Those of you who have been following my column know that I talk a great deal about the Plan F. I know this because when I’ve met many of you, one of the first topics that come up are questions about plan F. Some of you have really done your homework, gone online, or researched the original Medicare supplements in some way. Some of you have pretty much made up your mind before I meet you, which plan you think will work best for you. I admit that I have a tendency to lean in the direction of plan F in most cases. It is the industry standard.
I’m not changing my mind or turning traitor by discussing plan N. We touched on it last year during the Annual Enrollment Period. In fact, we looked at all of the various plans that are offered by private insurance companies for seniors who have chosen original Medicare. We compared each of them to plan F because I think we all can agree that plan F is the most comprehensive supplemental plan that is offered. Most insurance companies don’t offer all of the plans, but I haven’t found any company that doesn’t offer plan F.
The reason that I want to examine plan N at this time is because many of you are preparing to once again experience the Annual Enrollment Period. The word I get is that it’s not the most pleasant experience of the year and most of the people I meet who go through this each year would rather not. These are eople who have chosen Medicare Advantage instead of original Medicare. These are people who feel they can’t afford a Medicare supplement or perhaps they have chosen an Advantage plan just to save money on the monthly premium.
Unfortunately, there is a third reason. Some people find that their health history prevents them from buying a Medicare supplement at any cost. These people may be able to change from their current Advantage plan to a different Advantage plan or even an Advantage plan offered by a different company. However, advantage plans are not guaranteed renewable and quite often change benefits, premium costs, co-pays and deductibles. Sometimes a company may discontinue the plan completely.
This leaves the insured in the lurch. In order to make the best possible decision as to what to do in these situations, the insured needs not only to understand the coverage that they’ve lost or that has been changed, but also to understand all of the other policies that are currently available, and each year try to determine which one best suits their current needs. That doesn’t sound like fun to me at all!
I’m really not trying to bash Advantage plans. They serve a purpose and some would not have any coverage if the Advantage plans were not available. However, some of us in the business have become so attached to the plan F, we may not take the time to show some of the less expensive plans. All of these plans have something that none of the Advantage plans have. They are all guaranteed renewable as long as the insured pays their premiums on time.
This means that once an insured is approved with any Medicare supplement from any reputable company, they never have to worry about the Annual Enrollment Period again! All of the “Lettered” plans are variations of plan F. All of the plans cost less than plan F. All of the plans have some benefits that are the insured’s responsibility to pay.
Plan N is very similar to plan F, but it might be the difference in price that would allow an applicant to choose to pay a little more than the premium on their Advantage plan, but have guaranteed benefits for life. Plan N covers all of the same Medicare Part A deductibles and daily co-pays as plan F. It pays the same Skilled Nursing Care benefits and co-pays. It pays the blood deductibles and Medicare’s Hospice co-pay/coinsurance.
Plan N pays all of the same Medicare Part B expenses as plan F except the following:
You are responsible for the Medicare Part B annual deductible (currently $147).
You are responsible for up to $20 per office visit.
You are responsible for up to $50 per ER visit which is waived if you’re admitted to the hospital and the ER visit is covered as a Part A expense.
You are responsible for any excess costs charged by a physician that exceeds the 20% that Medicare approves but doesn’t pay. (Some physicians are allowed to charge an additional 15%). Since you can choose your own physicians, you can choose physicians who accept Medicare approved costs only.
Blood deductibles under Medicare Part B are covered if you have already met your annual Medicare Part B deductible.
Home Health Care Medicare Approved Services are covered after you’ve paid your annual Medicare Part B deductible.
These are relatively minor out of pocket expenses. If you are facing yet another Annual Enrollment Period and are in good health or if you are just turning 65 and do not have to qualify for your policy by meeting the health standards, you may want to look at a plan N for yourself.
If you have any questions about Medicare Advantage or Medicare supplements or for back issues of this column, please call my office. In the next issue, we’ll look at additional ways to save money on your premiums.
Orion Steen is a licensed agent and specializes in Medicare supplemental plans. He has been advising his clients on life and health insurance matters in Arizona for over 45 years. He can be reached for related questions by E-mail at email@example.com, call toll-free 888-846-6891 or cell 623-846-6891.