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.
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!
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.
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?
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.
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.
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.
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?
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.
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?
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?
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!
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. ua-cam.com/video/hTwF6ME9oeM/v-deo.html
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!
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.
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. 😮
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.
Marvin Music is the hardestworking gentleman on UA-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
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.
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.
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 think we all need to move to South Carolina!
Best option? Community pricing vs issue age vs attained age? in terms of price stability. Thank you . Big help for us seniors.
I'd love to see you do a video comparing Plan N with Plan High Deductible G, especially in Florida.
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.
Continued excellence! Thanks😀
Glad that we can help. If you have any questions you can call our office at 800-864-8890.
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.
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?
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!
Informative video
Glad you think so!
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.
Great info as usual 👍🏼👍🏼
Glad you enjoyed it
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.
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?
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.
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: ua-cam.com/video/hTwF6ME9oeM/v-deo.html . If you have any questions you can contact our office at 800-864-8890.
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.
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!
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. ua-cam.com/video/hTwF6ME9oeM/v-deo.html
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!
That change would still remain the same for your plans, the only thing that could change is the name of the carrier.
Do you not recommend an advantage plan at all? The supplemental plans are so expensive.
I need help
“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.
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. 😮
My husband’s plan N raise 15% for 2025 ( Mutual of Omaha) 😡😭
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.