Medicare Open Season is October 15 through December 07!
Open season can be a bit confusing for many seniors as many on regular Medicare with Medigap insurance coverage believe it pertains to them as well. In fact, Medicare Open Season is only relevant to those seniors with a Medicare Advantage plan or new to Medicare. Seniors with existing original Medicare can change their Medigap / Medicare Supplement plan at any time, as long as they meet the health requirements. In this article we attempt to answer the question; What Is the Best Medicare Plan?
What is the Best Medicare Plan for Seniors?
“Whether you are just turning 65 and are new to Medicare, or a long-time Medicare recipient, this Blog post should have useful information to help you decide which is best for you.”
The battle of choices between Medicare Advantage and the original Medicare with a Medigap supplement insurance coverage is a classic example of the old saying “There is no such thing as a free lunch”. According to the U.S. government Centers for Medicare & Medicaid Services (CMS), the average cost of a Medicare Advantage plan is just $33.90 per month. Some have no premium at all. That compares to an average cost of $194 per month for a Plan F Medigap coverage. Plan F is the most comprehensive Medigap plan in that it covers 100% of what traditional Medicare does not pay.
Certainly, with such an enormous cost difference the obvious choice would be Medicare Advantage, wouldn’t it? We will answer that question in detail in a moment, but consider the following: According to the latest statistics from CMS there are 53,590,746 seniors in the U.S. eligible for Medicare. Of those 53.6 million seniors, only 12,671,062 seniors have chosen the lower cost Medicare Advantage over traditional Medicare. That’s just 23.6%. That’s right, only 23.60% of seniors eligible for Medicare choose Medicare Advantage. If the choice between Medicare Advantage and traditional Medicare were so cut and dry based on the average monthly premium, we would expect to see a lot more seniors on Medicare Advantage. So what is it that seniors see in traditional Medicare plus Medigap insurance that they don’t see in Medicare Advantage? What we hear most from seniors when we discuss the options available to them with original Medicare and Medigap coverage are words like; security, predictability, control, choices and flexibility.
“…only 29.0% of seniors eligible for Medicare choose Medicare Advantage. If the choice between Medicare Advantage and traditional Medicare were so cut and dry based on the average monthly premium, we would expect to see a lot more seniors on Medicare Advantage. …What we hear most from seniors when we discuss the options available to them with original Medicare and Medigap coverage are words like; security, predictability, control, choices and flexibility.”
With traditional Medicare and Medigap plans, insurance companies are required by law to pay your medical bills on a timely basis. They are penalized (not you) if they don’t pay on time. You can choose your Doctor, as long as the Doctor takes Medicare (most do). Your coverage is good anywhere in the U.S. So you don’t have to worry about medical bills while traveling to visit grandchildren. Your medical care is decided between you and your Doctor. No insurance company can control what coverage you have, and your Medigap insurance coverage cannot be canceled unless you stop paying the premium.
That is not the case with Medicare Advantage. The table below offers a side-by-side comparison.
Medicare Advantage plans are either Health Maintenance Organizations (HMO), a Preferred Provider organization (PPO), Private Fee-for-Service plan (PFFS) or a Special Needs Plan (SNP). A detailed description of the differences between these types of plans starts on page 82 of the 2015 Medicare & You Guide.
When compared side by side the reasons that most seniors choose original Medicare with a Medigap plan become obvious. We want predictability, control over our medical care, we want to choose our own doctor and hospital and we want to know that the best care available is available to us. That is what original Medicare with Medigap insurance offers that Medicare Advantage does not. At the end of this article we will also include a few links to stories and videos that show the nightmare some seniors have faced with their Medicare Advantage plans. If you are on the fence, choosing between Medicare Advantage and original Medicare, these links will have very important information to consider. If you currently have Medicare Advantage, you can switch back to original Medicare during open season, if you qualify medically as per noted above.
Now here is the sad part about Medigap insurance:
Most seniors on original Medicare overpay for their Medigap insurance. On average, they overpay by between $500 and $800 per year, per policy. We have seen multiple cases recently where senior were overpaying by $1,200 per year on each policy and had no idea that they could get the exact same policy for half the price they were paying.
Want to know if you are overpaying for Medigap insurance? Complete this brief quote form now!
Why do so many seniors overpay? While the service provided by insurance companies in the Medigap market is highly regulated, the fee for those services is not. Many insurance companies will charge a low teaser rate to get new business from seniors just turning 65 and then gradually raise those rates over time. They also offer lower rates to new business on a continual basis, while raising the price of existing policies. So if you are not shopping for a new policy you have no idea how much you could be saving just by shopping around. Lastly, many insurance agents only represent one insurance company. Even if they are aware the same policy can be purchased for less elsewhere, they won’t tell the consumer for fear of losing the business.
Many seniors also don’t realize that with traditional Medicare you can switch Medigap policies at any time, not just during open season, as long as you qualify medically. There is no medical exam, but you will be asked a few medical questions when applying. In general, disqualifying medical events include things like terminal illness, complications from diabetes or taking more than 50 units of insulin per day, cancer or heart attack within the past two years, COPD, Alzheimer’s and so on. If you do not have a disqualifying medical history, then switching to a different insurer or even a different plan is a very simple process that will lead to significant savings every year for most seniors.
“Each Medigap policy is priced by zip code, age, gender and smoking status. What we do is input that data into our system and shop all the major Medigap insurance providers to identify which company can offer the plan you want at the lowest price. If a particular company has a history of raising existing policy prices, we will advise on that to help our customers make the best decision. Because we are not locked into any particular insurance company, our goal is to help our clients keep their insurance costs as low as is reasonable possible, while keeping the plan they feel most comfortable.”
Different insurance companies can charge widely different prices for the exact same policy, but they are required by law to provide the same benefits and pay the medical bills on a timely basis. Each Medigap policy is priced by zip code, age, gender and smoking status. What we do is input that data into our system and shop all the major Medigap insurance providers to identify which company can offer the plan you want at the lowest price. If a particular company has a history of raising existing policy prices, we will advise on that to help our customers make the best decision. Because we are not locked into any particular insurance company, our goal is to help our clients keep their insurance costs as low as is reasonable possible, while keeping the plan they feel most comfortable with. The table below shows the different Medigap Plans and what they cover. The most common plan types being purchased today are plans F, G and N. Our service is free of charge. If you choose to switch insurers to save money, the insurance company you choose to go with pays our fee. If you would like us to shop Medigap plans for you and find the lowest cost provider in your area, simply complete this Medigap Quote Form today! You will be pleasantly surprised with how much you can save!!
What is the best Medicare plan? More than seven out of ten seniors believe Orginal Medicare plus a Medicare Supplement Insurance policy is the best plan. Now it’s your turn to go over these pros and cons and ask yourself; What is the best Medicare Plan?
Some important links:
The US Government publication: Choosing a Medigap Policy
A video tutorial on Medigap insurance: Medigap Insurance Coverage
Get a Free Medigap Insurance Quote Online
Problems with Medicare Advantage:
Denied Coverage at the worst possible time.
Medicare Advantage Plans Canceled
Unexpected Medical Expenses from Medicare Advantage Loophole
Losing Your Medicare Advantage Doctor
More on Losing Your Medicare Advantage Doctor (At the root of this article is the realization that seniors with Medicare Advantage will face cuts in service that original Medicare and Medigap seniors will not experience.)
Shield Insurance Solutions is independent. Our goal is to find the best insurance company and policy for you. We specialize in living benefit life insurance and work with nearly 100 different insurance companies in order to find the right policy at the right value for you. We are transparent and have been in the financial services industry since 1984. In addition to Medicare Medigap insurance, our life products include Whole Life, Universal Life and Term Insurance. As independent agents, we work hard to find the best life insurance company for you, with the best life insurance rates and value. We are based in Jupiter and Palm Beach Florida and licensed in almost every state. If you are shopping for a life insurance quote, we can show you what many of the top insurance companies will offer. The price differences will amaze you. Visit www.ShieldInsuranceSolutions.com to get a free life insurance quote comparison, or call us at (800) 847-9680.
