Rating Methods For Medicare Supplement Plans

Rating Methods For Medicare Supplement Plans text overlaying image of a mans hand aligning gold starsOriginal Medicare does not have an annual limit on out-of-pocket costs, and 4.5 million Medicare recipients are expected to spend more than $5,000 each on out-of-pocket health care costs in 2023. This lack of financial protection, combined with the fact that Original Medicare doesn’t cover all medical costs, has led to a lot of people buying Medicare Supplement Plans. This is because Medicare Supplement Plans fill in those gaps in coverage and financial protection. But how do private health insurance companies determine your premium? Insurance companies who offer Medicare Supplement Plans use three different pricing methods: attained-age, issue-age, and community-rated. Knowing how these prices work, can help you compare Medicare Supplement Plans and find the one that works best for you.

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The Pricing Methods

The method a company uses for pricing has a significant impact on the overall cost of a policy. These 3 ratings are each based on different factors. First, we have attained age rating, which is based on the age you are when you sign up for your plan and will increase as you age. Next is issue-age rating, this method also uses your age when you enroll to determine your premium, but it will not increase as you get older. Finally, there is community-rated, which isn’t based on your age but instead is based on where you live. Below we’ve detailed each of these plans and how they work.

Community Rating

The costs of community-rated Medicare Supplement plans depend on where you live. No matter someone’s age, everyone pays the same premium for the same Medicare Supplement plan within their region, which is decided by the insurance company it can be by city or county. So, if you and your neighbor buy the same Medicare Supplement plan, your monthly premium will be the same even if you are 70 and your neighbor is 80.

 

Only a few states offer Medicare Supplement plans that are rated by the community. Maine, Vermont, Massachusetts, Connecticut, New York, Arkansas, Minnesota, and Washington are some of these states. States that don’t offer community-rated plans may charge you a higher premium based on your age, depending on whether they offer attained-age or issue-age-rated plans at enrollment. Most of the time, community-rated plans have the least expensive premiums, but rates may be different depending on where you live, whether you live in a city or a rural area, among other things.

What States Have Community-Rated Medicare Supplement Plans?

In these eight states, the monthly premiums for Medicare Supplement policies must be based on the community rating:

 

  • Arkansas
  • Connecticut
  • Massachusetts
  • Maine
  • Minnesota
  • New York
  • Vermont
  • Washington

Issue Age Rating

The premiums for issue-age-rated plans are based on how old you are when you sign up for coverage, similarly to attained age but they do not incrementally increase with age. For example, if you sign up for a plan at 65 your initial premiums will be less than if you signed up at 75. Most of the time, issue age plans also raise rates every year, but the rate increases are not based on your age like attained-age premiums are. Instead, they raise based on inflation and other factors that affect health costs.

 

If you sign up for this type of plan when you first become eligible to buy a Medicare Supplement plan, it costs less in the long run than plans for people who are older. But you should be aware that issue-age-rated plans start with higher premiums than attained-age-rated plans.

The issue-age method is used to rate Medicare Supplement insurance policies in the following states:

 

In these states, however, carriers may opt to use community ratings instead through an appeals process.

Attained Age Rating

Most of the time, Medicare Supplement insurance companies use attained-age rating models. The age when you sign up for the plan is used to figure out how much your premiums will cost. The younger you are when you enroll the lower your premiums will be. But these premiums are not locked in for life, as you age they will increase. For example, if you’re 65 years old, the premium for a certain Medicare Supplement plan might be $130, but if you’re 75, the same plan might cost $170. Generally, rates go up by a small amount each year or at a designated time. These rate increases are generally decided by state health insurance agencies.

 

Some states, like Massachusetts, Minnesota, and Wisconsin, have different rules for coverage as well as different Medicare Supplement Plans available. While those states have different plans they do all offer the same benefits they just operate in slightly different ways and have different names. If you live in one of these states, you can look at our state-by-state Medicare Supplement guide to find out exactly how your plans will be priced.

States that Offer Attained-Age Medicare Supplement Plans

No state requires carriers to offer Attained-Age Medicare Supplement plans. However, any state that is not required to specifically use a certain method is allowed to offer attained-age plans. There are many states that offer this pricing method but they can also offer any of the other methods as well. These states are: 

 

 

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Choosing Between Attained Age, Issue Age, and Community Rating

When choosing between attained-age, issue-age, or community-rated plans, there are a few things to think about, such as:

 

  • Your medical needs as a whole
  • Costs and benefits of the plan
  • Your age
  • The plan provider’s reputation
  • Premium cost rate projections

Different states have different levels of protection for Medicare recipients who want a Medicare Supplement plan. One such right to be on the lookout for is ‘guaranteed issue’ protections. With these rights, a Medicare Supplement insurance company can’t turn you down if you meet certain requirements. Such as, you suddenly lost a group health plan that covered your Medicare cost-sharing, You disenrolled from Medicare Advantage within 12 months of enrolling, or if your previous insurer no longer offers your Medicare Supplement Plan or commits fraud. They also promise to cover pre-existing conditions and won’t raise your premiums too much because of your health.

 

The easiest time to join a Medicare Supplement plan is during your six-month Medicare Supplement Open Enrollment Period, which starts when you sign up for Medicare Part B. After this initial enrollment period, Medicare Supplement plan providers can turn you down for coverage if you already have a health problem. 

 

For example, if you drop your Medicare Supplement attained-age-rated coverage because it’s too expensive, you might not be able to buy another Medicare Supplement plan unless your state has continuous guaranteed issue rights or you meet other requirements. The states that have continuous guaranteed issue rights are Connecticut, Maine, Massachusetts, and New York. Continuous guaranteed issue rights mean that all Medicare Supplement providers must sell policies at least once a month or all year long.

 

Before you sign up for a Medicare Supplement plan, it’s important to know the rating category so you can figure out how much your long-term premiums will cost.

What Else Affects Medicare Supplement Plan Costs?

Medicare Supplement premium prices can be affected by a number of other things. Rates can be affected by things such as the rate of inflation, the state you live in, the cost of health care, and your lifestyle. Lifestyle factors can include choices like smoking or drinking. 

 

The plan benefits that you want to include will also affect the price of your plan. The cost of the plan will be higher if it has more benefits. Your premiums will be less if you choose a plan with a higher deductible. In order to choose the best plan, you should carefully look at your health care needs and how much each plan will cost in the long run.

How To Lower Medicare Supplement Plan Costs

There are other ways to lower your Medicare Supplement premiums besides researching your options and comparing different insurance companies, such as:

 

  • High deductible plans – This could be a good choice if you are in good health and think you could pay more for the few claims you make.
  • Getting a plan for your partner – Some companies give a Medicare Supplement Household Discount to couples who both buy Medicare Supplement policies from them.
  • Bundling – Companies may lower the cost of your Medicare Supplement premiums if you buy another type of insurance from them, like life insurance.

It’s important to understand your pricing plan, whether you’re signing up for Medicare Supplement for the first time or you already have a policy. As a customer, if you know how companies charge for their services, you can make better decisions about what to buy. Be sure to do your research, and you might be surprised by how much you can save.

Working With EZ

If you are in the market for a Medicare Supplement Plan, one of the most important things you can do is compare the various plans’ premiums and benefits. This can require a significant amount of research, which can take a notable amount of time because you will need to call a number of different insurance companies in order to get quotes. 

 

However, if you collaborate with an EZ agent, you can reduce the amount of time it takes to compare prices by 50%. When you work with a licensed agent, you gain access to a centralized resource where you can compare the Medicare Supplement Plan offerings of multiple insurance companies. 

 

In addition to providing you with price comparisons, your agent can also explain the distinctions between the various plans. Your insurance agent will be able to assist you in comparing the out-of-pocket costs to the monthly premiums so that you can select the strategy that will save you the most money in the long run. Give us a call at 877-670-3602 to get started with your search for a Medicare Supplement Plan. 

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Medicare Supplement Plan N vs. Plan G: Which Plan Is Better?

medicare supplement plans g vs n text overlaying image of a woman deciding between two options with question marksIf you are a Medicare recipient or are about to become one, you may have noticed that Original Medicare (Parts A and B) does not cover all of your medical costs. Therefore, you will likely need a Medicare Supplement Plan to help cover out-of-pocket expenses. The good news is, you have plenty to choose from, there are 10 different plans available all with different levels of coverage. However, Plan G and Plan N are currently the most popular. Choosing between these two plans can be hard because they do have a lot in common, in fact they have more similarities than differences. It is essential to understand what each plan covers. Being misinformed can leave you with extra unnecessary out-of-pocket costs. So, let’s compare these plans so you can get an idea of which one fits you better.

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What Both Plans Cover

  • Medicare Part A deductible In 2023, if you are hospitalized for inpatient care, you have to pay the Part A deductible of $1,600 per each 60-day benefit period. The Benefits period restarts after you have been out of the hospital for 60 consecutive days. This is not an annual deductible, you could end up paying this deductible more than once in a single year. Having these plans cover this deductible means it’s not coming out of your pocket. 
  • Part A hospital care and coinsurance – Part A partially covers hospice care leaving you copays or coinsurance. Certain prescription drugs will also have a copayment. However, you will be responsible for all of these copayments without a Medicare Supplement Plan that covers them.
  • Part B coinsurance – Medicare Part B requires a coinsurance payment for each covered service. Meaning Part B will pay 80% of the Medicare-approved amount for each covered service. Leaving you to pay the remaining 20% as your coinsurance payment (after you meet your annual Part B deductible). Plans N and G will both cover 100% of the Part B coinsurance.
  • Blood – If you need a blood transfusion for any reason, Original Medicare will only start covering the pints of blood after you have already paid for the first 3. Plans G and N will cover those first 3 pints for you so you’ll never have to pay for blood.
  • Skilled Nursing Facility Care – Medicare Part A will require you to pay a daily coinsurance if you are admitted for more than 20 days. As of 2023, your coinsurance could reach up to $200 a day. Thankfully, Plans G and N cover this coinsurance entirely.
  • Foreign Travel Emergencies – Typically, Original Medicare does not cover any medical care that you receive outside of the U.S. Plans G and N will both cover 80% of the costs of qualifying emergency medical care if you need it outside of the country.

What Neither of Them Cover

The only benefit that both of these plans will not cover is the Part B deductible. This is because of the Medicare Access and CHIP Reauthorization Act, or MACRA. This law altered Medicare with a modification to regulations that say plans are not allowed to offer any first-dollar coverage. This is also why Plans C and F are no longer available to new Medicare beneficiaries because both plans offered the Part B deductible coverage. 

The Coverage Differences

Now that we know what benefits these plans both have in common, let’s look at the differences between them.

Benefits

  • Doctor Visit Copays – While Plan G will cover 100% of doctor visit copays, Plan N will not. With Plan N you will still have a $20 copay for each doctor’s visit. Therefore, if you visit your doctor fairly often this could really add up over the course of the year.
  • Emergency Room Copay – First, keep in mind that visiting the emergency room and being admitted are two different things. Just coming to the emergency room and then being released will cost you a $50 copay with Plan N. However, with Plan G there are no additional costs or copays for an emergency room visit.
  • Medicare Part B excess charges – Doctors and other healthcare providers can sign an agreement to accept “Medicare Assignment”. Which is essentially a fee schedule between Medicare and the provider saying that Medicare believes services should cost a specific amount and the doctor agrees to accept those prices. If the healthcare provider does not sign this agreement then they are allowed to charge up to 15% more than the Medicare-approved amount. That 15% is what is known as the Part B excess charge. Excess charges are one of the most significant coverage differences between Plan N and G as it could leave you with significantly higher medical expenses if it’s not covered. Plan G covers 100% of these excess charges whereas Plan N doesn’t cover them at all.

 

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Costs

Cost is another difference, obviously even though the coverage differences are slight any plan with more benefits will be more expensive even if it’s only by a small margin. The price of Medicare Supplement Plans vary based on your location, age, and smoking status. In areas with higher costs of living, monthly premiums are generally more expensive. In general, Medicare Supplement Plans are priced in three ways: community-rated, issue-age-rated, and attained-age-rated.

 

Community-rated

Everyone, regardless of age, who has the same Medicare Supplement Plan pays the same monthly premium under this pricing structure. Your premiums may increase due to inflation and other factors but never due to your age.

Issued-age-rated

With this structure, your Medicare Supplement Plan premium is baked on your age at the time you purchase it. The younger you are the lower your premiums will be, and they will not increase with your age. Just like with community-rated, these plans will only ever become more expensive due to inflation and other outside factors but not your age.

Attained-age-rated

This type of pricing will calculate your premium based on your current age and does increase as you get older. Your premiums will be lower when you’re younger, but will steadily rise with your age. Increases can also happen due to inflation and other factors as well as your age.

 

Having Said that Plan G premiums range between $100 and $300 on average. Now, if you’re interested in a Plan G plan but the premium is a bit too expensive there is an alternative. Plan G also has a high-deductible version that offers all the same benefits with a lower premium. In exchange for the lower monthly cost you have to meet a higher deductible than you would with the standard Plan G. As for Plan N the average premium is between $120 and $180 as of 2023. When you factor in all the variables that can affect your premium Plan N can cost as low as $70 or be as expensive as $400. 

So Which One Is Better?

The answer to this all depends on you. But in our opinion Plan G is the most valuable. Compared to Plan N, it provides the most coverage and saves you a significant amount of money. However, if you don’t need to visit your doctor frequently, you may easily be better off with Plan N. Overall if you’re a healthy person on a tight budget Plan N does have fantastic benefits. Although, even if you only visit the doctor a few times a year, Plan G does offer that extra bit of protection for only a little bit more money. With Plan G the only out-of-pocket Medicare cost you have to worry about is the $226(2023) Part B deductible.

How To Enroll

The best time for you to enroll is during your Medicare Supplement Open Enrollment Period. This is because if you enroll during this time you automatically receive guaranteed issue rights. Meaning you can’t be denied coverage or charged more due to your health or any pre-existing conditions. You only get one Medicare Supplement Plan Open Enrollment Period, so it is important to make use of it while you have it. The Medicare Supplement OEP begins once you turn 65 and enroll in both Medicare Part A and Part B; it continues for 6 months. 

Need Some Help?

Financial planning and figuring out which benefits you need and don’t need can be time-consuming and frustrating. That’s what EZ.Insure is here for. A Medicare agent can do all of that research and compare plans for you. As well as take the time to get to know your budget and explain everything that will affect you personally. This means you’ll have professional help ensuring you get the best coverage. EZ.Insure provides you with your own personal agent. You’ll never have to worry about bouncing from agent to agent, yours will always be there to answer your questions, compare plans, and enroll you all for no extra cost. They can even help you after you’ve enrolled by reviewing your coverage annually or helping submit claims. To get started with your agent today simply enter your zip code in the bar below or give us a call at 877-670-3602.

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What Is A High-Deductible Medicare Supplement Plan?

what is a high-deductible medicare supplement plan text overlaying image of an older man thinkingMedicare Supplement Insurance fills in the “gaps” left by Original Medicare by paying for things such as copayments, deductibles, and coinsurance. A high deductible choice is available with some Medicare Supplement policies. The premiums for high-deductible Medicare Supplement Plans are lower than those for regular plans, but the coverage threshold is higher. If the premium difference between the high-deductible and the standard plan is small, then the high-deductible plan may be more cost-effective.

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Which High Deductible Medicare Supplement Plans Are Available?

Both Plan F and Plan G have a version with a high deductible. Beneficiaries who became eligible for Medicare after 2020 will no longer be able to get Plan F, or its high deductible option. But anyone can sign up for Plan G with a high deductible.

 

The only exception is in Massachusetts. Massachusetts is one of 3 states who standardize their Medicare Supplement Plans differently than the rest of the country but they do have the same benefits. In Massachusetts there are only 3 plans available and none of them are high deductible plans. 

How Do High Deductible Medicare Supplement Plans Work?

In the majority of states, residents can choose from one of 10 different Medicare Supplement Plans designated by letters. The government sets the benefits for each type of plan. High-deductible options are limited to Plans F and G. The only difference between the standard and high-deductible versions of these Medicare Supplement Plans is the date on which coverage will begin. While standard plans pay for their benefits right away, high deductible plans don’t begin paying for them until the annual deductible is met.

What Do High Deductible Medicare Supplement Plans Cover?

The high deductible versions of Plan F and Plan G cover the same things as their standard counterparts. Plan F is the most popular Medicare Supplement plan and has been for a long time, even though it is unfortunately discontinued. Your only out-of-pocket expense with this plan is the monthly premium for Plan F, as it covers everything else. It covers:

 

  • Deductibles for Medicare Part A and Part B
  • Medicare Part A and Part B coinsurance or copayments
  • Medicare Part B excess charges
  • Skilled nursing facility coinsurance
  • Foreign travel emergency expenses up to plan limits

Since Plan F was discontinued, Plan G has become extremely popular among Medicare beneficiaries and is now among the most widely selected Medicare Supplement Plans. Plan G is the most affordable Medicare Supplement plan and helps fill in the gaps that Original Medicare doesn’t cover. Plan G covers: 

 

  • Medicare Part A deductible
  • 100% of hospice copayments and coinsurance
  • Additional foreign travel emergency benefits
  • 100% of Medicare Part B excess charges

How Much Do High Deductible Medicare Supplement Plans Cost?

With a high-deductible Medicare Supplement Plan, you are responsible for both the premiums and the deductible. In 2023, the deductible for high-deductible Plan G and Plan F is $2,700, however it changes yearly. The plan’s premiums vary from person to person. According to Medicare.gov, the premiums for Medicare Supplement Plans are determined by private health insurance providers and can vary depending on a person’s age, gender, geographic location, tobacco use, and health history.

 

The premiums for high-deductible Medicare Supplement Plans are lower than those for standard Medicare Supplement Plans because members are responsible for paying the deductible before the plan begins paying for covered services. A new Medicare beneficiary of age 65, for instance, may be charged $105 per month for the standard version of Medicare Supplement Plan G, while the high-deductible version may cost only $35 per month from the same insurer. As you get older, the premium gap between the regular and high deductible plans can widen. A Medicare recipient who is 85 might pay $195 per month for Medicare Supplement Plan G, with a low deductible and $60 per month for a high deductible version of the same plan.

Advantages and Disadvantages of High Deductible Plan G

The best thing about a high-deductible health plan is the low monthly premium. People who think they will only need preventive care can save a lot of money. Also, once the deductible is paid, the benefits are the same as with plan G.

 

A disadvantage of the High-deductible Plan G is that you have to pay the Part B deductible for Medicare for non-hospital care. Also, you don’t get insurance benefits until you’ve paid your annual deductible. Every year, these deductibles start over and usually go up. And, you’ll have to pay the Part B coinsurances until your deductible is met.

Advantages and Disadvantages of High Deductible Plan F

Unfortunately Plan F is no longer available to anyone you became eligible for Medicare on or after January 1st 2020. This is because the Medicare Access and CHIP Reauthorization Act of 2025 included a change that says Medicare Supplement Plans can not cover the Part B deductible. However, if you were eligible before that date or already had Plan F you are still able to keep or purchase it.

 

As with any option with a high deductible, the main benefit of a high deductible is a lower premium. Once the deductible is paid, the benefits are the same as Plan F. The biggest problem is that if health problems worsen, they can lead to an increase in medical bills. Also, the deductible can change every year, which makes it hard to plan for medical costs in the future. 

 

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Is A High Deductible Medicare Supplement Plan Worth It?

When the combined cost of your premiums and deductible is less than the premiums for a standard Medicare Supplement plan, the high-deductible plan makes more financial sense. There are three things you’ll need to consider.

1. If You Can Meet The Deductible

If you’ll spend enough on coinsurance, copayments, and deductibles to meet the Medicare Supplement deductible for a high-deductible Medicare Supplement plan, you should compare quotes to see which one is the most cost-effective. For the high-deductible version to cost less than the standard option, the lower premiums must be more than enough to cover the extra cost of meeting the deductible- remember you have a high deductible. In 2023, the deductible for Medicare Supplement plans will be $2,700, which equates to $207.50 per month. For you to spend less on a high-deductible plan overall, its monthly premiums would have to be at least $207.50 less than those of a standard plan.

2. If You Can’t Meet The Deductible

When you are reasonably confident that you will not be able to meet the deductible, selecting a Medicare Supplement plan with a high deductible is not the best option for you. If you have expenses that are lower than the deductible, the plan will not pay for any of the services that you receive. You are, in all respects, not compensated in any way for the premiums that you pay.

3. If You’re Unsure If You Can Meet The Deductible

If this describes your situation, one way to figure out whether or not a high-deductible Medicare Supplement plan is right for you is to evaluate your current financial standing. Then determine how much money you have available to pay for out-of-pocket medical expenses. When you do not end up meeting the deductible, you will not only be responsible for the cost of the premiums, which are typically quite affordable. But you also run the risk of losing coverage that is available with a standard Medicare Supplement plan. If you are able to meet the deductible, you will be covered from that point. Which will help you limit the amount of money you will have to pay out of pocket in the event that you face unexpectedly high medical costs.

Alternative Options

Another choice for Medicare Supplement coverage that could help you save money on your monthly premiums is the Medicare Supplement Plans K and L. A cost-sharing benefit and out-of-pocket spending caps are included in these plans. A Plan N could be beneficial to you if you want more coverage than what is offered by those two options. In exchange for a few copayments, participants in Plan N pay a premium that is marginally lower than the standard Plan G or Plan F premium.

 

One more alternative to consider is enrolling in a Medicare Advantage plan. Because the monthly payments are so much more affordable. On the other hand, considering the ongoing out-of-pocket costs that come in the form of copayments and coinsurance, a Part C plan might end up being more expensive in the long run.

Sign Up With EZ

Whether you’re looking for a high-deductible plan or something else, we can help you choose the right policy. We’re here to make it easy for you to weigh your options and choose the most beneficial arrangement possible. Working with an EZ agent will cut down time spent shopping around. You can compare and contrast numerous Medicare Supplement Plan providers and plans by working with a licensed agent. In addition to providing you with cost comparisons, your agent can explain the nuances between the various plans. Furthermore, your agent can assist you in comparing premium costs to out-of-pocket expenses to help you choose the most economical plan. Get started on your search for a Medicare Supplement Plan by calling us at 877-670-3602 right away. 

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What is Medicare Supplement Plan Underwriting?

What is Medicare Supplement Plan Underwriting? text overlaying image of a stethoscope laying on a blue tableMedical underwriting is a process health insurance companies use to decide how risky you are to insure and how much your premium should be. If you’re eligible for Medicare and want to also add a Medicare Supplement Plan to your Original Medicare coverage, the private insurance company you choose may require you to go through underwriting before you can buy your policy.

 

Underwriting can be complicated, and each insurance company handles it differently. To help you understand we will go into detail about why companies underwrite, how it works, and when it applies. We’ll also talk about health conditions that will get your application turned down so you know what steps to take if you are.

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Underwriting Basics

Underwriting is how insurance companies find out about your health and decide if they want to take on the financial risk of insuring you. It requires a thorough look at your health history, both on the application and in a follow-up phone interview. If a company thinks you have too many expensive health problems, they can refuse to cover you, limit your coverage, or raise your rates.

 

Insurance companies underwrite people to keep premiums and risks as low as possible and maintain stability. However, limiting access to Medicare Supplement Plans could mean that the people who need the extra coverage the most don’t get it. Logically, if a company takes on more people with expensive health problems, it will have to pay out more money for claims. To make up for the difference, the insurance company would either charge higher premiums or not let those people on the policy at all.

 

The federal government sets standards for the different types of Medicare Supplement plans and gives enrollees some protections in the form of guaranteed issue (GI) rights, but they have no control over how insurance companies decide who to accept as a customer. Carriers don’t always agree on what makes an applicant uninsurable.

What Triggers An Underwriting Process

If you want to switch from one Medicare Supplement Plan to another, or switch from Medicare Advantage to Original Medicare and you’re not eligible for IEP, then you’ll trigger the underwriting process. You’ll have to answer a lot of questions about your health. The insurance company can also send you to a doctor or nurse for a medical exam to get a better picture of your current health.

 

You can change from one Medicare Supplement Plan to another any time of year, but you’ll have to be in good enough health to pass underwriting. To return from a Medicare Advantage (MA) plan to Original Medicare with a Medicare Supplement Plan, you’ll have to wait until the Medicare Annual Enrollment Period, from October 15 to December 7, and pass underwriting.

Underwriting Timeline

Underwriting takes time, so we recommend sending in applications two to three weeks before the date you want the policy to start. This will give the underwriter time to look over the application and talk to you on the phone. We’ve found that the underwriting process takes, on average, between seven and ten days, but it could take as little as one day or as long as thirty days. If underwriting takes longer than expected and your application doesn’t start on the first of the month you asked for, the insurance company will either backdate it to the original start date or move it to the first of the next month automatically. If this happens, you should check in with the carrier in case you need the original start date, but the carrier automatically moves it to the next month.

 

Some companies have started using an auto-accept or auto-reject feature in their online applications, but this only works for clear-cut cases where there is no room for confusion. To get an automatic acceptance, an applicant would have to say “no” to every health question and be in great health. Applicants whose answers lead to a “maybe” will have to talk to an underwriter over the phone for further explanation and complete the underwriting process.

How Underwriting Affects Your Premiums

Depending on the carrier, the results of underwriting can cause premiums to increase. Some companies have less strict rules for underwriting, which means they accept applicants with worse health conditions but raise the premium to make up for it. Applicants with more health problems may be put in another pricing tier called “class” or “level.” Companies use this system to try to find a good balance between keeping premiums from going up too much and giving a lot of people access to the policy.

What Conditions Can I Be Denied For?

Companies that offer Medicare Supplement insurance are more likely to charge you a higher premium than to turn down your policy. However, they can still turn down your application. No matter which company you choose, you may not be able to get Medicare Supplement insurance if you have a certain health condition.

 

Some medical conditions that often lead to a denial are:

 

  • AIDS
  • Activities of daily living assistance
  • Alzheimer’s
  • Atrial fibrillation
  • Any history of cancer
  • Cirrhosis
  • Certain cognitive conditions
  • Certain medications
  • COPD
  • Congestive Heart Failure
  • Diabetes not under control with medications
  • End Stage Renal Disease
  • Heart attack
  • Implantable cardiac defibrillator
  • Kidney failure
  • Multiple Sclerosis
  • Nebulizer use
  • Parkinson’s disease
  • Organ transplant
  • Osteoporosis
  • Supplemental oxygen use
  • Stroke

It’s important to remember that each company has its own rules for underwriting. If one company turns down your application, another may be willing to take on the risk. Working with one of our licensed insurance agents can help you find a “guaranteed issue” policy or a company that will accept your application even if you have health problems.

 

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How To Avoid The Underwriting Process

During certain times when you have guaranteed issue (GI) rights, you will be able to sign up for a Medicare Supplement Plan without having to go through underwriting. During a GI period, insurance companies must sell you a policy without considering your health or any pre-existing conditions. Your Initial Enrollment Period (IEP) is the first seven months after you turn 65, this is when you can sign up for Original Medicare without being penalized. 

 

Your Medicare Open Enrollment Period (OEP) is usually part of your Initial Enrollment Period (IEP). This is when you have a GI right to sign up for a Medicare Supplement Plan. The OEP starts on the first day of the month that you start getting Medicare Part B. It lasts for six months, during which time you can sign up for any Medicare Supplement Plan letter with any insurance company, no matter how healthy you are.

 

In rare cases, you may be eligible for a Special Enrollment Period, which also gives you the right to a Guaranteed Issue, where you can change your policy without having to go through the trouble of underwriting. There are also parts of the underwriting process you can avoid such as the medical exam. Some states let you change your Medicare Supplement plan without having to go through a medical exam:

 

California

You can switch plans around the time of your birthday during a 91-day Open Enrollment Period because of a rule called the “birthday rule.”

Connecticut

Guaranteed Issue is always the case with Medicare Supplement plans in Connecticut. In this state, you have to use community rating methods. But Connecticut is one of the states where Medicare Supplement costs the most.

Idaho

Idaho has a rule that starts on your birthday and lasts for 63 days to sign up for Medicare Supplement Plans.

Illinois

The Illinois birthday rule is a bit more complicated. Only Medicare Supplement policyholders in a certain age group can use it for 45 days.

Louisiana

In Louisiana, the birthday rule gives people 93 days to sign up for Medicare Supplement Plans.

Maine

Beneficiaries in Maine can switch to plans with the same or less benefits during the month of June without having to go through an underwriting process.

Missouri

There is an anniversary rule that lets people change companies without having to go through underwriting for 62 days. Instead of your birthday, the time is based on the date of the policy.

New York

New York Medicare Supplement is expensive, but you can get a policy that covers you no matter what.

Oregon

Oregon has the “birthday rule,” which says that you have 30 days after your birthday each year to change your Medicare Supplement plan.

Vermont

Some Vermont private insurance companies don’t ask about health at all times of the year.

Washington

beneficiaries in Washington state can switch from one policy to another at any time (except for Plan A).

Does Medicare Use Underwriting?

Original Medicare doesn’t use underwriting. The federal government gives this insurance to people over 65 or who have been on Social Security disability for at least 24 months. Underwriting is not used for Medicare Advantage plans or Medicare Part D drug plans. Anyone can sign up for these insurance plans. Keep in mind you can’t have both a Medicare Advantage plan and a Medicare Supplement plan at the same time.

Comparing Plans With EZ

When looking for a Medicare Supplement Plan, it’s important to compare the costs and benefits of each one. That means you’ll have to do a lot of research, which can take a long time since you’ll have to call numerous insurance companies to – receive price quotes.  But if you work with an agent from EZ, you can compare prices in half the time. Working with a licensed agent gives you access to many Medicare Supplement Plan carriers and plans in one place. 

In addition to giving you price comparisons, your agent can tell you how each plan is different. Also, your agent can help you compare out-of-pocket costs with premium costs to figure out which plan will save you the most money over time. Call us today at 877-670-3602 to start looking for a Medicare Supplement Plan. 

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Medicare Supplement Plan G vs Plan F

Medicare Supplement Plan G vs Plan F text overlaying image of a man holding out two hands with cards in themOriginal Medicare, which is made up of Medicare Parts A and B, pays for a portion of the health care services you may need. However, it does not cover the cost of everything, and you may have to pay some things out of pocket. Thankfully, Medicare Supplement plans can help with this. These plans fill in some of the “gaps” in Original Medicare and will help you save money in the long run by paying for certain Medicare deductibles, copays, coinsurance, and other costs. Two of the most comprehensive Medicare supplement plans are Plan F & Plan G. In order to decide if one of these plans might be a good fit for you, you will need to explore what they cover and how much they cost.

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Medicare Supplement Plan F

Medicare Supplement Plan F is one of the most popular Medicare Supplement Plans because it offers the most coverage out of all of them. But unfortunately, it’s no longer available to everyone on Medicare. 

 

When compared to the other Medicare Supplement Plans that are currently available, Medicare Supplement Plan F has the most benefits and fills the coverage “gaps” left by Medicare Parts A and B best. For a low monthly premium, this plan lets you go to a doctor’s office or hospital, get approved treatment, and leave without paying anything out of pocket.

 

Plan F also covers other Medicare-approved expenses that aren’t related to Parts A or B. This includes coverage for emergencies that happen while you’re traveling abroad and coinsurance for skilled nursing facilities. Plan F is also notable because it is one of only two plans that covers Medicare Part B excess charges.

 

Plan F can only be bought if you had qualified for Medicare before December 31, 2019. Anyone who has become eligible after that date is unable to purchase Plan F. Even if you qualify, it can be a lot more expensive than other Medicare Supplement Plans, so you may end up spending more than the value of the extra coverage you’d get.

What Plan F Covers

As was said above, Medicare Supplement Plan F covers all of the services that Medicare Parts A and B cover, but with less out-of-pocket costs. If your doctor accepts Original Medicare and it is your main insurance, Medicare Supplement Plan F will cover everything that Original Medicare doesn’t. That includes:

 

  • Part A hospital deductible and coinsurance
  • Hospital costs up to an additional 365 days after Medicare benefits are exhausted
  • Part A hospice care coinsurance or copayment
  • Blood (the first 3 pints)
  • Other Medicare-approved expenses associated with Part A hospitalization
  • Medicare Part B 20% coinsurance and copayments
  • Medicare-approved doctor’s office fees
  • Part B deductible
  • Medicare Part B excess charges
  • Other Medicare-approved expenses associated with Part B coverage

Plan F Costs

Medicare Supplement Plan F may have higher premiums than other Medicare Supplement Plans, but that’s because it has the most benefits compared to the plans. Medicare Supplement Plan F costs about $230 per month on average, but premiums can be anywhere from $150 to $400 per month or more. This is because many things can affect the price of your premium, such as your zip code, gender, age, whether or not you smoke, and so on.

 

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Medicare Supplement Plan G

Plan G is one of the best options for people who don’t qualify for Plan F. Medicare Supplement Plan G is a top choice for anyone who has Medicare. If you choose Medicare Supplement Plan G, your out-of-pocket costs will usually be a fraction of what they would be if you only had Original Medicare, since you will only be paying one low premium price. Then, once you’ve paid your annual Part B deductible, the rest of your health care costs for the rest of the year will be covered in full.

What Plan G Covers

Medicare Supplement Plan G covers a wide range of services and helps you save money when you use Medicare-approved medical services. As previously mentioned, one of the best things about Plan G is that it pays for all Medicare-related costs after your Part B deductible has been met. Many other Medicare Supplement Plans, on the other hand, require you to pay more out-of-pocket costs after you’ve paid your Medicare Part B deductible. 

 

All of this means that because Medicare Supplement Plan G covers a great quantity, it helps you keep your out-of-pocket costs low. Here’s a breakdown of exactly what’s covered:

 

  • Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up
  • Part A deductible
  • Part A hospice care coinsurance or copayment
  • Part B coinsurance or copayment
  • Part B excess charges (if a provider is permitted to charge more than Medicare’s approved amount and does so)
  • Blood transfusion (first 3 pints)

Plan G Costs

Plan G costs different amounts depending on where you live, your age, whether or not you smoke, and your gender. For example, the monthly premiums for Medicare Supplement Plans are usually higher in places where the cost of living is higher. So, the monthly premiums for Medicare Supplement Plan G are usually between $100 and $300.

How They Compare

Plan F and Plan G are two of the most popular Medicare Supplement plans that people who qualify for Medicare can choose from. Both plans cover costs in addition to what Original Medicare does, but there are some differences between them that you should think about when deciding which one is best for you. Looking above you’ll notice they cover a lot of the same things:

 

  • Part A deductible
  • Part A coinsurance
  • Part B coinsurance or copayment
  • The first three pints of blood used in a transfusion
  • Skilled nursing facility coinsurance or copayment costs
  • Hospice care coinsurance or copayment costs
  • Medicare excess charges (up to 15% more than the amount Medicare says a service is worth)
  • Foreign travel emergencies

Plan F covers the annual Medicare Part B deductible, but Plan G does not. This is the main difference between the two plans. Even though Original Medicare Part B deductibles are getting more expensive over time, it may still make financial sense to choose Plan G because it usually has a lower monthly premium than Plan F.

 

Plan F and Plan G have similar coverage, but Plan G is the most complete Medicare Supplement plan for new Medicare recipients. This is another important difference between the two.

 

Plans F and C are no longer available to new Medicare recipients because of new laws passed by the federal government. You can still apply for Plan F if it’s available where you live and if you were eligible for Medicare before 12/31/19. You are able to keep using Plan F if you obtained it before 2020.

Pros and Cons

As with all insurance options, Plan F and Plan G come with both advantages and disadvantages. So let’s take a look at what these are. 

The pros:

  • Plan F is the best Medigap plan because it covers more Medicare-approved costs at 100% than any other plan. It also gives you the option of choosing a high deductible, which lets you pay lower premiums while still being covered for all approved costs once you’ve met your deductible.
  • Plan G covers almost all of the same approved Medicare health care costs as Plan F, except for the annual deductible for Medicare Part B. Before your insurance pays for Part B, you will have to pay for it out of your own pocket. Still, the premiums may be cheaper than Plan F, depending on where you live and how much coverage you want. Plan G also has a version with a high deductible that usually has even cheaper monthly premiums.

The cons:

  • Unfortunately, both plans don’t cover prescription drugs. Original Medicare recipients can add a Medicare Part D prescription drug plan, which only covers prescription drugs, or they can sign up for a Medicare Advantage plan (also called Medicare Part C), which covers their Original Medicare health benefits and may cover prescription drugs.
  • If you choose the version of either plan with a high deductible, you may have to pay more due to the need for more money up front before any coverage is able to begin.

FAQs

  • Which is better?

Plan F covers a little bit more than Plan G, but not by much. Its premiums and deductibles are higher than those of Part G. In the end, the best choice will depend on what you need and how much money you are able to spend. If you are thinking about either plan, you should talk to a Medicare agent to find out which one they feel is best for you.

  • Should I switch from Plan F to Plan G?

It can be a good idea to switch from Plan F to Plan G depending on your needs. If you switch to Plan G, which is usually less expensive than Plan F, you may save money on premiums. In the end, it depends on what you need and how much money you have. You can switch plans at any time, but if you don’t have “guaranteed issue rights,” the insurance company can use “medical underwriting” to figure out how much your premiums will be and may even refuse to cover you.

  • Why Is Plan F Discontinued?

Federal law says that Medicare Supplement plans can no longer pay for the Medicare Part B deductible. The goal of the change is to cut down on visits to the doctor that might not be necessary, which will save money on health care.

Working With EZ

When looking for a Medicare Supplement Plan, it’s important to compare the costs and benefits of each one. That means you’ll have to do a lot of research. Which can be time consuming as you’ll have to call multiple insurance companies to get price quotes. However, if you work with an agent from EZ, you can compare prices in half the time. Working with a licensed agent gives you access to many Medicare Supplement Plan carriers and plans in one place. In addition to giving you price comparisons, your agent can tell you how each plan is different. Also, your agent can help you compare out-of-pocket costs with premium costs to figure out which plan will save you the most money over time. Call us today at 877-670-3602. Or enter your zip code in the bar below to start looking for a Medicare Supplement Plan. 

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Stressed About Finding A Medicare Plan? Let EZ Help You

Turning 65 can feel like hitting a milestone. At this point in your life, you’ve lived a long life and made a lot of memories and are looking forward to making more! And one of the best ways to keep going strong is to have a good insurance plan that will protect your health. Fortunately, turning 65 also means you can finally benefit from Medicare, which you’ve been paying into your whole working life, so you will have some pretty good coverage to help you do this. But Medicare alone is not enough. You’ll also need something, like a Medicare Supplement Plan, to fill the gaps in your coverage.

 

You might be seeing a lot of commercials about different Medicare plans available to adults 65 and older to help you fill those gaps. And it can all be confusing as to what direction you should go, but this is where EZ can help you. We will go over everything you need to know and provide you with quotes for all the plans in your area at no cost to you, so you can get fully covered and get back to living your life!

Medicare Supplement Plans

So why do you need an insurance plan if you already have Medicare? Well, while Medicare Part B covers outpatient medical services, including durable medical equipment, there are quite a few out-of-pocket expenses associated with it. You will have to pay a monthly premium and meet your annual deductible, as well as cover your 20% coinsurance for each service you receive, since Part B only covers 80% of costs. 

 

To fill these gaps in Part B, you’ll need a Medicare Supplement Plan. For one low monthly premium payment, Medicare Supplement Plans cover things like deductibles, copays, and coinsurance, and can even offer extras like coverage for when you’re traveling. 

Save Time

There are around 10 Medicare Supplement Plans available, meaning you have a lot of options. But it also means that looking into all the various plans available, and what each plan entails, while trying to figure out if these plans will suit your specific needs, can be very overwhelming. Working with one of our agents will save you the time and frustration of searching through all the different plans available in your area. 

 

We will also save you time by sitting down with you and discussing your medical needs and your budget, to find only the plans that will work for you. We’ll show you which plans cover your current providers, and any other necessities you would like, such as travel insurance. Then we will go through all available options with you and explain each one so that you get a full understanding of the coverage options and the costs. 

Finally, we will save you time by helping you enroll in the plan in a matter of minutes when you are ready. image of a clock next to piles of coins with sprouts growing on them

Save Money on Medications

One of the most nerve-wracking things is trying to find a plan that keeps your prescriptions affordable. It is no secret that many Americans, especially seniors, struggle to pay for medications, but working with an EZ agent will allow you to see all of your options for prescriptions coverage and save the most money.

Find A Medicare Plan That Fits Your Budget

If you’re retired and living on a fixed income, you’ll need to budget carefully for your daily expenses, and you’ll need a plan that fits into that budget. We can help you find a plan that will do just that, giving you the ability to save money for other things that matter in your life, such as traveling or your grandchildren.

No Need to Look Further

As we pointed out above, if you’re a Medicare beneficiary and need help paying for the things that Medicare doesn’t cover, you have the option of purchasing a Medicare Supplement Plan. Your plan can help pay for the things that Medicare does not, including the 20% coinsurance that you will have to pay out-of-pocket for every Part B-covered service. One of these plans could cover 100% of your Part A coinsurance and hospital costs, as well as 100% of Part B coinsurance and copayments, for one low monthly premium price.

 

There are 10 different Medicare Supplement Plans to choose from, each offering different coverage options and rates. It’s worth looking into a Medicare Supplement Plan to save as much money as you can, so speak to an EZ agent for all of your options. EZ’s agents work with the top-rated insurance companies in the nation and can compare plans in minutes for you at no cost. To get free instant quotes for plans that cover your current doctors, simply enter your zip code in the bar on the side, or to speak to a licensed agent, call 888-753-7207.