Ask John Crump | Medicare Question #1
Question: How do I know which Medicare Supplement Plan my physician and/or specialists take? Will Plan G or Plan N will work better? Also, does it matter which Medicare Supplement company’s Plan G or Plan N I go with?
Great question! This is a very common question. Let’s briefly review the structure of Medicare and a Medicare Supplement Plans briefly to clarify this scenario.
Medicare (Part A & B) are both set as your primary insurance on the effective date which you can view on your Medicare card. ie. 09/01/2022. Since you chose to keep your Medicare as it was originally designed and chose not to sign it over to a Medicare Advantage Plan, you have the ability to add a Medicare Supplement insurance plan to help pick up the out of pocket costs not covered under Original Medicare Part A and B. The Medicare Supplement Plan will act as the secondary policy to your Medicare (again, which is primary). Think “truck and trailer”. This means that if your physician, specialist, and /or Medicare provider takes Medicare, ALL Medicare Supplements will follow as the secondary plan to cover you with Medicare doctors and providers. To summarize, you can see all your physicians that accept Medicare as well as add any Medicare Supplement Plan to your Medicare. With that said, which Medicare Supplement Plan? Plan G or Plan N?
Deciding between Plan G and Plan N will not make a difference with access to physicians or providers. Rather, how much more “supplemental” insurance would you like to add to cover expenses when seeing physicians/providers. Plan G is the most comprehensive. You’ll have full coverage on all out of pocket medical expenses after you fulfill the Part B deductible for the year. In 2022, the Part B deductible is $233. For example, a $1200 bill in a primary care office would cost you roughly 20% of the cost of Part B deductible after the 1st of January. If you were to see a physician or provider after that appointment, whether it be $100 or $10,000 surgery, you would not have out-of-pocket costs for the medical procedure or appointment. You can now see why my clients prefer the consistency and predictability of what Medicare Supplement Plan G provides.
As for Plan N, this Medicare Supplement Plan is slightly cheaper per month and it does have the same Part B deductible. However, Plan N has a few other areas of Medicare that are not covered as compared with Plan G. The two are: excess charges and not covering the full 20% of Part B expenses after the Part B deductible is paid. Plan N states that once the $233 Part B deductible is paid for 2022, the client may be subject to a $20 copay in office or $50 for the emergency room visit. This means you’ll likely have a $20 copay for each medical visit whether it be your primary care physician, specialist or a provider, such as a physical therapist. So, why choose Plan N? Well, if you’d rather spend $30-40 less per month knowing you’ll be subject to $20 copays for each visit, then this may be the plan for you. However, one of the reasons my clients go with Plan G over Plan N is because they prefer predictable costs and consistency with each appointment. With Plan N, you could possibly spend more money throughout the year if you’re spending $20 for each appointment–as it is a variable cost that can not be predicted. The variable cost of the copay is most often a disadvantage if you see multiple doctors and providers throughout the year. For example, primary, dermatologist, cardiologist, orthopedic, physical therapist, and chiropractor, etc. As always, this is difficult to predict. If you have questions about excess charges, please review the Medicare glossary on my website, Medicare.gov, or contact me directly.
To recap Plan G vs. Plan N. Both are great plans, but I believe Plan G has the edge. More predictability as you wont have variable copays with Plan N that may outpace the amount you save in monthly premiums. I recommend to start in Plan G and if you ever want to lower your coverage to Plan N this is a simple change that can be done during your Medicare Supplement CA Birthday 60 day period. As for upgrading from Plan N to Plan G, you will likely need to go through medical underwriting (health questions asked) to make the upgrade. Most clients looking to upgrade have had substantial copays from seeing medical providers, so they same reason they’re trying to upgrade to avoid those variable costs is the same reason the upgrade from Plan N to Plan G will likely be denied when you go through the medical underwriting.
Again, this is a personal choice and either will work exactly the same when it comes to accessibility to your physicians and/or Medicare providers.
Lastly, which Medicare Supplement company should you go with? Well, as they are all standardized and provide the same level of access to physicians and providers, the only variable is price, right? I recommend contacting me to run a quote. I’ll be using your age and zip code to shop multiple carriers to find the Plan G or Plan N Medicare Supplement with the best rates for your age and zip code. Its really that simple!
What if my rates go up and I want to shop other carriers for the same Plan G or Plan N in the future? Well, just make sure to contact me within 60 days of your birthday and we can use the CA Birthday Rule to move you from like plan to like plan (Plan G to Plan G or Plan N to Plan N) keeping the same level of access and coverage, but lower your premiums with another carrier offering you better rates for your current age and zip code.
If you have any other questions, please contact my office through MedicareSupplementMentor.com or call my office toll free at 844 636- 8671 or locally at (916) 619-6553 (530) 864-2027.
