Offer Plan G and Plan F - Keep It Simple!

[myinsurebiz]

You're more often than not to be right with that statement, but there are some areas where N is priced much lower than F or G, so it wouldn't hold as much water in those areas. One other factor is in cases where you need a GI and Plan G isn't available for that and Plan F is much higher in premium. Plan N can start to make a good bit of sense then.

Part B excess? Very rarely an issue.

The quote I did today - the N was only $16 less than the G. 1 office visit and it doesn't make sense. But - I get your point. I will just show N alongside F & G, explain the difference in benefits in relation to cost and let Mrs Jones decide . . .

What excess charges have you seen over the years Todd?

 

[Chazm]

The quote I did today - the N was only $16 less than the G. 1 office visit and it doesn't make sense. But - I get your point. I will just show N alongside F & G, explain the difference in benefits in relation to cost and let Mrs Jones decide . . .

What excess charges have you seen over the years Todd?

Quote I did yesterday was a Plan N that was $70 cheaper than a plan F or $60 than a G. It's just makes too much sense when that person would have to go +30x to the doctor in one year to make the F more valuable.

I've seen an excess charge once in 8 years. But now that I'm in Jax, where there is Mayo Clinic, I let my jax clients know the situation.

 

[DS4]

What about the Part B excess?

The Part B excess charges could be $1000 and $1000 of dollars. Why expose a senior to financial ruin?

 

[kgmom219]

The only time I've dealt with Excess Charges is for an oral surgeon. And of course it was a Plan D...for my daddy.

(And the earlier post is what happens when the oven timer goes off and you hit the wrong button)

 

[LostDollar]

The Part B excess charges could be $1000 and $1000 of dollars. Why expose a senior to financial ruin?

As I have watched and listened over the last couple of months, I have seen pretty consistent response from agents that excess charges, at least of any significant amount, are pretty unusual circumstances. Not to say they don't happen, but unusual.

My suspicion is that cost becomes a factor and that plan N becomes an effort to keep an insured in Medigap coverage, vs letting them drop over to MA type coverage.

I think the likely major risk with N would be developing big time illness, Cancer, Heart, Kidneys and wanting treatment from some specialist that didn't take medicare. I don't have the knowledge/experience to assess that one, but in the end it is going to come down to all the other normal insurance issues-perceived risk vs how much money one has to pay for coverage.

I think I have seen both a CA and FL agent indicating they have significant portions of their business in plan N, that says to me it is a concept I should not dismiss out of hand.

 

[myinsurebiz]

I think the likely major risk with N would be developing big time illness, Cancer, Heart, Kidneys and wanting treatment from some specialist that didn't take medicare.

My understanding is if it is not covered by Medicare it is not covered thru the Med Sup . . .

 

[LostDollar]

My understanding is if it is not covered by Medicare it is not covered thru the Med Sup . . .

Yes.

I think the excess charge issue just comes into play if you have a provider that accepts Medicare, but does not accept Medicare assignment. I had a really good answer in another thread, which I have now lost because I don't know how to organize this stuff so I can find it again, explaining why Dr's don't like to NOT accept medicare assignment because of some risks it exposes them to.

So if I get cancer and go to a Dr that accepts medicare Part B and Plan N cover me.

If I get cancer and go to a Dr that accepts medicare, but does not accept Medicare assignment, then Part B and Plan N kick in but I am exposed to excess charges. These charges are limited to 15% of something-I have to get some more info stuck in my head there.

If I get cancer and want to see a Dr that does not accept medicare then I have to pay. (And as I type that, I see another study project. In GHP coverage, the insured can submit a bill to the company. I wonder if a Medicare insured can submit bills to Medicare and a Medigap plan and get money back up to Medicare limits?)

At any rate, that's my understanding so far.

 

[goillini52]

My understanding is if it is not covered by Medicare it is not covered thru the Med Sup . . .

That's correct. If Medicare doesn't approve the charge, your Med Supp won't pay.

 

[FLM2]

That's correct. If Medicare doesn't approve the charge, your Med Supp won't pay.

There is so much misunderstanding in the past few messages (not yours) it almost defies logic, some of you need to read about the simple basics, such as Medicare assignment, before posting anything in a public forum.

 

[Chazm]

As I have watched and listened over the last couple of months, I have seen pretty consistent response from agents that excess charges, at least of any significant amount, are pretty unusual circumstances. Not to say they don't happen, but unusual.

My suspicion is that cost becomes a factor and that plan N becomes an effort to keep an insured in Medigap coverage, vs letting them drop over to MA type coverage.

I think the likely major risk with N would be developing big time illness, Cancer, Heart, Kidneys and wanting treatment from some specialist that didn't take medicare. I don't have the knowledge/experience to assess that one, but in the end it is going to come down to all the other normal insurance issues-perceived risk vs how much money one has to pay for coverage.

I think I have seen both a CA and FL agent indicating they have significant portions of their business in plan N, that says to me it is a concept I should not dismiss out of hand.

I think he was being facetious. I've seen an excess charge one time and it was for about $40.

If a dr doesn't accept assignment they only get paid 95% (top of my head no time to look up) of what Medicare would normally pay for a procedure. So the client would essentially pay 9.25% above their normal amount IIRC

Currently 96% of doctors accept assignment so it's typically not an issue.