Choosing The Right
Medicare Supplemental Plan
Can Be Extremely Stressful!
Morning Toni:
When I first got Medicare, I picked a Medicare supplement plan F. Next year I was approached by an insurance agent and he talked me into plan L to save me a few bucks since I was in good health. I was hospitalized in Jan 2015 due to low sugar and passed out in doctor’s office, result from that caused me to do dialysis.
Since I was in plan L, I have to pay the deductible plus 5% copay. I tried to go back to plan F, but the agent said I can’t because I’m doing the dialysis.
I thought with new healthcare law that pre-existing conditions don’t count. Can you help me to understand this? Your assistance would be greatly appreciated?
~ Thanks, Tony
Wow, Tony…What a great question:
Most that do not have health problems need to realize that a healthcare crisis can happen at a seconds notice, such as yours has. Everyone wants to save a few dollars and do not realize that the costs of healthcare is skyrocketing. That’s why choosing the right Medicare Supplemental Plan can be extremely stressful and cost you more money in the long run, when you need it the most.
The pre-existing clause is only for Obamacare (ACA plans), not your Medicare Supplement Plan when you are past 65 and want to change Medicare Supplements.
Tony, you went from the top of the line Medicare supplement plan “F”, where you would have zero out of pocket and all Medicare covered expenses would be covered 100% to “L” which does pick up Medicare expenses, but has out of pocket on your side for non-covered Medicare expenses.
Because you now have End Stage Renal disease, which requires dialysis, you cannot qualify for a Medicare Supplement or even to change to a Medicare Advantage plan. Even an AARP Medicare Supplement asks, “do you have end stage renal (kidney) disease, and it is one of the easiest Medicare Supplements to qualify for.
There are 2 chapters in my book, Medicare Survival Guide® that explains the difference in Medicare supplements and Part C Medicare Advantage Plans. In chapter 6, I explain what Part C or Medicare Advantage plans are and the different type of plans…HMP, PPO, PFFS (Private Fee for Service), SNP (Special Needs Plans). In chapter 8 of the Medicare Survival Guide®, I discuss Medicare Supplements, also known as Medigap policies.
With a Medicare Supplement, the most comprehensive plans that cover more of your Medicare expenses are “Plan F and G”.
Medicare Supplement plan “F” picks up most of your Medicare approved amounts with zero out of your pocket. Plan “G” is similar to Plan “F” except it does not include the Part B deductible. Your out of pocket is that deductible, which for 2015 is $147 once a year.
Both Plans “F” and “G” include Medicare Part B “excess” charges, which your Plan “L” does not include. This may be where a lot of your out of pocket could be coming from because your healthcare provider wants their Medicare “excess” Part B charges.
November “Confused about Medicare” Workshops
Senior Care Expo
Tuesday, November 17, 2015 (9:00AM to 3:00 PM)
The Crown Plaza-River Oaks
2712 SW Freeway
Houston, TX 77098
“Confused about Medicare” Workshops will take place at 10:00AM-11:00AM or 12:00PM-1:00PM. Join Toni, as many Senior and Medicare providers will be available to answer your healthcare questions.
Reservations are required for both workshops. RSVP to 832/519-TONI (8664)
Toni King is the author of the Medicare Survival Guide®, which is on sale at HERE. For a personal consultation, please contact Toni at Ask Toni. Tonisays.com is expanding in January with Medicare Peace University. Visit Medicare Peace University for more information.
