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The Big Change in Medigap Insurance

In 2012, close to 200,000 more people bought Medigap insurance compared to 2011 according to a Mark Farrah Associates Healthcare Business Strategy report.  As of December 31, 2012, Medigap plans covered 10.1 million Medicare beneficiaries.

According to the report, Medigap plans also incurred $17.405 billion worth of claims last year.  That’s up 1.6 percent from 2011.

Which Medigap Plan Is Most Popular

Half of those who bought a Medigap plan last year chose the most comprehensive benefits available – Medigap Plan F.  That marked an increase of 47 percent over the number of people selecting Plan F in 2011.

Plan F protects you from Medicare Part A and Part B charges, and adds something extra when you travel outside of the country.  For Part A, Plan F completely covers the $1,184 deductible no matter how many times you have to meet it.  It’s not an annual deductible.

Medicare’s Part A coinsurance charges for hospital care are also covered up to 365 days after Medicare benefits are exhausted.  Medicare covers up to 60 days in the hospital.  If you need to stay beyond that, you pay $296 per day through 90 days.  You also have 60 lifetime days of partial coverage.  During those “lifetime reserve days,” you pay $592 per day.  After that, Medicare doesn’t help at all.

When you’re first released from the hospital, Medicare may also cover up to 20 days in a skilled nursing facility to give you time to fully recover before going home.  If you need more time, you pay $148 per day for up to 100 days.  Plan F will handle that payment for you.

Plan F also takes care of the cost for the first three pints of a blood transfusion, if there is any charge, and Medicare picks up subsequent charges if you need more blood.  Plan F will cover Part A copays on hospice care, too.

The annual Part B deductible of $147 is also covered by Plan F, and so is the 20 percent copayment that’s required whenever you see a doctor for something other than recommended preventive care.  If your doctor charges you over and above Medicare’s standard payment, you can rely on Plan F to fully cover those excess charges.

As you probably know, Medicare doesn’t cover you if you travel outside of the U.S., but Plan F has substantial foreign travel emergency benefits.

The Preferred 2010 Medigap Plan

Mark Farrah Associates also reported that more than 358,000 people have purchased Plan N since it became available in June 2010.

There are only a couple of differences between Plan N and Plan F.  Plan N doesn’t cover the $147 annual Part B deductible or Part B excess charges if your doctor doesn’t accept Medicare’s rate of payment.

Plan N also has a copayment of up to $20 for some doctor appointments.  If you go to the emergency room and aren’t admitted to the hospital, Plan N charges a $50 copay.

Plan N should be available at lower premiums than Plan F, but there’s no requirement for different insurance companies to offer the same benefits for the same price.  Let us do the shopping for you.  We represent different insurers so we can help you compare more coverage options.

Jim McFadden has over 11 years of executive-level experience in the health insurance industry, is a youth baseball, softball and football coach, and has one of the worst fantasy football records in the world.

 

 
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