High-Deductible Plan F' against AARP's "No deductible Plan F" the Anthem Deductible plan saves you $2,166.84 for the year in premiums, If you end up spending the $2,000 in expenses before your $2,000 annual deductible is satisfied, you pretty much break even. I am thinking many of us seniors might receive medical services that cost over $2,000 without batting an eye.
The Bottom Line?
Speak with us about your choices and your particular situation. The information is free, and can help you more precisely choose the plan that may work best for you.
For Plan A or B: Plan A with AARP for $122.75.
For Plans C: United of Omaha for $211.39
For Plan D: United of Omaha for $197.60
For Plan F or G: AARP Plan F for $219.75
For Plan F "High Deductible" Plan: Anthem BC & BS for $39.18
For Plan K: AARP for $87.75
For Plan L: AARP for $125.00
If you have a pre-existing condition and are not in the initial enrollment period for those new to Medicare, Anthem and United of Omaha have no Pre-existing condition clauses to worry about.
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Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare.
Also, See doctors that accept Medicare Assignment in your area.
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