Greg Giles Insurance

What Does Medicare Cover?

There are basically six items that are NOT covered by Medicare A & B

The first three I call the three holes in your head:

1. Vision (eye exams and corrective lenses)
2. Dental (exams, cleanings, dentures, bridges, fillings, etc.)
3. Hearing (exams and hearing aids)

The last three are:

4. Prescription Drugs - covered by Medicare Prescription Drug Plans (PDPs)
5. Acupuncture
6. Elective Procedures

Keep in mind that if a physician is performing diagnostic work, monitoring an existing condition or performing a medically necessary procedure, you are covered. (an example here is Cataracts as they are a medical condition)

There are a few other rare items out there that are not covered, but they are few and far betweeen.

Everything else is covered but not fully paid and subject to deductibles.

To see what Medicare calls the non-covered services refer to Page 59 of the Medicare & You book.

Medicare Made Easy Video

Click here to watch my short video and get your personalized recommendation!

www.MedicareMadeEasyVideo.com

How does a Plan F Medicare Supplement work in conjunction with MEDICARE?

If it is covered by Medicare but not fully paid by Medicare - it is paid 100%

Plan F is a true zero deductible plan. You have 1st dollar coverage!

And you get to choose your own doctor.

Plan F runs out of benefits if you spend over 500 days in a hospital or more than 100 days in skilled nursing care. Medicare was never designed to cover those costs. Long-Term Care Insurance has been created to cover these kinds of costs.

Most folks like you choose plan F.

If you can afford the premium you should choose to own a Plan F Supplement.

My mother owns a Plan F

Plan F Summary

NOTE: Plan F Owners will be able to keep their plans beyond 2020 and will be able to purchase a Plan F after 2020.

Those new to Medicare after 12/31/2019 will not be able to purchase a Plan F Under current Law.

NOTE: Purchasing a supplement and drug plan directly from an insurance company is not going to cost less than purchasing from an agent. The premium is the same as that with an agent. Plus with me you get an agent that believes service after the sale is very important!

How does a Plan N Medicare Supplement work in conjunction with MEDICARE?

Plan N is closer to the coverage you might have under an employer plan.

The main difference is that Plan N does not pay the excess 15% doctors who do not take Medicare Assignment can charge - and - Plan N will have the Part B Deductible (2018 - $183) and up to $20 co-pay for office visits and up to $50 co-pays for Emergency Room visits.

Currently a Majority of doctors take Medicare Assignment, but with the low Medicare Reimbursement rates there is an uprising of doctors choosing not to take assignment.

If there is less than twenty-five dollars a month difference in rates between plan F and Plan N I would definately choose a Plan F for the peace of mind that you will not have any surprises pop up from doctors not taking Medicare Assignment - even though inthe present environment probability is low. Also, you won't have any co-pays along the ay for offce and emergency visits with Plan F.

It is not unfathomable to have a $50,000 bill these days. Excess charges could add up to 15% of that = $7,500!

Ask yourself - do I want to save $15 or $20 per month and have exposure to that kind of surprise? If YES - you want a plan N - Otherwose you are more conservative like me and would be more comfortable with a Plan F.

Remember - If you choose a plan N you have to devide that annual deuductible by 12 and add it to the premium, becuase you are going to see that every year. Plus the co-pays for office calls.

If you really break it down - Plan N is not going to save you much money!

My mother owns a Plan F.

Plan N Summary

How does a Plan G Medicare Supplement work in conjunction with MEDICARE?

Many agents seem to be pushing Plan G these days.

I find it mostly agents that do not represent a whole lot of companies like I do.

If you look at the Plan G premiums ( for the lowest cost plan in the market) compared to the Plan F premium (for the lowest cost plan F in the market) factoring the annual part B deductible that the plan G has, there really is not much savings if any. Sometimes plan G after the deductible is just under Plan F and when it happens it isn't under by much - the plan F is better so you don't have that front end charge each year - you pay it a little each month in the premium.

That Part B Deductible ($183 in 2018) is the only difference between plan G and Plan F.

Plan G Summary

To see a flow chart on the decision process to selecting a plan CLICK HERE.