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Comparison of Florida Medicare Supplement Insurance Plans

 

Consulting with an independent  Florida Medicare supplement insurance agent can guide you provide you with even more valuable feedback, since that agent has helped many other clients and has a history in dealing with more than one Medigap insurance company.

Even though the U.S. Government standardized Medicare Supplement insurance (Medigap) Plans back in the mid 1960’s, the quotes you receive now can vary significantly and working with an agent has absolutely no bearing on the price. In other words, the price you get by going direct with a company or with an appointed agent are identical. For example; you can get the exact same Medigap Insurance Plan that your friend has, but you could end up paying a different premium. Often times I receive calls from customers and they express that their friend has this Medigap plan for such and such a price. I then proceed to ask them the following: where does your friend live, how old are they, do they smoke and which Medigap plan do they have? Insurance companies set their own rates based on your age, where you live, gender and the Medigap Plan type you select. If you live in California, you will get a different rate than if you live in Florida. The rates also vary based on which county you live in. For example, Plan F in 2017 with one carrier, costs $264 in Palm Beach and Broward County yet only $186 in Martin and St. Lucie County. If you go with Medigap Plan F; the one that offers the most comprehensive coverage, expect to pay more. However, if you just need a simpler form of coverage such as Medigap Plan A, you’ll pay a lower premium.

To enroll in a Medigap Insurance plan, you must have Medicare Parts A and B. There are 10 Medicare Supplement Insurance Plans or Medigap Plans to choose from, although they’re not all available in every state. Coverage is identical from one company to the next. Rates, on the other hand, can vary quite a bit.

When choosing a Medicare Supplemental Insurance product you should take three main factors into consideration: your current health, your financial situation and family health history. Paying for insurance is similar to gambling. The less you pay, the more risk exposure you have. It’s difficult to project a few years into the future let alone a few days. You never know what tomorrow will bring. Hopefully, you never have to use insurance at all. Medicare Supplement Insurance is considered a guaranteed issue insurance plan for six months when you join Medicare Part B. In other words, it’s guaranteed and without any medical underwriting for up to 6 months after the month you turn 65.

Ending employer sponsored insurance coverage or dropping a Medicare Advantage Plan are additional reasons or triggers for guaranteed issue Medicare Supplemental coverage. If you are not in an open enrollment period or guaranteed issue period, you must qualify by answering some health related questions. Also keep in mind that Medigap plans are prices based on age bands. So, if you wait until you’re 66 or older, you’ll be in a higher age band and will pay a higher premium than a 65 year old. That monthly premium is then locked in for the rest of your life. Premiums can go up, but when they do, it’s across all age bands in a particular county or state.

When discussing Medicare and Medigap plans there is often a discrepancy when referring to Medicare Part A or B and Medigap Plan A, B, C, etc. So, please pay close attention when I refer to Part A, Part B verses Plan A, Plan B, Plan F, etc.

Medicare Supplement Plan F is the only Medigap plan without any holes or gaps in coverage. When admitted to a hospital, Medicare Part A – Hospital Services pays all but the Part A deductible of $1316. The Medigap Plan F pays this $1316 Part A deductible. This amount can and often does increase slightly from year to year. Medicare Part A – Hospital Services also covers 100% of the initial 20 days at a skilled nursing facility. This is also referred to as a skilled rehab facility. From the 21st thru the 100th day at a skilled inpatient rehabilitation facility, Medicare Part A will continue to pay all approved amounts except for $164.50 per day. Fortunately, the Medigap Plan F pays this $164.50. If there is any needed Long term care above and beyond the 100 days, you would have to pay all costs yourself or have a long term insurance policy pay for it. At this point, having a long term care insurance policy would be very helpful since it would aid in defraying these costs as well as the costs associated with non-skilled care, if needed. This additional coverage for non-skilled custodial care is costly and you would have to apply and get approved to have such an insurance policy in place in order to pay for such services. Of course, it would be next to impossible to get a long term insurance plan after an incident such as a broken hip or stroke. At that point, you would be un-insurable for long term care insurance.

Medicare Part B – Medical Services pays 80% for all doctor costs, skilled home health services, out-patient physical therapy, occupational therapy and speech therapy. It also pays 80% for all other out-patient testing and treatment including out-patient surgery. Medigap plan F pays the other 20% for all of these services.

Since providers can opt not to accept Medicare on assignment, they can then charge an additional 15% to you, the patient. This is referred to as the excess charge and Medigap Plan F pays this excess charge for you. The only other Medigap plan that covers this excess charge is Medigap Plan G.

Medigap Plan G is identical to Plan F except for one gap in coverage. Plan G does not cover the one-time annual Part B deductible, which is $183 in 2017. So, when comparing apples to apples, you can compare Medigap Plan F and Plan G but remember to factor in the annual out-patient deductible of $183.

Medigap Plan A has the most gaps in coverage. The only gap that it does cover is the 20% for all doctor bills and all out-patient bills.

Medigap Plan B is the same as Plan A except it does cover the Hospital Part A deductible of $1316

Medigap Plan C is identical to Plan F but it does not cover the Part B excess fees, when and if that should occur.

Medigap Plan K only pays 10%, rather than the usual 20% of all doctor bills and out-patient services. It also only pays ½ of the hospital deductible of $1316. It does not cover the Part B deductible of $183, does not cover Part B excess and does not cover any foreign travel. The max-out-of-pocket for Plan K is $5120, after which, the plan then pays all gaps fully.

Medigap Plan L is identical to Plan K except it pays 15% of all doctor bills and out-patient services and only pays ¾ of the hospital deductible of $1316.

Medigap Plan M only pays 50% of the Part A Hospital deductible and does not cover the Part B outpatient deductible or excess charges.

Medigap Plan N also does not cover the Part B outpatient deductible or excess charges. It also asks that you pay a $20 copayment for any office visit and a $50 copayment for any emergency room visit.

The Medicare Supplemental High Deductible Plan F is a great value for a Medigap plan. There are significant savings on a monthly basis with a monthly premium just a fraction of the price of the Full Plan F. In 2017, the monthly premium for a female is $69 per month. The catch is the $2200 yearly deductible that must be paid before the benefits will begin to pay. In other words, you would have to pay all gaps in coverage up to the max-out-of-pocket of $2200. At that point, the Medicare supplement company will pay 100% of all gaps in coverage for the remainder of the year. On January 1st of each year, that $2200 deductible resets.

If a doctor or other health care provider chooses not to accept the Medicare approved amount that the government has implemented or simply does not want to accept Medicare on assignment, a limiting charge at 15% above the Medicare approved amount is the most that the provider can balance bill the patient. This 15% above the Medicare approved amount is referred to as the Medicare excess charge. Remember that only plan F and plan G cover this excess charge.

In summary, the language of Medicare and Medicare supplemental coverage can be confusing at first. After a few reviews and after sitting down with an experienced independent Medicare Supplement agent, it will start making more and more sense. After you begin using your Medicare and Medicare supplement benefits, you will be amazed at how easy and efficient this government plan actually is.

Speak with an experienced Florida Medicare supplement insurance broker to compare Medicare plans and:

  • Get free no obligation Medicare supplement insurance plan quotes
  • Easily compare Medicare supplement insurance plans
  • Choose the from the best Medicare supplement insurance plan prices available.
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Neil Primack helped me navigate the Medicare maze. He is very knowledgeable and we quickly found insurance that was just what I was looking for. I would recommend Neil to friends needing help.
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Neil Primack certainly deserves a five star rating. He clarified the Medicare supplement choices and lessened the many concerns that I had in choosing a new policy. Neil was considerate, kind, and immediately available.
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