Why are most people choosing Medicare Plan G?

In this video, the speaker explains why most people today are opting for Medicare Plan G as their supplemental plan.

What are the Medicare gaps and why do they exist?

• Medicare is divided into two parts: Part A covers inpatient services, skilled nursing care, and hospice, while Part B covers outpatient services and doctor visits.

• There are gaps in coverage where Medicare recipients have financial responsibilities.

• Part A has three gaps:

• Deductible: $1,600 per year for the first 60 days of hospitalization.

• Extended hospital stays: After 60 continuous days in the hospital, there is a daily copay of $400 (month three) or $800 (months four and five).

• Skilled nursing facilities: Days 21 to 100 require a daily copay of $200.

• Part B also has three gaps:

• Deductible: $226 per year.

• Co-insurance: Medicare pays 80% of covered services, while the recipient is responsible for the remaining 20%.

• Excess charges: When doctors don't accept Medicare reimbursement rates, they can add up to a maximum of 15% to the bill.

What does Medicare Plan G cover?

The speaker discusses what gaps are covered by Medicare Plan G.

Coverage provided by Plan G

• Plan G fills in the gaps left by original Medicare.

• It covers the deductible for Part A ($1,600), even if it occurs multiple times in a year.

• For extended hospital stays (months three to five), it covers the copays ($400/day or $800/day).

• It provides an additional 365 days in the hospital at zero cost.

• For skilled nursing facilities, it covers the copay of $200/day after the first 20 days.

• Plan G also covers the deductible for Part B ($226/year).

• Medicare pays 80% of covered services on Part B, and Plan G covers the remaining 20% co-insurance.

• It also provides coverage for excess charges up to 15%.

The transcript does not provide information beyond this point.

New Section

This section discusses the coverage provided by Plan G in Medicare, including out-of-pocket expenses and deductibles.

Coverage of Plan G

• Plan G covers the 20% co-insurance and excess charges for Medicare Part B.

• The only expense not covered by Plan G is the annual deductible for Medicare Part B, which is $226.

• All providers that accept Medicare will also accept Plan G as a secondary payer.

• Plan G covers any service that Medicare deems should be paid, without any interference from the insurance company.

• There are no pre-authorizations required for services covered by Plan G.

New Section

This section highlights the permanence and portability of coverage provided by Plan G in Medicare.

Permanence and Portability of Coverage

• Once enrolled in a supplemental plan like Plan G, the coverage is guaranteed renewable for life.

• The policy remains active as long as the premium is paid, regardless of age or location changes.

• Supplemental plans like Plan G provide nationwide coverage, allowing policyholders to receive care anywhere in the country without any difference in coverage.

New Section

This section provides information on the cost of enrolling in a Plan G supplemental plan.

Cost of Plan G

• The average monthly cost for a Plan G throughout the country is around $125. However, actual costs may vary depending on location.

• Some companies offer household discounts if another person in the same home has a policy from the same carrier or is eligible for Medicare.

• Additional discounts may be available when paying through electronic funds transfer (EFT) or bank ACH methods.

Please note that these summaries are based solely on the provided transcript and may not capture all details from the video.

Understanding Policy Lapses and Reinstatement

The speaker discusses the importance of updating policy information and the consequences of policy lapses.

Policy Lapses and Reinstatement

• Failure to update policy information can result in a policy lapse after 30 days.

• To reinstate a lapsed policy, individuals must go through underwriting.

• Some individuals may not pass underwriting and lose their supplemental plan.

• It is recommended to always pay with a bank draft to avoid such issues.

Factors Affecting Premiums

The speaker explains that initial premiums are important but stability of rates is crucial in the long run.

Factors Affecting Premiums

• Once a rate is established, it can be discounted for multi-policy holders or those paying through a bank draft.

• While initial premiums are important, stability of rates matters more due to medical inflation.

• Writing with national companies provides more stable rates as risks are spread out among more policyholders.

• Regional carriers with smaller blocks may have unstable rates if they have many health problems.

Importance of Large Blocks for Stable Rates

The speaker emphasizes the benefits of being part of a large block when it comes to stable rates.

Importance of Large Blocks for Stable Rates

• Joining a large block spreads out the risk of healthcare costs among more policyholders.

• Being part of a smaller block, such as with regional carriers, can lead to higher rate increases if there are many health problems within that group.

• National carriers tend to have larger percentages of business in specific markets, resulting in more stable rates.

Monthly Premiums and Transferring Liability

The speaker discusses the monthly premium cost and transferring liability to the insurance company.

Monthly Premiums and Transferring Liability

• Monthly premiums are necessary to transfer the liability of deductibles to the insurance company.

• The cost of monthly premiums can vary but typically range around $125 per month.

• The history and stability of the insurance company should also be considered when evaluating premiums.

Open Enrollment Period (OEP)

The speaker introduces the concept of the Medicare Gap Open Enrollment Period (OEP) and its significance.

Open Enrollment Period (OEP)

• The OEP is a crucial feature of any Medicare supplemental plan.

• During this period, individuals do not have to go through underwriting or answer health questions.

• Insurance companies are required to approve applications during this period, known as guaranteed issue.

• The OEP is tied specifically to an individual's B date, which is their Medicare eligibility date.

Duration of Open Enrollment Period

The speaker explains the duration of the open enrollment period based on an example.

Duration of Open Enrollment Period

• The open enrollment period lasts for six months from an individual's B date.

• For example, if someone turns 65 today with a B date on August 1, 2023, their open enrollment period would be from August 2023 to January 31, 2024.

• During this period, no health questions will be asked, and pre-existing conditions must be covered by the insurance company.

• After February 1, 2024, in most states, individuals would need to go through underwriting if they want a Medicare supplemental plan.

Please note that due to limitations in access to video content beyond timestamps provided in transcripts I may not be able to provide a complete summary of the video.

Enrolling in Medicare and Selecting B Date

This section discusses the process of enrolling in Medicare and selecting a B date.

Enrolling in Medicare

• Individuals enroll in Medicare using an SCP (Special Enrollment Period).

• Two forms, L564 and CMS-40B, are used for enrollment.

• The selected B date is important as it determines the start of the OEP (Open Enrollment Period) window.

Selecting the B Date

• The B date is typically chosen based on when the individual's group plan coverage ends.

• In the given example, the individual's group plan coverage ends on December 31, 2024.

• They select January 1, 2025, as their B date to ensure continuous coverage.

• The OEP window starts from the selected B date and lasts for six months.

Medically Qualifying for Medigap Coverage

This section explains the importance of the B date and qualifying for Medigap coverage.

Importance of the B Date

• The six-month OEP window is tied to the selected B date.

• It provides an opportunity to enroll in Medigap plans without medical underwriting.

• Missing this critical date may result in having to medically qualify for Medigap coverage.

Medically Qualifying for Medigap Coverage

• After July 1, 2025, individuals residing in 46 states need to medically qualify for Medigap coverage during their OEP window.

• It is crucial not to miss this opportunity to secure comprehensive health insurance.

Timestamps have been associated with relevant bullet points.