Legislation in 2015 established these changes. These changes were made with a goal of saving the government money. This means you will almost assuredly have more out-of-pocket expenses.
Let’s talk about how Medicare Supplements work:
Medicare Supplement Insurance, also referred to as Medigap, is an insurance policy sold by a private insurance company. The purpose for purchasing such a plan is that it will pay for some of the costs that original Medicare does not pay for, like deductibles, copayments, and coinsurance. So it “supplements” your original Medicare.
You pay the private insurance company a monthly premium for your Medigap plan. This is in addition to the premium you pay Medicare for your Part B coverage.
Medigap policies are guaranteed renewable no matter what your health situation is. As long as you pay your premium, the company cannot cancel your policy.
When you go to the doctor or hospital, Medicare pays its share of the Medicare-covered expenses. Then, your Medigap policy pays its share. If there are copayments, you will be required to pay these prior to services rendered. You will pay deductibles or your coinsurance amount after Medicare and Medigap have paid their share.
There are different types of Medigap Plans you can purchase. You make the choice based on your medical needs and your budget. Some of the most popular plans include Medigap Plans C and F.
- Plan C provides coverage for Part B deductibles. This means you have very little out-of-pocket costs.
- Plan F provides coverage for almost all deductibles as well as any Part B excess charges. An excess charge is when a Medicare provider does not accept assignment, or does not accept Medicare as payment-in-full for the charges. This means the provider may charge you up to 15 percent more than what Medicare paid for the service. Since Part F provides coverage for excess charges, with this Plan, you have practically no out-of-pocket costs.
Medicare Supplement Changes and Options for anyone enrolled in Medicare by 12/31/2019
As of December 31, 2019, Plans C and F are being eliminated. The good news is that if you are enrolled in Medicare Part A by December 31, 2019, and have a Medigap Plan C or F, you may keep it. You may even purchase your Medigap Plan from a different company as long and you medically qualify, or make the change during an Open Enrollment or Guaranteed Issue time.
For example, if you receive a notice that your premium for Plan C or F is being increased, you will still be able to shop for a Plan C or F from a different company.
Plans C and F have been among the most popular Medigap Plans since they are the only ones that cover the deductible of Medicare Part B.
Options if you enroll in Medicare on or after 01/01/2020
If you enroll in Medicare on or after January 1, 2020, you will not be able to purchase a Medigap Plan C or F. There will be no Medigap Plan available to you that will cover the Plan B deductible. You will be able to purchase a Plan G, which has all the benefits of Plan F. However, it does not pay the Part B deductible.
Legislators thought that if every recipient of Medicare had to be responsible for some out-of-pocket expenses, they would go to the doctor less often. This will benefit the government by saving it money on health care expenses.
We are here to Help!
Here at Independent Benefit Advisors, we help Medicare recipients learn more about their Medicare supplement options. We’ll help you find a supplement that meets your specific needs and budget. Give us a call at 888-303-9690 and we will find the right Medigap plan for you!
Choosing The RIGHT Medigap Plan is Unique For Every Situation. The Independent Benefit Advisors, serving Raleigh & The Triangle, Charlotte, and ALL of North Carolina can help determine the plan that is best for YOU.