Greg, be very, very careful if you sign up for Medicare Advantage. It sounds attractive up front but you could run into pitfalls down the road. Do your research!
My husband knee replacement surgery on plan N cost us: $250 deductible, $20 surgeon consultation, $20 primary physician clearness, $20 cardiologist clearness and $20 appointment with surgeon before surgery. This is it. Follow up appointments, pt are $0 copay
@ he paid $92. It is first year. We do not know price for 2025 yet. It is Mutual of Omaha and we living in Midwest state. When he applied plan G was $135
I hope I can afford G. Plan, was cheap per month but those co pays really put a dent on my fixed fixed income. Theres no where together help with any ins.
I would like to thank Medicare School for explaining so well what the different plans are all about. I am originally from the UK and it has been a mystery to me. Your company being an independant broker is so important as you have the clients needs in the forefront of your advice. When I originally dealt with Medicare I completely trusted the advice of a gentleman who came to see my wife and I. Had he explained the pros and cons of the supplement v advantage plans I would have made a better informed decision. Thankfully you have taught me so much.
Thank you so much for sharing your thoughtful feedback! We’re delighted to hear that MedicareSchool.com was able to demystify the complexities of Medicare plans for you, especially coming from a different healthcare system in the UK. It means a lot to us that you found our explanations helpful and informative, empowering you to make more confident decisions. As an independent broker, we take pride in putting our clients' needs first, and we're grateful that our dedication made a difference for you. Thank you for trusting us with your Medicare journey, and if you ever have any further questions, feel free to reach out to us at 800-864-8890. We’re here to support you every step of the way!
In NY, Plan N is way to go for many. That nearly $800 gap (annual) is significant; a patient would need to see 40 medical professionals over the course of the year, all charging the full $20 co-pay, before losing money. Many doctors don't even charge the full co-pay, if at all. Excess charges give some pause, but they're very rare and you can ask up front, as Marvin noted. Best is in NY, you can upgrade from an N to a G basically any month without going through underwriting. That's a nice option, although it's also why our monthly premiums are so high. If I lived outside NY, in most states I'd dive right into a full Plan G, but N is the way to go for many here in NY. Can't go wrong with either.
There are eight states which do not allow eccess charges. My state of Pennsylvania is one of them. It doesn't matter if you are one of those States they cannot charge it to you. Even if you are not in one of those eight states you can also check with Medicare to see if your doctor provider whoever is under the rule of non-access charges.
In MN, where we don't have G plans - we have Basic plans which are sort of similar - the spread between N and Basic is about $100.00+ per month. I had planned on taking Basic, but that difference is crazy.
It would be helpful to clarify that excess charges are 15% "of what". Is it 15% of the sky high amount the physician would charge an out of network uninsured patient? Or is it 15% of the regulated fee for service amount Medicare allows. The unregulated rates for medical services seem like they can be 10x of regulated prices. Is it legal for doctors to treat someone over 65 on medicare but not accept medicare at all (i.e., will charge more than 15% above medicare rates, because they are fully not participating)?
The 15% excess fee, also known as a Medicare Part B excess charge, is an additional amount that some healthcare providers may charge beyond what Medicare approves for a service. It is not illegal for them to treat Medicare patients if they do not accept Medicare, they have to make it known that their insurance is not accepted and if you decide to move forward anyway with their services, they can treat you as self pay.
I have a Plan G and would recommend to not change to another plan if at all possible. My wife and I have had several hospital stays and I had one operation without any additional costs. I looked at the medical bills and realize why so many people have enormous medical bills.
I'd love to see you do a video on ACOs, especially ACO REACH. It seems that more & more providers are joining ACOs and asking their Original Medicare patients to "align" with them so they can receive capitation payments thru their ACO instead of getting Fee for Service payments from Medicare. To me, ACOs sound a lot like managed care for original Medicare where doctors are given financial incentives to lower medical costs. What is your take on ACOs and their potential affect on patient care?
Mutual Of Omaha goes by age....every yr they go up and say it's because of age! I always write back and say why don't you go by health? Insurance companies are a business and don't care!
I'm having a hard time getting an answer to this question: I signed up for plan G in October 2024 but I realize that because my medication is expensive, i would prefer Plan N to save money on premiums. Can I switch? Is there a deadline? I live in Illinois.
It depends on when your part B started, if you are still in the first 6 months of Part B you can switch now with no wait! Or you can switch around your birthday if you are outside of that window. Give us a call we'd be happy to help, you can reach us at 800-864-8890.
How does one determine what the cost of the bill that an extra 15% is allowed? Does Medicare have a published list of medical procedural costs (your "assignment costs) that someone call look up to see how the excess fee is calculated?
That is typically up to your provider on if they accept Medicare assignment or not. You can always directly ask your providers if this is something they charge or not. They legally have to disclose that information.
About comparing plan G and plan N: it's not just about saving money. I think very soon plan N will be more popular than plan G. Maybe it's easier to pay the premium when we are 65, but when we're getting older, this premium will be higher and higher with every year. Most of the people will not be able to afford it. My point is: look in the future when you choose your plan.
Do you have a post, where you are ,62 and getting Medicare in january, because i retired and disabled? Is their special info for those shopping for supplement at 62, in New Jersey?
A flex card is usually something that is offered for those that also qualify for Medicaid. It would be included with the plan you select. Typically referred to as a dual plan. You can contact our office at 800-864-8890, if you have any questions!
Your comparison link only provides offers from your most popular options; which is only 3 Companies and they are the same Companies for both Plans G and N. Does that mean those are my only options and there isn't any other Carrier under those plans for my State?
My parents had Medicare before 2020 (2010/2014), do they have to choose plan F only or have an option to choose between F or G? Lives in California, switching to supplement due to guaranteed issue right/ plan is ending. Thanks.
My dad has premium plan. I’m not sure which one but he’s 94 and it was with Aetna supplemental and none of the urgent cares where we live will no longer take Aetna no matter what even though he this is a supplemental plan I thought for sure they would take him no matter what because he has a supplemental plan and they’ve decided to no longer take Aetna up here where I live in California.
That is not right, by law they have to accept all supplement plans. When he is being seen at these places do not give them your supplement plan card. Just provide them with your Medicare red, white and blue card. They will only bill Medicare and Medicare will forward the remainder of your bill to Aetna. But they should not be turning you away with a supplement plan. I hope this helps, if you have any questions you can call us at 800-864-8890.
My plan provider Cigna is merging with HCSC in 2025. Not sure how this will affect plan rates. Sounds like they need to merge Plan G into Plan N to avoid confusion, simplify choices and perhaps lower costs. Thanks!
No one moves from Miami to Seattle 😂 Seriously, if seems logical to me that N would have the people who tend to be healthier, or at least think they will be healthier and don’t need to worry about the “extra” charges as compared to G folks?? Therefore the rates will be not only lower, but also more stable?? I know predicting is difficult but what is your experience??
Yes your healthy so your on plan N saving premium cost then the unexpected happens where plan G saves you a lot of money in the long run. But here’s the caveat, you probably won’t be able to switch to G from N because now you have a health condition and won’t pass the 40 questions test. It’s a catch 22. Your healthy, your on plan N. Something happens, you can’t get on plan G. 😮
You mentioned when your on an advantage plan it is hard to move over to a letter plan. My husband is under retirement age, on disability and 2025 will be his 2nd yr with an advantage plan. He still has 10yrs till 65. Will it be difficult to move to G or N at that time after being with an advantage plan for 12 yrs?
That is a different scenario, those on Medicare under 65 will have a complete reset at 65, so they can get those supplement plan without having to medically qualify. Here is a video that we did about this! If you have any questions you can contact our office at 800-864-8890. th-cam.com/video/hTwF6ME9oeM/w-d-xo.html
@vincentmaloney5835 is it better in the long run to drop the advantage plan and wait for 65? 12 yrs anything can happen with regards to cancer, diabetes etc
@@servingourlord If there's no other option, I would keep the advantage plan till I turn 65 years old. After that I would try to switch to original medicare and buy a medigap plan.
N and G cost the same here in my area of Michigan according to a broker i talked to. Actually 5 cents difference between 3 different companies. Why is that?
Same thing happened in Arkansas with those two premiums! New rates were just a few dollars different between Supplement G and N on BCBS and AARP United. Healthcare. (Only two I checked.) That's was a shock AND a deal killer for plan N. I also wonder if excess charges will become common for doctors who can't continue being forced to accept lower payments for care? Or, can Medicare increase the plan N $20 payment to providers?
They do not cover dental and vision, you would have to look into adding those plans on separately. If you have any questions you can contact our office at 800-864-8890.
Wrong, Wisconsin has neither. Wisconsin is one of 3 states that doesn't have standard d, g, or n plans but instead has a bunch of riders that you build a supplemental plan. Best to see a broker/specialist to help you decide.
I live in Wisconsin. We have a base plan and we can add riders to them to make them equivalent to the national plans. If you ask your agent for a plan G equivalent, it would be the base plan plus four riders. Plan N would be the base plan plus three riders and we have an HDG equivalent. I hope this is helpful.
If you take an advantage plan, you will get sick of all the referrals and pre-authorizations which involves long phone conversations. You will have to check the network all the time to make sure the doctor accepts your plan. All this will get on your nerves.
We have GExtra in SoCal for $405 for both husband and wife per month ($202.50 each) we chose that when first applying for Medicare. I had heard that you should think carefully before going from an all inclusive plan like GExtra to G or to N, since if you wanted to switch back to GExtra , they would look at pre-existing conditions and they can deny switching back. Not sure if this is correct?
It depends on the situation. We are aware that supplements can be expensive and not everyone can afford them. It's just good that you understand what your advantage plan coverage actually includes. You can call our office and our team would be happy to review plans and provide any insight you need. You can contact our office at 800-864-8890.
@@terrihartbarger My wife got enrolled in advantage plan 4 years ago. She didn't even know that traditional Medicare was available. The insurance agent sold her the advantage plan without any explanations. Easy money.
Marvin Music is the hardestworking gentleman on TH-cam; his creative output of informative and helpful videos is unparalleled!
We appreciate those kind words. If you have any questions don't hesitate to give us a call at 800-864-8890.
Thank you Mr Musik
@@davidfolts5893 yes I tell everyone I meet when they show concerns. Very educational.
We are new to medicare...
thanks for helping us understand.
Greg, be very, very careful if you sign up for Medicare Advantage. It sounds attractive up front but you could run into pitfalls down the road. Do your research!
Happy to help, if you have any questions you can give us a call at 800-864-8890.
My husband knee replacement surgery on plan N cost us: $250 deductible, $20 surgeon consultation, $20 primary physician clearness, $20 cardiologist clearness and $20 appointment with surgeon before surgery. This is it. Follow up appointments, pt are $0 copay
How much are you paying per month? What state?
@ he paid $92. It is first year. We do not know price for 2025 yet. It is Mutual of Omaha and we living in Midwest state. When he applied plan G was $135
I hope I can afford G. Plan, was cheap per month but those co pays really put a dent on my fixed fixed income. Theres no where together help with any ins.
Sign w/ AFLAC...N.. $91 a month......😂
@@patriciamorrison5519I live in AZ and pay $96 for my plan N and zero for my Drug Plan with Well Care.
I would like to thank Medicare School for explaining so well what the different plans are all about. I am originally from the UK and it has been a mystery to me. Your company being an independant broker is so important as you have the clients needs in the forefront of your advice. When I originally dealt with Medicare I completely trusted the advice of a gentleman who came to see my wife and I. Had he explained the pros and cons of the supplement v advantage plans I would have made a better informed decision. Thankfully you have taught me so much.
Thank you so much for sharing your thoughtful feedback! We’re delighted to hear that MedicareSchool.com was able to demystify the complexities of Medicare plans for you, especially coming from a different healthcare system in the UK. It means a lot to us that you found our explanations helpful and informative, empowering you to make more confident decisions. As an independent broker, we take pride in putting our clients' needs first, and we're grateful that our dedication made a difference for you.
Thank you for trusting us with your Medicare journey, and if you ever have any further questions, feel free to reach out to us at 800-864-8890. We’re here to support you every step of the way!
I'd love to see you do a video comparing Plan N with Plan High Deductible G, especially in Florida.
Thanks!
In NY, Plan N is way to go for many. That nearly $800 gap (annual) is significant; a patient would need to see 40 medical professionals over the course of the year, all charging the full $20 co-pay, before losing money. Many doctors don't even charge the full co-pay, if at all. Excess charges give some pause, but they're very rare and you can ask up front, as Marvin noted. Best is in NY, you can upgrade from an N to a G basically any month without going through underwriting. That's a nice option, although it's also why our monthly premiums are so high. If I lived outside NY, in most states I'd dive right into a full Plan G, but N is the way to go for many here in NY. Can't go wrong with either.
I think we all need to move to South Carolina!
There are eight states which do not allow eccess charges. My state of Pennsylvania is one of them. It doesn't matter if you are one of those States they cannot charge it to you. Even if you are not in one of those eight states you can also check with Medicare to see if your doctor provider whoever is under the rule of non-access charges.
Continued excellence! Thanks😀
Glad that we can help. If you have any questions you can call our office at 800-864-8890.
In MN, where we don't have G plans - we have Basic plans which are sort of similar - the spread between N and Basic is about $100.00+ per month. I had planned on taking Basic, but that difference is crazy.
Exactly. Even if you have a lot of medical bills N is probably cheaper.
I should have added that Minnesota is a "no excess charge" state.
It would be helpful to clarify that excess charges are 15% "of what". Is it 15% of the sky high amount the physician would charge an out of network uninsured patient? Or is it 15% of the regulated fee for service amount Medicare allows. The unregulated rates for medical services seem like they can be 10x of regulated prices. Is it legal for doctors to treat someone over 65 on medicare but not accept medicare at all (i.e., will charge more than 15% above medicare rates, because they are fully not participating)?
The 15% excess fee, also known as a Medicare Part B excess charge, is an additional amount that some healthcare providers may charge beyond what Medicare approves for a service. It is not illegal for them to treat Medicare patients if they do not accept Medicare, they have to make it known that their insurance is not accepted and if you decide to move forward anyway with their services, they can treat you as self pay.
I have a Plan G and would recommend to not change to another plan if at all possible. My wife and I have had several hospital stays and I had one operation without any additional costs. I looked at the medical bills and realize why so many people have enormous medical bills.
The same hospital stays and operations are covered with plan N.
Great info as usual 👍🏼👍🏼
Glad you enjoyed it
Informative video
Glad you think so!
Very informative
Glad you think so! If you have any questions you can always give us a call at 800-864-8890.
I'd love to see you do a video on ACOs, especially ACO REACH. It seems that more & more providers are joining ACOs and asking their Original Medicare patients to "align" with them so they can receive capitation payments thru their ACO instead of getting Fee for Service payments from Medicare. To me, ACOs sound a lot like managed care for original Medicare where doctors are given financial incentives to lower medical costs. What is your take on ACOs and their potential affect on patient care?
I would love to know more about my coverage for home health care. Is there an oop expense?
Mutual Of Omaha goes by age....every yr they go up and say it's because of age! I always write back and say why don't you go by health? Insurance companies are a business and don't care!
This is the main reason why I will take N but not G.
Best option? Community pricing vs issue age vs attained age? in terms of price stability. Thank you . Big help for us seniors.
I'm having a hard time getting an answer to this question: I signed up for plan G in October 2024 but I realize that because my medication is expensive, i would prefer Plan N to save money on premiums. Can I switch? Is there a deadline? I live in Illinois.
It depends on when your part B started, if you are still in the first 6 months of Part B you can switch now with no wait! Or you can switch around your birthday if you are outside of that window. Give us a call we'd be happy to help, you can reach us at 800-864-8890.
Bill Clinton is only kissing Donald Trump‘s butt to try to stay out of prison because he doesn’t want prosecuted for his crimes.
How does one determine what the cost of the bill that an extra 15% is allowed? Does Medicare have a published list of medical procedural costs (your "assignment costs) that someone call look up to see how the excess fee is calculated?
That is typically up to your provider on if they accept Medicare assignment or not. You can always directly ask your providers if this is something they charge or not. They legally have to disclose that information.
About comparing plan G and plan N: it's not just about saving money. I think very soon plan N will be more popular than plan G. Maybe it's easier to pay the premium when we are 65, but when we're getting older, this premium will be higher and higher with every year. Most of the people will not be able to afford it. My point is: look in the future when you choose your plan.
Do you have a post, where you are ,62 and getting Medicare in january, because i retired and disabled? Is their special info for those shopping for supplement at 62, in New Jersey?
Here is a video we did about this: th-cam.com/video/hTwF6ME9oeM/w-d-xo.html . If you have any questions you can contact our office at 800-864-8890.
I assume excess and access are the same charges discussed.
My Plan N in NY went up nearly $40 from last year.
It will be like that every year. This is the main reason why I am choosing plan N. I cannot afford plan G.
@@vincentmaloney5835 Do you know anything about TransAmerica? I have AARP/UHC now. Wondering if TA is better or only temporarily less expensive.
What is the flex card ???
A flex card is usually something that is offered for those that also qualify for Medicaid. It would be included with the plan you select. Typically referred to as a dual plan. You can contact our office at 800-864-8890, if you have any questions!
Your comparison link only provides offers from your most popular options; which is only 3 Companies and they are the same Companies for both Plans G and N. Does that mean those are my only options and there isn't any other Carrier under those plans for my State?
There are other options as well. We do not work with all carriers in your state but the more national carriers.
Your comparison link only offers plan G companies. Why when I choose plan N does it go to plan G automatically?
There’s a button to switch between G and N so you can see the price comparison.
My parents had Medicare before 2020 (2010/2014), do they have to choose plan F only or have an option to choose between F or G? Lives in California, switching to supplement due to guaranteed issue right/ plan is ending. Thanks.
They have both options, depending on if they are available in your area. You can contact our office at 800-864-8890, we'd be happy to review and help!
The person signing up for supplemental insurance chooses which plan they want when they initially sign up.
My dad has premium plan. I’m not sure which one but he’s 94 and it was with Aetna supplemental and none of the urgent cares where we live will no longer take Aetna no matter what even though he this is a supplemental plan I thought for sure they would take him no matter what because he has a supplemental plan and they’ve decided to no longer take Aetna up here where I live in California.
That is not right, by law they have to accept all supplement plans. When he is being seen at these places do not give them your supplement plan card. Just provide them with your Medicare red, white and blue card. They will only bill Medicare and Medicare will forward the remainder of your bill to Aetna. But they should not be turning you away with a supplement plan. I hope this helps, if you have any questions you can call us at 800-864-8890.
Folks still don't understand Advantage ( insuramce) vs Traditional Medicare
My plan provider Cigna is merging with HCSC in 2025. Not sure how this will affect plan rates. Sounds like they need to merge Plan G into Plan N to avoid confusion, simplify choices and perhaps lower costs. Thanks!
That change would still remain the same for your plans, the only thing that could change is the name of the carrier.
No one moves from Miami to Seattle 😂
Seriously, if seems logical to me that N would have the people who tend to be healthier, or at least think they will be healthier and don’t need to worry about the “extra” charges as compared to G folks?? Therefore the rates will be not only lower, but also more stable?? I know predicting is difficult but what is your experience??
Yes your healthy so your on plan N saving premium cost then the unexpected happens where plan G saves you a lot of money in the long run. But here’s the caveat, you probably won’t be able to switch to G from N because now you have a health condition and won’t pass the 40 questions test. It’s a catch 22. Your healthy, your on plan N. Something happens, you can’t get on plan G. 😮
You mentioned when your on an advantage plan it is hard to move over to a letter plan. My husband is under retirement age, on disability and 2025 will be his 2nd yr with an advantage plan. He still has 10yrs till 65. Will it be difficult to move to G or N at that time after being with an advantage plan for 12 yrs?
That is a different scenario, those on Medicare under 65 will have a complete reset at 65, so they can get those supplement plan without having to medically qualify. Here is a video that we did about this! If you have any questions you can contact our office at 800-864-8890. th-cam.com/video/hTwF6ME9oeM/w-d-xo.html
He will have to answer 20 questions. If he doesn't have cancer, diabetes, A fib etc., they will probably approve his application.
@vincentmaloney5835 is it better in the long run to drop the advantage plan and wait for 65? 12 yrs anything can happen with regards to cancer, diabetes etc
@@servingourlord If there's no other option, I would keep the advantage plan till I turn 65 years old. After that I would try to switch to original medicare and buy a medigap plan.
What do you think of Mutual of Omaha vs AFLAC on a plan N?
Both are great carriers. If you would like for us to compare both options with you 1-on-1 we're happy to. You can contact us at 800-864-8890.
AFLAC is so new in the Medigap business. I don't know if that is a positive or negative?
N and G cost the same here in my area of Michigan according to a broker i talked to. Actually 5 cents difference between 3 different companies. Why is that?
Same thing happened in Arkansas with those two premiums! New rates were just a few dollars different between Supplement G and N on BCBS and AARP United. Healthcare. (Only two I checked.) That's was a shock AND a deal killer for plan N. I also wonder if excess charges will become common for doctors who can't continue being forced to accept lower payments for care?
Or, can Medicare increase the plan N $20 payment to providers?
I bet the difference will be bigger in a couple of years or so.
I this plan applicable for year 2025?
Yes! If you would like to review those options you can give us a call at 800-864-8890.
“g” plan covers dental and eye, please?
I hope no, since the original Medicare doesn't cover them
They do not cover dental and vision, you would have to look into adding those plans on separately. If you have any questions you can contact our office at 800-864-8890.
Does Wisconsin have plan N or G?
Yup, I just got one from this company for my wife and me.
Wrong, Wisconsin has neither. Wisconsin is one of 3 states that doesn't have standard d, g, or n plans but instead has a bunch of riders that you build a supplemental plan. Best to see a broker/specialist to help you decide.
I live in Wisconsin. We have a base plan and we can add riders to them to make them equivalent to the national plans. If you ask your agent for a plan G equivalent, it would be the base plan plus four riders. Plan N would be the base plan plus three riders and we have an HDG equivalent. I hope this is helpful.
We'd be happy to review those options with you, you can contact our office at 800-864-8890.
I need help
Do you not recommend an advantage plan at all? The supplemental plans are so expensive.
Don't get an Advantage plan. That's specifically for insurance companies making money on you.
If you take an advantage plan, you will get sick of all the referrals and pre-authorizations which involves long phone conversations. You will have to check the network all the time to make sure the doctor accepts your plan. All this will get on your nerves.
My husband’s plan N raise 15% for 2025 ( Mutual of Omaha) 😡😭
We have GExtra in SoCal for $405 for both husband and wife per month ($202.50 each) we chose that when first applying for Medicare. I had heard that you should think carefully before going from an all inclusive plan like GExtra to G or to N, since if you wanted to switch back to GExtra , they would look at pre-existing conditions and they can deny switching back. Not sure if this is correct?
That is correct, you have to medically qualify.
Do you not recommend an advantage plan at all? The supplemental plans are so expensive.
It depends on the situation. We are aware that supplements can be expensive and not everyone can afford them. It's just good that you understand what your advantage plan coverage actually includes. You can call our office and our team would be happy to review plans and provide any insight you need. You can contact our office at 800-864-8890.
Advantage plans are for insurance companies to make money on you.
@@terrihartbarger My wife got enrolled in advantage plan 4 years ago. She didn't even know that traditional Medicare was available. The insurance agent sold her the advantage plan without any explanations. Easy money.