guaranteed enrollment Archives - Medicare Life Health

What is Medicare Plan F?

Carly H. Cummings — Sun, 19 Jan 2020 17:58:03 +0000

What is Medicare Plan F?

You may have heard, but there have been changes with who can get what Medicare Supplement Plans (aka Medigap Plans) now. Plan F and Plan C are not available to people turning 65 on or after 2020. So, you might be wondering, what is Medicare Plan F?

In this quick article, let’s look at what are Medicare Supplements and then specifically, what is Medicare Supplement Plan F.

Medicare Supplement Plans Explained

Medicare Supplement plans are supplemental policies that people can purchase to cover the costs that Original Medicare does not pick up.

There are many different plans to choose from, and they are all labeled with a Plan Letter. In addition, there are many different insurance companies that offer these plans, but they all over the exact same services as what is listed in the letter plan benefits. The only difference from private insurance company to company is the price they can offer in each specific market (area of the country).

Here is a Chart of What Supplement Letter Covers What Services

CLICK HERE to see more about the various Medigap plans and what they offer.

Why People Like Supplements (Medigap)

People like Medicare Supplement Plans because of their flexibility and their routine costs. First, these plans offer flexibility because they allow beneficiaries to see any providers that accept Medicare in the whole country. Second, Medigap Plans have the same premium charged each month, and plans like F, have no costs other than that for covered services. As a result, Medigap Plans are good for budgeting and knowing what your costs are going to be each month.

Remember, the other option for supplementing Original Medicare covered services is a Medicare Advantage Plan. That is a plan you have INSTEAD OF a supplement (Medigap) plan.

To start, you can read more about Medicare Advantage Plans here.
Then, you can read more about Medigap vs Medicare Advantage.
Or, you can read how to choose the right plan for you, here.

Who is Eligible for a Supplement?

Anyone with Medicare Benefits can apply for a supplement. When you first age into Medicare, you have a window of “Guaranteed Enrollment Eligibility” to get the supplement of your choosing. After that, you will either need a special enrollment option to get into another one, or go through medical underwriting to get a supplement.

Medicare Supplement Plan F Explained

Medigap Plan F (aka Medicare Supplement Plan F) covers the most amount of services out of all the supplemental plans. So, this means if you have Plan F, you pay your monthly plan premium for the supplement, and then you pay no other costs for Medicare covered services.

For example, Medicare Supplement Plan F is one of only two Medigap plans that covers Part B Excess Charges (read more about this here.)

As a result, it has been one of the most popular plans. If you take a look at the Medigap Plan chart above, you will see that…

Plan F Covers:

Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used
Part B coinsurance or copayment
Blood (first 3 pints)
Part A hospice care coinsurance or copayment
Skilled nursing facility care coinsurance
Part A deductible
Part B deductible
Part B excess charges
Foreign travel exchange (up to plan limits – 80%)

People like Plan F for its full coverage and it’s travel coverage both in the states and internationally.

Since every private insurance company offers the same coverage for each letter plan, it is important to understand and compare pricing. To learn how insurance companies price plans, read this article.

Who Can get Medicare Plan F and Who Cannot?

A while back., the U.S. government passed MACRA bill, or “The Medicare Access and CHIP Reauthorization Act of 2015”, that made changes to who could sign-up for Medicare Supplement Policies that covered the Medicare Part B Deductible. These plans are not “going away,” but not everyone can get them as of January 1, 2020.

Here is who CAN get Plan F still:

Click here to read more.

You CAN get Medicare Supplement Plan F (or keep Plan F) is you turn 65 before January 1, 2020. (Same applies to Plan C.)
In addition, you CAN get Medicare Plan F (or C) if you turn 65 on or after January 1 2020, BUT ALSO you have a Medicare Part A Effective Date that started before the year 2020. (One example of this might be someone who was on Medicare prior to turning 65 because of a disability.)
You can KEEP your Plan F if you are already on one. It is not going away. However, there might be reasons for you to switch to a Plan G, or another plan that does not have the Part B Deductible covered. The main reason people switch is because the plans that can accept younger people into their pool, often have lower cost increases over time. You can read more about switching to a Plan G here.

Who CANNOT Get Plan F Now:

Conclusions

In summary, Medicare Plan F is a robust, comprehensive Medicare Supplement Plan (aka Medigap Plan) that picks up all of the extra costs that Original Medicare does not cover.

Plan F is only available to people who already turned 65 before January 1, 2020. However, this plan is not going away at this time. It is still a popular plan and will continue offer full coverage and service flexibility to its beneficiaries.

If you need help in choosing a Medicare Supplement, including Plan F vs. Plan G, please contact us here if you live in NE or IA.

If you live in any other state, please click here to find an agent near you.

5 Biggest Medicare Mistakes

Carly H. Cummings — Sun, 08 Sep 2019 16:19:44 +0000

The 5 Biggest Medicare Mistakes and How to Avoid Them

No one wants to make a mistake that will cost them hundreds (or thousands) of dollars down the road if they can help it! However, Medicare can be very confusing, and even very knowledgeable people can miss things. Here are the five biggest Medicare mistakes people make, and how you can avoid them!

#1 in Our Biggest Medicare Mistakes: Missing Enrollment Deadlines

Although the government gives us all a little wiggle room around each Medicare Milestone we pass, there are certain deadlines you must mind to avoid late penalties and inconveniences.

Original Medicare Coverage Deadlines

You will need to sign-up for Medicare when you turn 65 if you are not already getting Social Security. You will be automatically signed-up for Medicare if you are getting Social Security. In addition, you will need to tell the government if you are delaying Medicare because of other credible coverage (such as an employers coverage).

You will have three months before your birthday to sign-up, the month of you birthday, and then three months after to sign-up. However, what some people do not understand, is that if you enroll after you turn 65, your coverage will not start until the first of the month after you enroll. This could lead to a gap in your health care coverage.

A NOTE ON CREDIBLE COVERAGE: Some people will delay Medicare coverage if they have a good health plan from their employer. This is usually okay, but there is an exception for small business employers to be aware of: If your employer has less than 20 employees, you will need to enroll in Medicare right away when you turn 65.

This is because when you work for a small business, their insurance will become secondary insurance and Medicare will be your primary payer. If this is the case, you will need to enroll right away in Medicare to avoid a penalty. (Also note that Cobra is not credible coverage.)

Medigap Guaranteed Enrollment Deadlines

The last Medicare Enrollment Mistake people make is missing their Guaranteed Enrollment period for a Medigap Plan. You will have six months, from the beginning of the month you first turn 65, to enroll in a Medigap plan with a guarantee to be issued a policy. If you apply after this window, you will have to go through medical underwriting. This means that companies have the right to deny issuing you a policy based on your medical history after your open enrollment is over.

It is important to remember that Medicare Advantage Plans have a different enrollment process than Medigap. The Medicare Advantage Annual Election Period is not for Medigap Plans. Which lead us right into Mistake #2…

Medicare Mistake #2: Not Understanding Medigap Plans vs. Medicare Advantage Plans

There are two main ways you can set up your Medicare Health Care Plan: Medicare Advantage (Part C) and Original Medicare with a Medigap Plan. You either have one or the other, not both. Both can be good ways to set up your health care, but not understanding how they work can lead to making on of our biggest Medicare mistakes.

We have a whole article on Medicare Advantage vs. Medigap Plans here. I suggest reading it if you are unfamiliar with the two plan types. Considerations with these plans include how you get your Prescription Drugs and how you want to budget your money. Cash flow can be different plan to plan with premium payments and out of pocket expenses to consider when making a decision. Your lifestyle needs and travel patterns also need to be considered when making a choice between MA and Medigap.

Mistake #3: Assuming Your Doctors and Drugs are Covered

We all know what assuming can lead to… mistakes! It is very important to make sure that your doctors are covered with the Medicare option you choose. The carrier will be able to help you confirm that you will be able to continue with your current doctor if you so desire. If you are working with an Insurance Agent, they will have the ability to do this for you as well.

Checking your drug options with a plan is also an important part of finding coverage. The government does make sure that at least two kinds of drugs are available per category of treatment. Moreover, carriers will have a process for you to make an exception for a drug not on its list (called a formulary). However, it makes for a smoother transition to check ahead of time to see what is covered for your specific needs.

Biggest Medicare Mistake #4: Assuming Medicare Covers Long-Term Care

It is a common mistake to assume that your Medicare coverage includes long term care – it does not. Skilled nursing facilities for recovery from a certain event are covered (and come with different co-insurances based on different plans). However, long term stays in assisted living and nursing homes are not covered. You will need to have a plan in place to cover these needs. Your planning may include:

Long term care insurance
IUL policies with long term care (or critical illness) riders, or
Self-insurance (paying cash).

Another option, for those that do not have a lot of resources saved up for retirement, is to “spend down” your assets to qualify for Medicaid to help you in paying for your care. However, I would not suggest this option for those that have the means to plan ahead for the level of care they desire or those that want to pass money on when they pass.

Biggest Medicare Mistake #5: Enrolling Directly with a Carrier

Ok, follow me on this one. When you first turn 65, you are bombarded with advertisements for different Medicare plans. Sometimes, it feels easiest to just pick up the nearest postcard and give that insurance company a call. Or maybe you have done your research on your own (which is just fine!) and decide to enroll directly with the carrier you want to go with. Here is where you should stop and consider this as a mistake.

Here is the problem: when you enroll with an insurance company for one of their plans directly, you have to deal with them alone. On the other hand, when you enroll with that same company through an independent insurance agent, you now have an advocate and support system to help you work with that carrier.

Here is how an independent agent helps:

First, if something goes wrong, you can call your agent for help! You are not on your own, and this is a big deal. As we all know, everyone can make mistakes – you, your doctor’s office, your insurance company. When these mistakes happen, you can call your agent for support and they can work with you and the insurance company to make sure you are taken care of.

Second, rates and plans change! A good independent agent will keep on top of industry changes and plan changes for you. They can stay on top of your premium rates and what might be new or changing in your area to make sure you always have the best coverage. You will not get this level of service when you work directly with a carrier.

Finally, you do not pay anything extra for working with an independent agent. They are still paid as an independent agent from Whichever company you are placed with at no charge to you.

Medicare Mistakes Summary

In addition to this article, another great resource is the Medicare and You book put out by the government. Since this is a large (120 page) document, we have created a Medicare and You User’s Guide for you to read and reference here.

In summary, you can avoid the biggest Medicare mistakes with a little research and a little help.

Reach out to a professional to answer any of your market specific questions and find out more about Medicare, Medicare Advantage, Medicare Supplements, and their differences here on MedicareLifeHealth.com.

guaranteed enrollment Archives - Medicare Life Health

What is Medicare Plan F?

What is Medicare Plan F?

Medicare Supplement Plans Explained

Here is a Chart of What Supplement Letter Covers What Services

Why People Like Supplements (Medigap)

Who is Eligible for a Supplement?

Medicare Supplement Plan F Explained

Plan F Covers:

Who Can get Medicare Plan F and Who Cannot?

Here is who CAN get Plan F still:

Who CANNOT Get Plan F Now:

Conclusions

Further Reading

5 Biggest Medicare Mistakes

The 5 Biggest Medicare Mistakes and How to Avoid Them

#1 in Our Biggest Medicare Mistakes: Missing Enrollment Deadlines

Original Medicare Coverage Deadlines

Medigap Guaranteed Enrollment Deadlines

Medicare Mistake #2: Not Understanding Medigap Plans vs. Medicare Advantage Plans

Mistake #3: Assuming Your Doctors and Drugs are Covered

Biggest Medicare Mistake #4: Assuming Medicare Covers Long-Term Care

Biggest Medicare Mistake #5: Enrolling Directly with a Carrier

Here is how an independent agent helps:

Medicare Mistakes Summary

Further Reading: