Why is Georgia Medicare supplement plan N the "forgotten" plan? Click SHOW MORE to see time stamps. Georgia Medicare expert Bob Vineyard explains. Call (404)252-5859
Few Medicare beneficiaries hear about the G plan. Fewer still even know Medigap plan N exists.
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Time Stamp
0:35 Talk to an agent that has plan N
1:40 The copay
2:10 The $20 chemotherapy treatment? Nope.
2:46 Excess charges
4:15 Mayo Clinic and excess charges
Why don't agents talk about N?
The agent you are working with does not understand how plan N works and is afraid you might ask a question they can't answer.
Plan N has lower premiums than F or G.
Medicare supplement plan N does not pay your Medicare Part B premium.
The N plan has a doctor visit copay that cannot exceed $20.
Medigap plan N also requires you to pay a $50 for ER visits.
And the most misunderstood portion of N. Excess charges are not covered.
Do you know how simple it is to avoid Medicare excess charges? Call 1-800-MEDICARE before seeing a Medicare provider.
Consider this. About 96% of Medicare providers accept the assignment. The ones that accept assignment are not allowed to bill excess charges. The rest are limited by Medicare as to how much they can collect.
I enrolled in Medicare in September, 2015. Cancer is a word I know too well. My mothers twin sister and older sister died of cancer. My wife's father and mother died because of cancer. All 5 of my father-in-laws siblings died of cancer. Two of my mother-in-laws siblings died of cancer.
I have seen what cancer can do to the human body and the misery that accompanies this dread illness. If you are diagnosed with cancer, the last thing on your mind should not be "How will I pay for my treatment?"
I know how quickly things can change. When my health changes I want to control the direction of my care. Insurance carriers are not going to give me a list of doctors and tell me this year I can only use these, and next year the list may change.
I am enrolled in original Medicare plus Medigap plan N.
In 2018 most Advantage plans issued in Georgia limit your out of pocket for approved in network health care expenses to $6700.
The American Cancer Society tells us that more than half the 1.4 million new cancer diagnoses occur in people age 65 and older. Roughly 20% of retiree deaths are a result of cancer. Medicare pays for almost half of the $74 billion spent on cancer treatment. The elderly account for 70% of cancer deaths each year.
Some cancer centers, such as Mayo Clinic and MD Anderson do not participate in Medicare Advantage plans.
Not all cancer responds to chemotherapy, but 80% of cancers are treated with chemo. Those treatments occur in an outpatient setting and are covered under Medicare Part B.
Chemotherapy drugs administered in a doctor's office or clinic normally fall under Part B. Medication from a retail pharmacy or by mail fall under your PDP.
This is why most of us chose a Medicare supplement plan in 2018. Bob Vineyard, independent Medicare insurance broker in Georgia, can explain your Georgia Medicare insurance options and will allow you to decide.
We represent several carriers including Aetna, Anthem Blue Cross, Humana and more.
According to the Mayo clinic, "new cancer treatments are routinely priced at over $100,000 per year of treatment."
Both Medigap and Advantage plans cover the same types of medical treatment, but what you pay out of pocket for your care, and where you receive your care, is very different.
Advantage plans are managed care plans. Some are PPO, some are HMO. In 2018 about half the plans are HMO with the balance being PPO.
If you receive non-emergency out of network care under a PPO you may have higher copay's and deductibles. Your max OOP may also be higher. Some plans do not cap out of network charges.
Non-emergency out of network care charges may be denied if you have an HMO.
Medicare Part B is for outpatient health care treatment. Doctor visits, labs, X-rays, MRI, CT scan (CAT scan), ambulance, ER, outpatient clinics, etc. Essentially any Medicare approved health care received outside the hospital setting. Treatment considered medically necessary under Medicare guidelines. Medicare Part B has a calendar year deductible. Once satisfied, Medicare pays 80% of the approved charge, you are responsible for the remaining 20%.
Most major expenses will fall under Medicare Part B outpatient expenses. Original Medicare stand alone has no cap on your out of pocket expenses.
You pay until you run out of money, get well or die.
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Bob Vineyard, Georgia Medicare Expert
Excellent description of Plan N Bob, so much easier to understand than that Chris guy’s video. By far the best Plan N video I’ve seen. Keep putting these videos up, because I’m learning a lot.
Thanks for the kind words, Tom.