Have a Question Call Now 818-342-9200

Category: California

14 posts

There is no best since they are all basically the same.  All plans of the same letter provide exactly the same benefits, the only difference is price.  (Don’t take my word for this – even Medicare says this).  Medicare designs all Medigap plans so you can be sure of the same benefit regardless of company.

Some people want to check with their doctor to be sure they accept a new company.  This is 100% not necessary.  First, the doctor doesn’t bill the insurance company.  They send a bill only to Medicare.  Medicare then sends it to the company on file (this is called “crossover).  Both Medicare and the Medigap plan will then pay their share.

The second reason the doctor will accept all Medigap plans is because it’s illegal for them to pick one over the other.  Since they all pay the doctor just as quicklly this wouldn’t be an issue and certainly not an issue legally.

The bottom line is you should never worry which company is providing you with a Medicare Supplement.  They are all the same except for cost.  Why pay more than you have to?

If you’re not working with an independent agent you should.  Call us if we can be of help.

Medicare Supplements or Medigap policies may be changes anytime as long as you are in reasonable health.  What’s reasonable?  “Normal” issues such as non-insulin diabetes, high blood pressure, etc. won’t cause problems.  Heart and Lung problems along with the use of a walker may limit your choices.

Some states including California allow for movement to another plan without medical questions once a year.  The “birthday rule” in California has saved my clients money as they can change to a more competitive plan annually.  Recently a 70 year old with MS came to me.  She was paying a small fortune for her Plan F.  She couldn’t easily change without the birthday rule.  She’s moving to Plan G and will save over $600 a year by being willing to pay the $183 Medicare deductible instead of having her current insurance pay it.

In other states including Nevada you need to be accepted by the underwriters at any company when you’re outside of the open enrollment period (usually when you turn 65).  However, I was able to save a couple in Reno well over $1,000 a year despite some serious medical conditions.

It’s important to talk with an indepedent agent that represents a large number of companies to be sure you have the lowest price for the plan you desire.

As with most questions, there is no “best” plan for everyone. Many large cities have several insurance companies competing for your business.  In fact, many times there is no monthly premium for the plans, zero copay for office visits and even hospitalization.  Even if there are costs they can be limited to as low as $2,000.  And they likely include a prescription drug plan.

So why wouldn’t everyone want to be in a HMO?

Well, the biggest drawback is the limited physican and sometimes hospital network.  As long as you’re healthy this isn’t a big deal aside from the tendency to have delays in making an appointment and the usual need for a referral to be approved.

If you have health issues are you willing to simply default to the network specialist for treatment?  Let’s assume you want treatment at UCLA, Cedars or City of Hope.  That probably won’t happy with an HMO.  Last year UCLA only accepted on plan and the latter two did not accept any HMOs.  This not to say treatment elsewhere won’t be great.  The point is you lose control of your medical care.  You have given it to one medical group.  One.

I’ve helped hundreds (if not thousands) of people find the HMO they prefer.  And usually it boils down to dollars not flexibility of who to see.  HMOs are neither good nor bad.  They just are what they are.

We’re happy to discuss the HMO plans in your area along with other coverages including Medigap.  Let us know how we can help.

No one plan is better.  Medigap (Medicare supplements) have no network.  If you doctor and other providers accept Medicare they are available with any Medigap Plan regardless of the company.

Medicare Advantage is generally an HMO or a PPO.  In most areas where HMO plans are available there is zero monthly premium and the maximum out of pocket for copays and coinsurance may be as low as $2,000 a year.  So if money is the only criteria and HMO is terrific.  The downside are mainly that HMO plans use a limited network of providers.

PPO Plans are available in few areas and will likely have premiums ranging from $50-$200.  Copays and coinsurance continue until the maximum annual out of pocket is paid, usually around $6,000.  These are great plans if you never have a medical catastrophe.  If you do have major issues you could easily spend up to the maximum.

Which is best for you?  That’s a great discussion with an independent agent.  Let us know if we can help.

Simply a Medigap or Medicare Supplement pays dollars for you for covered services. Medicare determines what is covered not the plan. All supplements of the same letter provide the same medical benefit. The only difference is price.

Medicare Advantage plans are private insurance policies similar to what people have prior to becoming Medicare eligible. Most if not all of the monthly premium for these plans is paid by Medicare. Once a person enrolls in an advantage plan they no longer receive benefits from Medicare. All care is via the insurance company.

Which one is right for you is a discussion you should have with an independent insurance agent. We have over 25 years of experience working with Medicare beneficiaries for both Medigap and Medicare Advantage Plans. Make sure your agent can help you with all options.

This question is asked of me almost daily. Or people have the notion that their plan (usually Plan F) is the best. The simple answer is that all plans are the best and that no plan is the best. The best plan is the one that provides you with the coverage you need at the best possible price.

When discussing Medicare supplements I ask “Why did you choose Plan F?” The answer I hear almost all the time is “It’s the best.” And it is the best unless you factor in the premium.

Many times when an insurance agent suggests Plan F it’s because it’s easy to explain. With Plan F there is no out of pocket costs for services covered by Medicare. Any other plan would require the agent to 1) understand insurance and 2) spend a few minutes in discussion. Many agents or company representatives don’t want to bother with either.

If you are looking into plans either a someone just joining Medicare or to try to save some money please look at Plan G and Plan N. Both are better values for most people than Plan F.

To keep this simple let’s look at Plan G. The ONLY difference between G and F is who will pay the annual Medicare Part B deductible of $183. For most people, the premium savings by moving from F to G is about $450. So by willing to pay $183 you save $450.

Looking at this another way, you would be paying $450 to an insurance company in exchange from them paying $183. As I tell my clients, this is why so many buildings have the name of an insurance company at the top.

Do yourself and your bank account a favor. Do some shopping or let an independent agent do it for you. We’re happy to help and if you do indeed have a great deal we’ll let you know.

So many people start studying plans a year or so before they are eligible for Medicare.  I speak with many people doing this and have to hold back my laughter.  Everyone seem to do this.

Medicare is really not complicated, especially for those of us who have been helping people for 25 years or more.  There is no reason to contact every company offering benefits.  If you simply call an independent agent who represents most of the major companies offering plans this can be a relatively painless time.

Many areas have a variety of HMO plans, sometimes a PPO or two, and always 10 Medicare supplement plan choices offered by 30 or more companies.

Please do yourself a favor and let a professional sit down and narrow down the choices for you.  If you are in an HMO now maybe you’d like to continue in that type of plan.  PPO plans might be a good choice but it’s important to compare price, benefits.  But even PPO plans have a network albeit not as restrictive as an HMO.

In some areas the premium for a PPO are not much less than a Medicare supplement.  The price of insurance has to include the potential cost for a catastrophic claim such as hospitalization, cancer treatment or stroke.  Most PPO plans have a share of cost of $6,000 or more.  While the premium might be a bit higher for a supplement, the out of pocket can range from zero to $2,240.

An HMO might have a premium as low as zero.  That sounds great until you want to go to UCLA, Cedars, or the City of Hope.  Then the zero premium plan likely is not going to help you at all.  Those hospitals will most likely not be an option.

People that do their own research (which usually means asking their friends) tend to spend much more money than necessary.  Plan F is the most popular Medicare supplement.  It’s also the most expensive.  Review other plans to see if you can find the plan that provides you with the most value.

We all want the lowest priced plan available.  After all, since all Medicare Supplements of the same letter are identical (even Medicare says this), why would anyone pay more than necessary?

While the lowest price sounds great, the more important question is “Is this plan the lowest priced for which I can qualify?”  While this isn’t an issue when you first turn 65 it can be an issue when you apply at an older age.

Recently I was referred to a 74 year old who told me she had no medical conditions.  In fact, we completed the application and submitted the application.  A week or so later she was declined!

She was declined because she had a procedure scheduled between the time the application was taken and the company called to verify medical questions.  This company asks “Within the past 12 months have you been advised by a medical professional to have treatment, further evaluation, diagnostic testing, or any surgery that has not been performed.”  While she answered this question as “no” on the application upon a verification call she did say an eye treatment had been scheduled.

We then applied to another company.  Their question was “Within the past 2 years, have you been advised to have surgery which has not yet been done.”  Because this question was limited to surgery she could indeed answer no.  The policy was issued.

While the monthly cost was about $10 more than the lowest priced company she was able to be approved for coverage.  Without an independent agent who understands the underwriting differences from one company to the next she would not have been able to have a policy issued.

She was in an HMO plan and had lost her doctor.  She also wanted the freedom to see a greater choice of doctors and certainly more hospitals.

Sometimes the lowest price available is not the best choice.  Let me help you find the lowest price you can get!

I spoke with a gentlemen a few days ago. His Plan F was $689 more than switching to Plan G. The only difference is that he would pay the Medicare Part B deductible of $183 rather than the insurance company,

How could he say no? His reasoning was his financial planner said Plan F was the best so he wasn’t going to consider the change.

I specialize in Medicare. A financial planner specializes in either increasing your assets or keep you from losing money. Clearly, this financial planner knows less about Medicare Supplements than I know about which mutual fund is the best.

Using the word “financial” does not make someone knowledgeable about all subjects. Very few insurance agents actually specialize in Medicare. And probably zero financial planners are qualified to give advice outside of their field.

Use experts that are actually experts.

This is an interesting concept that many of my clients like and surprisingly, few people know about. If you have money sitting in a bank account earmarked as a legacy for your children/grandchildren you may indeed be able to increase the amount they inherit by as much as double.

How? Rather than just having the cash in the bank where it can be subject to probate, move it into a single premium life insurance policy. Moving $25,000 from the bank may generate as much as $40-50,000 in benefit for your loved ones. And you never lose access to your funds in the event of an emergency.

You need to be relatively healthy but even people with issues like high blood pressure, diabetes and other issues can qualify. And best of all, it’s a win-win for you and your family.