In this video I am going to review Medicare supplement Plan N and compare the costs and benefits of Plan N to both Medicare
supplement Plan G and Medicare supplement Plan D. Medicare supplement Plan N
can be your best value for a Medicare supplement.
This is especially true in those specific states that have state laws that reduce the value of Medicare supplement Plan G. In addition
some insurance companies already preparing for Medicare supplement Plan D to become a very popular plan after 2020. To be clear
referring to Medicare supplement Plan D not Medicare Part D, which is for your prescription drugs.
Medicare supplement Plan D is a direct competitor Medicare supplement Plan N. Do you live in this state that has
specific laws, the Medicare Override Measure laws that make plan and a better value?
Are you familiar with Plan D at all? Do you know what simple technique to use to tell if
Medicare supplement Plan N is a better value for you than Medicare supplement Plan G?
We're gonna be covering all of that and more in this video so stay tuned.
MedigapSeminars.org An Independent Medicare Insurance Broker.
Before we get into today's video on Medicare supplement Plan N, you should know that
whether you're new to Medicare and researching Medicare for the very first time
or you've had Medicare for some time and you just have questions
my website MedigapSeminars.org is where you'll find the answers are looking for. I've created a series of educational videos laid out
in a very easy to follow format that can take you from the very start of Medicare, how and when to enroll,
to talk about the different Medicare plans; Medicare supplement and Medicare Advantage.
All so that you can make an informed decision when you make your Medicare choice. If you have a specific question and you can't find the
answer on the web site than simply press to Contact Us form
complete it, give us your questions, and within 24 hours a licensed professional agent is going to respond to your e-mail questions
with the answer that you're looking for. So please visit MedigapSeminars.org. Our mission is to help you make an informed decision
about your Medicare choices. All right, so let's get started. Choosing which Medicare supplement plan is right for you can be a little
bit daunting certainly when you're new to Medicare and you just learning the ABCs of Medicare
making sure that you have the right supplement plan for your budget and your needs
can be a little bit of added stress. So first off let me take a little bit of that stress off your shoulders. Regardless of your health history
when you're new to Medicare you have a six months to choose the right Medicare supplement plan for you.
You can change your mind all you want every day if you want. for six months
and the insurance company is required to accept your application and give you the Medicare supplement plan of your choice
without question. If you're not new to Medicare you still have a 30-day window to change your mind. Here is why...
Many people will mistake your Initial Enrollment for Medicare with the same Initial Enrollment for your Medicare supplement.
Your initial enrollment in Medicare ends three months after your birthday month.
Your initial enrollment for Medicare supplement
ends six months after you have started Medicare Part B.
Even if you started Medicare Part B during your Medicare initial enrollment period.
So, you have of six months where you can change your mind. Change your mind every day you can go back and forth with plans you
can do whatever you choose during those six months, as often as you want, and insurance company is required
to give you the plan of your choice. You just cancel one and get another.
After those six months you can still change your mind all you want. It's just that whenever you apply for new Medicare supplement
you'll have to qualify by going through medical underwriting.
There you're gonna be asked questions about your health. They are looking for major
major things like heart attacks, stroke, cancer
and diabetes and is not in control, inplanted Medical Devices and
Parkinson's and those kind of things. Absent those
significant events then you can still change your Medicare plan anytime you want any day of the year. After your initial
enrollment period with your Medicare supplement, when you do change and you go through underwriting
you still have a 30-day window in which you can reverse your decision but no consequence.
So relax take your time make sure that as you research your Medicare supplement plans and which plan is right for you
that you end up with the plan that's right for your needs and your budget. But rest assured; if you're waking up every day worried about
whether not yet made the right decision, you can still change your mind.
during your six months after you're initial enrollment period, or 30-days after you've changed your plan
when you had to go for medical underwriting. I hope that relieves a little stress. Now lets get on with Medicare supplement Plan N.
Is Medicare supplement Plan N the right plan for you? Let's take a look at all the plans and
start by talking about how this plan is different than your other choices
This table is your Medicare supplement benefit table. It shows the benefits of all 10 of the Medicare supplement plans.
The plans themselves are identified in the top row by letter.
The general categories of Medicare benefits are listed in the left hand column.
Then in the column below each of the Medicare supplements
it shows you what percentage of coverage each plan has. You can find this table on our website or in most of the major Medicare
publications like the Medicare & You guidebook or the Choosing a Medigap Policy.
Now remember that regardless of which Medicare supplement you choose
Medicare Part A & Medicare Part B are your primary coverage. That's your primarily insurance. Part A for hospital insurance
Part B outpatient insurance. With Medicare as your primary insurance, you can see any doctor go to any medical facility in the country
as long as they accept Medicare.
and every facility you go to has to accept any Medicare supplement plan that you have, from any insurance company that you've purchased
it from. With Medigap Plan N we can see it covers 100% of the Medicare Part A toll insurance and hospital cost
up to an additional 365 days
after the Medicare benefits are used up.
Notice that all the supplement have this coverage!
And also notice here that the Medicare supplement Plan N please also pays the Medicare Part deductible.
That deductible in 2017 is $1,380 per event.
It will change every year. But with the Medigap Plan N that doesn't matter. You're supplemental will pay for it.
Without a supplement, you pay the deductible up front. Then have 60 days of hospital coverage before you start having co-pays or
coinsurance. With the Medicare supplement Plan N you can be an impatient in the hospital for more than 365 days
with 100% coverage. You will have no out of pocket cost you your Medicare Part A. You should already know that with Medicare Part B
Medicare Part B pays 80% of your outpatient services.
That leaves you a coinsurance of 20% that is your responsibility out -of -pocket. And there's no maximum out of pocket limit on that.
thankfully your Medicare supplement Plan N covers that 20% co-insurance so that you'll have no out of pocket after you've paid the
Medicare Part B deductible. That's the $183 calendar year deductible. The amount changes every year. It's $183 in 2017.
I will talk about what to expect of that deductible in the years ahead in just a moment.
So what do these asterisks mean? Do you notice than none of
the other insurance plans have a *. So this is an important feature that is unique to Medigap Plan N.
Asterisks indicate that you have a copay with Medicare supplement Plan N.
That copay is up to $20.00 per office visit, and a $50.00 charge if you go to an emergency room.
The keywords here are "Up To" $20.00. Here is what that means. For many common office visits
with your Medicare supplement Plan N this copay will be less than $20.00. I've seen it as low as $9.00.
Don't expect it to be exactly $20.00 every time you go to the doctor. When you go to a specialist, I'm sure it will be $20.00.
In fact what this is, is actually it's you're paying 20% of the office visit up $20 dollars.
Medicare has negotiated these office visits down so most of the general practitioner office visits
can be less than $100 or close to $100.
Of course specialist visits are going to be over $100, and 20% of that is going to be your max of $20.00.
So expected it to be under $20.00 most times, but up to $20.00 per visit.
You'll notice on this Medicare supplement Plan N, going down the column
of its coverage about 100% coverage until you reach the Medicare Part B deductible. That's an annual deductible currently $183.
You're gonna pay for that out of pocket, but it also has no insurance for Medicare Part B excess charges.
If you have a Medicare Part B excess charge and you have a Medicare supplement Plan N
you'll pay that excess charge out of pocket. Later in this video I'm going to go over in detail
a real life example of having a Medicare supplement Plan N and a common joint replacement.
What we're going to do with the real life example is to answer most of the misunderstandings and the questions that
people have on what exactly the Medicare supplement Plan N covers. That's a little later on
in just a moment. I mentioned the Medicare Part B deductibles currently $183 and 2017.
That that deductible will go up over time. Medicare itself has hinted to expected it to go up to $250 perhaps in the next
5 to 7 years. Of course every Medicare supplement that is purchased (new to Medicare)
in 2020 and beyond will require that individual, the Medicare beneficiary, to pay the
Medicare Part B deductible. Please note that Preventive Care also known as Wellness Visits
are exempt from any of the copays and deductibles. For example if your first visit to the Doctor during the year is a preventive care or
wellness visit; either you're Welcome to Medicare visit or an annual Wellness visit
it is entirely exempt from your Medicare Part B deductible and any of the copayments.
What about these Medicare Part B excess charges? How much are they?
This can get a little that involves, but it's very important. Especially if your considering a Medicare supplement Plan N.
When a doctor or hospital decides to work with Medicare they have one of two choices with their contract.
They can either decide to accept the rates that Medicare assigns
or charge more than what Medicare advises. If they accept the rates that Medicare assigns, it is called Medicare Assignment.
Then Medicare becomes there one-stop biller. You come in for a service, they bill Medicare. They don't bill your Medicare supplement.
They bill Medicare. Medicare pays its portion and then Medicare will contact your Medicare
supplement company and instruct them what to pay and when to pay it. They don't bill your supplement company and that's important.
If a doctor or hospital decides not to accept Medicare Assignment then
Medicare will pay them 5% less. Medicare will not be there one-stop biller...
and they can charge up to 15% more than what Medicare pays them.
The amount they charge that is more than what Medicare pays them is called a Medicare excess charge .
Excess charges are only allowed on Medicare Part B outpatient services. There are no Medicare
excess charges for Medicare part A. When you have a Medicare supplement Plan N
any Medicare Part B excess charges come out of your pocket.
But here's the good news.
Medicare part B excess charges are very easy to avoid. Here's how. Paying excess charges are easily avoided by simply going to
a doctor that only accepts Medicare Assignment.
When you're going to see a doctor for the first time, go to the Medicare.gov website and look them up. The Medicare.gov website will tell you
whether or not they accept Medicare Assignment. If they don't accept Medicare Assignment and you see them with a Plan N
expect an excess charge. If they accept Medicare Assignment they can't charge you an excess charge. Warning!
Do not call up the doctor's office and ask them if they accept Medicare Assignment.
The odds are that the people in the doctors' office, as good as they are at what they do
won't really know what you're talking about.
In today's day and age most doctors offices do not even do their own billing.
So I can't tell you how often that this type of scenario happens; a client will call up the doctor's office and ask;
Do you accept Medicare Assignment? I have a Plan N. The people in doctor's office have no idea what you're talking
about so they ask "What insurance company do you have?"
and they'll tell them the Insurance Company. The doctor's office will look up on the wall that their list of companies that they have a
Medicare Advantage Plan with and say "It's not there. We don't accept your insurance."
That is where the confusion is.
All doctors that accept Medicare accept all Medicare supplements from any Medicare supplement insurance company.
That's worth repeating. All doctors that accept Medicare accept
all Medicare supplements from any insurance company.
Remember, most doctors don't even bill your Medicare supplement. They bill Medicare.
Medicare controls that, communicates to the Medicare supplement company and tells them what to pay and when to pay it.
By the way of you are researching companies to find out which one is good...
thin about that for a minute. Medicare tells them what to pay and when to pay it. There is the negotiation there is no debate in
Regardless of how that insurance company may behave with other Insurance Products
when it comes to Medicare supplement you will not find
a company that doesn't do exactly what Medicare instructs them to do.
So hear inside you avoid the confusion.
Get on the Internet. Go to Medicare.gov.
Now in its search bar, up in the top here just type in "Physicians finder"
Go to your first choice. And hear you can type and the of the name of the doctor,
the name of the medical group or search by doctor specialty.
Right under the name
of the the doctor or the group it will tell you whether or not they take Medicare assignment.
If they take Medicare assignment, they cannot charge an excess charge. If you have a Medicare supplement Plan N,
you want to see doctors that take Medicare Assignment. How many doctors take Medicare Assignment ?
According to Medicare, 97% of all the doctors in the country accept Medicare assignment. 97%
That 3% that don't includes pediatricians, and you're seeing a pediatrician
you probably don't qualify for Medicare.
The Bottom line is -
that most people go through their entire Medicare experience without ever running into a doctor the charges Medicare excess charges.
It can happen and it takes extra effort to make sure that it doesn't. As far as individual hospitals, that is another question.
What if I'm an operation and maybe my doctor
won't charge me an excess charge. But what about the anesthesiologist?
Remember two things; one is that if it's an inpatient operation that's Medicare Part A and there cannot be any Medicare excess charges.
Of course. many operations are done on an outpatient basis.
When you are in an operation in a it's an all or none situation. Either all the doctors working through
this hospital will accept Medicare assignment and not charging excess charges,
or none of them do.
Now I can't profess to know all the hospitals out there, but I'd have done enough looking. The only one I can find
that will charge an excess charge is Mayo Clinic.
So if you have a condition or something of concern and you are going to go to Mayo Clinic because it's the best bet for you
If you have a Medicare supplement Plan N they will charge an excess charge. It'll be up to 15% more
for their Medicare Part B Services, and you will not have insurance against it.
Now there are also some states that absolutely forbid or severely restrict Medicare excess charges.
These states are called Mom states because the state laws that forbid or restrict Medicare excess charges are called
the Medicare Override Measure. (MOM)
If you live in one of the state's then none of the doctors in your state or hospitals can charge a Medicare excess charge, and that's important.
That changes the equation about Medicare supplement Plan N vs Medigap Plan G.
The states we are referring to that will either restrict will forbid excess charges are Connecticut, Massachusetts, Minnesota,
New York, Pennsylvania, Ohio, Rhode Island and Vermont. Those states have laws that make Medigap Plan N
an even better value than Medicare supplement Plan G.
If you are a resident of those states and you travel a lot. If you go out of state just remember that
when you're out of state you can still experience a Medicare Part B excess charge.
But in those states that' not going to happen. Let's go back to the Medicare benefit table. I will show exactly how this changes the
equation for you. Note on this table that both Medicare supplement plan F and Medicare Plan G both pay for any excess charge.
That means they're charging you for that extra insurance. That's one of the reasons the Medicare Plan F and
Medicare supplement Plan G cost more.
But if you live in a state that forbids excess charges, you don't need that extra coverage. You don't need to pay extra for that.
Now that's some serious food for thought because it changes the equation for you. If you live in a Medicare Override Measure state
Medicare supplement Plan N is more likely to be
a better value than the Medicare supplement Plan G or Medigap Plan F.
So here's what I suggest if you're looking at the different supplement plans and debating which one is right for you.
In some places, even some Medicare Override Measure states, the Medicare Plan G is only a couple dollars more per month
than the Plan N Medicare supplement, making it a better value just because it's not really very much money.
However, in a lot of places the Medigap Plan N is 25% to 35% less than a Medicare supplement Plan G.
In that case, you really have to look it look at it this way....
Both are good plans. With a Medicare supplement Plan G you have of a certain peace of mind. You can have your Medicare
supplement and you don't have to worry about Medicare excess charges, you don't have any other copays.
You pay your Medicare Part B deductible
and everything else related to Part A or Part B Medicare its covered. It gives you peace of mind.
But it cost more.
Medicare supplement Plan N is going to cost less. Typically 25% to 35% less. But it's going to take a little extra work.
You have to check every time before you go to the Doctor,
and you have to make sure that you don't pay excess charges. If you must go to a Mayo Clinic
you either find an alternative, or pay the excess charge.
So it is really two personalities there as well. Some people prefer
to have that complete peace of mind. Some people would rather pay less and don't mind making the little extra effort to do that.
Which are you?
There's one other point that you should consider when you're researching a Medicare supplement Plan N.
That's Medicare supplement Plan D!
Have you looked at a Medigap Plan D yet? Take a look at this.
Notice in the supplement table that Medicare supplement Plan D is exactly identical to the Medicare supplement Plan N
accept it doesn't have the asterisks.
That means that Medicare supplement Plan D is exactly like Medigap Plan N except you do not have
a copay. You don't pay up to $20.00 per office visit and you don't pay $50.00 for an emergency room visit.
But here's the catch; Medicare supplement plan D should cost between a Medigap Plan N and a Medicare supplement Plan G
But as I make this video in late 2017 in most states the Medicare supplement Plan D is simply not priced competitively
sometimes it even cost more than the Medigap Plan G.
The reason for this is really many reasons. The first being there has been low demand.
When you're talking to people and you're talking about a Medicare Supplement Plan D
it's too easily confused with Medicare Part B
and I can understand why. Medicare get a great job of
finding a name for different parts of Medicare that were very, very descriptive.
"Medicare Part A" for example is much more descriptive than simply saying "inpatient hospital coverage".
Or "Medicare Part B" is much more descriptive than saying "outpatient services". Alright, enough.
Here is the thing, as we approach 2020 insurance companies are starting to take a look at the Medicare supplement Plan D
Some have already started to re-price it in some states to make it more attractive.
What's expected is that Medicare plan D, your Medicare supplement Plan D, even I get confused talking about these things...
Medicare supplement Plan D maybe the supplement that will replace the Medicare
supplement Plan C as that's discontinued.
For now, in most places it's not priced competitively, in some places it is. As you get your
Medicare supplement quote, ask the independent insurance agent that are working with
to check the Plan D. At least check to see if it's the right price for you.
Even if it's not now, if you're reshopping this plan
in your early seventies, as you should, it may be a better price for you then. To wrap this up, let's take a look at a real life example of the
using Medicare supplement Plan N. In this real life example I'm choosing a person who is gone to an orthopedist
and needs a hip replacement and what this example is going to do hopefully is
not only answer the frequently asked questions, but resolve all some of the misconceptions that people have
about the copays and such with Medicare supplement Plan N.
So you go to your orthopedist and you have a Medicare supplement Plan N.
Your orthopedist says you have to have a hip surgery. Well you've already research your orthopedist before you went, so you know
your orthopedist takes Medicare Assignment.
If they take Medicare Assignment, they cannot charge you an excess charge.
So that means that other than your Part B deductible & office visit copay
everything is covered. As you've met your orthopedist a couple times
getting ready for the hip replacement. When you have the hip replacement
you're going to spend a couple days maybe three in the hospital
as an inpatient, and that's typically where you have your operation.
Being in the hospital and your operation is Medicare part A.
Medicare Part A doesn't have any excess charges, it's not going to have any copays.
Your operation and the
the physical therapy you get while you're in the hospital, getting ready to walk to get out of the hospital is all covered by Medicare Part A .
When you have aMedicare supplement plan N that shouldn't cost you anything.
So then you're discharged from the hospital. You're going to have in the home physical therapy for a short while.
and then you're gonna have to go off to visit a physical therapist. There's a lot of physical therapy.
Well guess what, the physical therapy that's that's not a doctor's visit.
There are no copayments when you have your physical therapy whether it's in your house
or you're going off to physical therapist to have it done. You will have another copay when you have a follow-up visit
with your doctor. That's very likely to have a copay with that.
If you have managed your doctor ahead of time, making sure that they take Medicare Assignment
that Medigap Plan N offers a pretty good value!
Warning #2. If you are billed for a coping with a physical therapy visit somebody is coded your visit incorrectly. It does happen
It does happen. I can help with that. I help my clients all the time.
Sometimes you are billed incorrectly. Medicare billing is rather complex.
If it happens
and you wanna fight it, it's an easy thing to correct. I hope you found this information helpful. If so please give it a thumbs up!
If you learned anything in this video give it a thumbs up and let YouTube know that this is a video that's worthwhile for people researching
Plan N. What that'll do is make it easier for them to find this video when they have the same questions about Medicare that you do.
In addition, if you wanna see more of my videos, subscribe to my channel and make it
easier for you to find my other videos. Now it's your turn
I make these videos for you. So please leave a comment down below let me know
what you found most useful or what you found more shocking about this video.
I am really interested in what you have to say and it helps me to write better videos for you in the future.
I am Matthew Claassen at MedigapSeminars.org Thank you for watching.
An independent Medicare insurance broker. Call 800-847-9680 or visit MedigapSeminars.org.
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