Before you Apply for Medigap plans
If you have not been automatically enrolled, Apply for Medicare
What is your Part B effective date? Confirm that you have Medicare Part B (the Medical insurance part of Medicare)
Consider if you are married….will you be applying together?
Are there any major health concerns that I should be aware of?
Have your list of medications, Medicare Red White and Blue Card, and check / account information handy.
Q: I am trying to assist my mother in wading through all of the information about Medigap insurance. She is interested in a policy which covers what Part A & B does not.
So far I have learned that Plan F is the most popular followed by Plan C.
Now I am looking for someone that can explain to my mother the various coverage plans and the cost involved with perhaps different companies. She is 78, lives in Dayton, and is on a fixed income. Is there more information you need from me?
A: I can certainly try to help.
What type of coverage does she currently have?
Also, are there any major health concerns or expensive prescription
drugs I should be aware of?
Q: She has Medicare Part A & B. She does need both hips replaced…and is looking for additional coverage to help with that. As far as prescription drugs…right now her out of pocket is about $68 per month. She takes two meds for high blood pressure, one for cholesterol, and one anti-inflammatory for her hips.
A: Unfortunately, on all Medicare Supplement applications, they ask the question:
In the past 2 years, has a doctor scheduled or recommended any tests,
surgery or workup to rule out disease or to determine the cause of
your health concerns that have not been completed?
Have you been advised by a medical professional to have treatment,
further diagnostic evaluation, diagnostic testing or any surgery that
has not been performed?
Based on the information that you gave me, she would not qualify.
There may be financial assistance available to her depending on her
It appears she may be able to move to a Part C aka Medicare Advantage
plan, however – we will want to have a list of Prescription’s, Dr.’s
and Hospitals in order to make the best recommendations.
Q: Dear Mr. Hill,
Thank you for your prompt response to my request for medigap rates. I need to make some decisions as soon as possible. My husband and I recently started Medicare A, but we are covered by my employer’s insurance until August 31, so we have yet to sign up for Medicare B and supplemental insurance.
I hope you can help me with a couple of questions:
- Am I correct that all Plans (I am interested in F and G) are the same regardless of the insuring company?
- Why is Mutual of Omaha so much cheaper than the others?
- What is the real difference between the 2 major companies I’m considering – Aetna and United Healthcare?
- What is the cost of the Part B deductible for Aetna’s Plan G? Is Plan G better than Plan F?
- I have a quote from STRS Aetna Medicare Plan (PPO) for @123.00 for myself and $290.00 for my husband totaling $413.00. Why is that price so much more?
- My husband takes several generic medications that we currently get by mail ExpressScripts. Obviously, I would like to have little out-of-pocket cost. What is the best plan?
I hope I have not overwhelmed you with my questions and you can help me sort things out. Email is probably the best method so that I can take time digesting the information
A: You are very welcome. I understand your concerns and will attempt to address them below. For your reference, please download this booklet http://www.medicare.gov/pubs/pdf/02110.pdf
You may need a Part B application https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/CMS40B-E.pdf
Q: Am I correct that all Plans (I am interested in F and G) are the same regardless of the insuring company?
A: Yes, a Plan G from Aetna will provide the same benefits as a Plan G from Omaha per se
Q: Why is Medical Mutual and Mutual of Omaha cheaper than the others?
A: I will need to run all quotes for a August 31 start date for accurate rates, but generally speaking Omaha and Medical Mutual of Ohio are two of the largest insurers since Medicare’s beginning and has maintained very competitive rates for a long time. They are Mutual companies, which means they are not publicly traded and are focused on the client rather than the interest of their stockholders and profits
Q: What is the real difference between the 2 major companies I’m considering – Aetna and United Healthcare?
A: In my opinion, there is not much. Those are some of the top companies in the industry. However, a historical look at rate increases is often recommended….I can help with that.
Q: What is the cost of the Part B deductible for Aetna’s Plan G? Is Plan G better than Plan F?
A: This year, Part B deductible for all companies(set by law) is $166 http://www.medicare.gov/your-medicare-costs/costs-at-a-glance/costs-at-glance.html – which basically translates to: If your monthly premium savings outweigh your yearly Part B deductible of $166 divided by 12mo’s, it may be wise to choose Plan G over Plan F. Also not that G has an average annual rate increase of 3% compared to Plan F’s 8%
Q: I have a quote from STRS Aetna Medicare Plan (PPO) for @123.00 for myself and $290.00 for my husband totaling $413.00. Why is that price so much more?
A: Unfortunately there seems to be no ryhme or reason when companies price Medicare Advantage plans. Keep in mind that Original Medicare plus a Mudeicare Supplement plan is much different than these Advantage plans. http://www.medicarerights.org/fliers/Medigaps/Medigaps-vs.-Medicare-Advantage.pdf?nrd=1 – Many of the people I talk to, do not like the doctor and hospital limitations of many PPO networks
Q: My husband takes several generic medications that we currently get by mail ExpressScripts. Obviously, I would like to have little out-of-pocket cost. What is the best plan?
A: Your Part D Prescription drug plan will be separate from your Medigap(Medicare supplement) plan. “Best” plans are not universal and are determined by the number and type of medications along with location within the sate of Ohio. Just like Medigap policies, these drug plans are priced all over the map. I could run the comparisons with a list of medications and your preferred online or hometown drug store